Polycystic Ovarian Syndrome

• Excess hair growing on your face, chest, stomach or back (hirsutism). Hirsutism affects up to 70% of women with PCOS [4]. 
• Thinning hair or baldness (alopecia)  
• Irregular Periods or menstrual cycle
• Abnormal vaginal bleeding
• Fertility issues
• Acne
• Dark patches on skin
• Weight gain
• Swollen belly/bloating
• Mental health concerns (anxiety, depression)

Ovarian Cancer

• Difficulty eating or feeling full quickly
• Frequent or urgent urination
• Menstrual irregularities
• Constipation or diarrhoea
• Back, abdominal or pelvic pain
• Tiredness
• Indigestion
• Unexplained weight loss or gain
• Abdominal bloating
• Pain during intercourse

*Please note there may be other symptoms of PCOS or ovarian cancer that have not been captured in this list.

How is polycystic ovarian syndrome detected? 

Similarly, to ovarian cancer, there is no one single test to diagnose PCOS. A range of tests may be undertaken including [3]: 

Physical examination [1]: 

• A doctor may examine body mass index, skin (for acne/discolouration or excessive facial), and scalp for hair loss.  

Ultrasound [1]: 

• Checks the endometrium lining (lining of uterus or womb) and examine ovaries for cysts or partially developed eggs [3].

Blood tests [1]: 

• Checks androgen hormone levels as higher levels can indicate PCOS. They will also check thyroid and cholesterol levels, as raised levels can be mistaken for PCOS, yet be indicators of other conditions. 

How is ovarian cancer detected? 

There is currently no early detection test for ovarian cancer. Over— with 70% of patients are diagnosed in late stages [11]. An early detection test would raise the survival rate, five years from diagnosis, from 48% to 90%. It is often diagnosed through a combination of the following: 

• Similarly to diagnosis of PCOS, an ultrasound may determine if there are visual signs of ovarian cancer. 

• A blood test may check CA125 levels. CA125 is an indicator in the blood, for which raised levels can indicate ovarian cancer [11]. Unfortunately, raised levels of CA125 can also be associated with other conditions so this alone is often not relied upon. 

• A sample of tissue may be surgically taken and tested for cancer. 

For both ovarian cancer and PCOS, diagnosis is not simple and relies on a combination of tests, with symptoms often mimicking every-day, harmless conditions. 

Find out how you can help to fund more research into an ovarian cancer early detection test.

Can polycystic ovarian syndrome cause cancer?  

Research suggests links between polycystic ovarian syndrome and conditions including: diabetes, high blood pressure, unhealthy cholesterol, sleep apnea, depression and anxiety [1]. However, researchers haven’t determined if PCOS causes these issues or if the issues contribute to causing PCOS [1]. Additionally, some research considers that those with the above issues, common in PCOS, can have an increased risk of developing endometrial cancer [1]. So, while there is no conclusive evidence that PCOS is associated with the risk of endometrial cancer, the risk factors (such as diabetes) can be similar [5].  

Are PCOS and ovarian cancer related?  

The short answer is that the jury is still out. Research has shown a more than doubled risk of ovarian cancer in women with PCOS [6], yet findings haven’t been confirmed in population studies and contradictory research in fact shows the opposite — a lower risk of ovarian cancer for women with PCOS — making linkage between the two currently inconclusive [7,8,10]. 

Treating polycystic ovarian syndrome vs treating ovarian cancer 

PCOS is not curable so primarily it is about managing the symptoms through medical and lifestyle measures [1], yet ovarian cancer is a lethal disease that often requires surgical intervention and chemotherapy [11]. 

Managing PCOS

Managing PCOS symptoms may include losing weight in consultation with a medical professional to rebalance insulin, hair removal/growth treatments, hormonal birth control to regulate the menstrual cycle [1]. 

Ovarian cancer treatment

Chemotherapy, surgery, PARP inhibitor drugs, and radiation are common treatments of ovarian cancer, however it does depend on the type of ovarian cancer and whether it has spread as to which is used. Chemotherapy is often used to eliminate any remaining cancerous cells post surgery [11]. Despite a low survival rate, treatments for ovarian cancer have not progressed significantly in three decades. With many types of ovarian cancer carcinomas, including serous, clear cell, mucinous and endometrioid [13], tailored and advanced treatment options continue to be urgently required. 

Polycystic ovarian syndrome, ovarian cancer and pregnancy 

Can PCOS cause infertility?

Although PCOS is one of the most common causes of infertility, it is also treatable [1] by regulating the menstrual cycle and ovulation. 

Can ovarian cancer cause infertility?

Ovarian cancer can require the removal of ovaries. Ovarian cancer survivor Vali Crues’ experience demonstrates that despite this, it can still be possible to have children.  

It’s clear that ovarian cancer and PCOS are very different conditions. Yet there is an important similarity. Those with either condition share a frustration on the ambiguity of information available to them, a lack of detection options and effective, personalised treatments — problems that can only be solved by funding research.  

References cited in this article:

1. Office on Women’s Health; https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
2. Health Direct; https://www.healthdirect.gov.au/polycystic-ovarian-syndrome-pcos
3. Jean Hailes Foundation; https://www.jeanhailes.org.au/resources/pcos-fact-sheet
4. American College of Obstetricians and Gynecologists. (2015). https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome pcos?utm_source=redirect&utm_medium=web&utm_campaign=otn 
5. Cancer Australia; https://www.canceraustralia.gov.au/cancer-types/endometrial-cancer/awareness/medical-history-and-medications/polycystic-ovarian-syndrome-pcos#:~:text=PCOS%20is%20associated%20with%20known,cancer%20in%20women%20with%20PCOS.
6. Schildkraut, J. M., Schwingl, P. J., Bastos, E., Evanoff, A., & Hughes, C. (1996). Epithelial ovarian cancer risk among women with polycystic ovary syndrome. Obstetrics and Gynecology, 88(4 Pt 1), 554–559.
7. Daniilidis, A., & Dinas, K. (2009). Long term health consequences of polycystic ovarian syndrome: A review analysis. Hippokratia, 13(2), 90–92.
8. Ehrmann, D. A. (2005). Polycystic ovary syndrome. New England Journal of Medicine, 352(12), 1223–1236.
9. Barry, J. A., Kuczmierczyk, A. R., & Hardiman, P. J. (2011). Anxiety and depression in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 26(9), 2442–2451.
10. https://www.nichd.nih.gov/health/topics/pcos/more_information/FAQs/cancer#:~:text=While%20some%20research%20has%20shown,lower%20risk%20of%20ovarian%20cancer.
11. Cancer Council; cancer.org.au/cancer-information/types-of-cancer/ovarian-cancer
12. Ovarian Cancer Research Foundation; https://www.ocrf.com.au/page/80/our-research-projects#pathogenesis-oc
13. American Cancer Society; https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html

Figure 1: https://www.mdpi.com/2227-9059/10/3/540/htm