Can endometriosis increase your risk of ovarian cancer?
By Asst Prof Ahmad Sayasneh

Endometriosis is not a deadly disease, but causes many painful symptoms and complications, that mostly affects women in their reproductive years, after they reach puberty but before they stop having children. There is no doubt that it is neither cancerous nor contagious. It is the growth of endometrial cells, which line the womb, outside of the womb. Endometriosis can grow on or inside the ovary, on the Fallopian tubes (the tubes that carry eggs from the ovary to the womb), or on any part of the peritoneal cavity (the inside skin of the abdomen). Endometriosis can sometimes spread to other parts of the body, like the lungs.

Endometriosis is a disease that lasts for a long time, and there is no treatment that is thought to be a cure. But there are many ways to control the disease, such as with hormone-based drugs like the birth control pill or non-hormonal drugs or surgery.

Endometriosis can happen without any signs or symptoms, and it can be found when a woman gets an ultrasound for something else or when her fertility is being checked. But it can cause a wide range of symptoms, such as pelvic or abdominal pain, feeling full, pain or seeing blood when urinating or going to the bathroom, having heavy or irregular periods, feeling sick and throwing up, having constipation or diarrhoea, a backache, pain during sexual activity, and infertility.

At the time of diagnosis, endometriosis can be mistaken for other diseases, such as benign or cancerous ovarian cysts or masses, bowel inflammatory disease, urinary infections, and others.

At The Princess Grace Hospital, part of HCA UK, we take special care at the one-stop diagnostic clinic, where we offer a variety of advanced imaging and laboratory tests to help diagnose the disease and figure out how far it has spread. Advanced cases can be talked about in a meeting with people from different fields and with different skills to come up with the best way to handle them. If surgery is needed, almost all of the time at The Princess Grace Hospital we think about minimal access surgery, such as laparoscopic or robotic technology.

It's only natural to worry that endometriosis might be linked to cancer given its close proximity to the body's cellular and hormonal processes, however this is not the case. The risk of developing cancer is not automatically higher in people with endometriosis. None of the study has found any correlation between the two. Endometriosis is not associated with an elevated risk for other forms of cancer in women. This includes cancer of the uterus despite the similarity in terminology (Endometriosis and Endometrium). There is currently no evidence linking endometriosis to any potentially cancer-causing genetic mutations.

Endometriosis, on the other hand, makes it slightly more likely that a woman will get rare types of ovarian cancer, like clear cell ovarian cancer and endometrioid ovarian cancer. When compared to other types of ovarian cancer, these two aren't seen as often. Even if there is no history of endometriosis, these cancers can still happen.

When a woman goes through menopause, her risk of getting ovarian cancer goes up. It is very important to get the diagnosis right the first time, especially if there are still signs of active endometriosis. When more care is needed to rule out cancer, ultrasound scans at regular intervals, ultrasound scans done by an expert, or a referral to an MRI can help.

Even if there are no signs of cancer, endometriosis can cause the cancer marker CA125 to rise. This makes it harder for tumour markers to tell the difference between benign and malignant changes in endometriosis.

Endometriosis usually goes away during pregnancy and menopause. However, decidualisation, which is a harmless increase in the vascularity and density of the tissues caused by the high levels of hormones during pregnancy, can sometimes look like cancerous changes and requires a skilled ultrasound examiner who can recognise patterns