SINGER and actress Adibah Noor Mohd Omar, 51, who made her name in Yasmin Ahmad's movies like Sepet and Gubra, died after a battle with ovarian cancer on June 18, a fact only known to her family and close friends.
Even her father, Mohd Omar Zainal Abidin was reported saying that he was totally unaware of his daughter's condition as she had not told him about the seriousness of her illness.
According to another report, her close friend Baki Zainal said Adibah knew that she was suffering from stage 4 ovarian cancer about three months ago.
Celebrity chef and TV personality Fazley Yaakob said he noticed that Adibah was already unwell while appearing on entertainment show Gegar Vaganza 8, which started in November last year.
Ovarian cancer is a growth of abnormal cells in the ovaries that multiply rapidly and subsequently invade and destroy surrounding healthy tissues and organs.
This contributes to symptoms like pain in the abdomen, feeling bloated, loss of appetite and weight loss. But just how lethal is ovarian cancer?
Pantai Hospital Cheras consultant obstetrician and gynaecologist Dr Ida Lilywaty Md Latar says unfortunately, there is no reliable screening method for ovarian cancer to ensure early detection and prevention of the disease, resulting in late presentation in the majority of cases.
More than 80 per cent of ovarian cancer cases are detected at stage 3 and above for the first time.
"Unlike cervical and breast cancer, which are relatively preventable with early detection through reliable screening methods like a pap smear and mammogram, respectively, screening for ovarian cancer is generally not reliable and not widely available, making early diagnosis difficult and challenging," says Dr Ida.
She adds that a higher index of suspicion is needed by looking at risk factors for each woman, such as family history, early age at first menstruation and late menopause, overweight and obesity, or someone who has never got pregnant, just to name a few.
"For women with higher risk, such as those with a strong family history of ovarian and associated breast cancer, with possible inherited BRCA 1 and 2 genes as well as Lynch syndrome, regular and annual surveillance with assessment of symptoms may be offered," she says.
GENE MUTATION
Dr Ida says a small percentage of ovarian cancer is caused by gene changes that are inherited from one's parents.
The popularly known genes in which mutations will increase the risk of breast and ovarian cancer are BRCA 1 and BRCA 2. Mutations on a few other genes are also known to increase the risk, including those associated with Lynch Syndrome and lesser-known genes like BRIP1, RAD51C and RAD51D.
"In general, if one has blood relatives who have been diagnosed with ovarian or associated breast and colon cancer, one may have an increased risk of getting the disease," says Dr Ida.
Symptoms are generally subtle and not specific, she adds. One of the most common is abdominal bloating or swelling, which gradually worsens due to the pressure effect of the growth.
Patients will feel full in a short time when eating, besides suffering from a loss of appetite and rapid weight loss.
"Some patients may also experience discomfort and pain in the pelvic area, fatigue and other non-specific symptoms like back pain and unexplained changes in their bowel habits.
"At late stages of the disease, when the tumour has metastasised to distant organs such as the lungs, patients may also present with shortness of breath and difficulty in breathing," she says.
WARNING SIGNS
Due to its non-specific and subtle symptoms, most women tend to ignore the warning signs.
Symptoms such as bloating may be ignored and mistakenly assumed as "just gas", while changes in bowel habits may be wrongly interpreted as a temporary problem because it also happens intermittently in a normal person.
"It is always pertinent, especially for those who are in the high risk group, to seek assessment early. Early detection of ovarian cancer ensures better prognosis and outcome. It is always advisable to discuss the risk of cancer with your clinician at any opportunity, during visits to your doctor for health check-ups and screening," says Dr Ida.
For those with a strong family history of ovarian or breast cancer, it is advisable to discuss with their doctors if genetic counselling and tests are needed. But this will be decided only after a thorough assessment of risks and comprehensive counselling by the clinician and genetic counsellor.
Dr Ida also says contrary to popular belief, birth control pills actually have a beneficial role in reducing the risk of ovarian cancer, and especially so in women known to carry the mutated genes.
"But these medications have their own risks, so it is crucial to discuss whether the benefits of taking the pill outweigh those risks based on each specific clinical situation," she says.
"It's also very important for women to do their annual pap smear so they can be screened for other cancers as well," she adds.