Each year 1,300 Australian women will be diagnosed with ovarian cancer – and anatomical pathologists will play a critical role in every diagnosis.

Unfortunately, diagnosis of ovarian cancer – known as the silent killer – is rarely simple.

The symptoms are vague and include abdominal bloating, pelvic pain, menstrual irregularities, fatigue and changes in bowel habits; symptoms experienced by all women which mimic common female complaints.

“These signs and symptoms may lead to a physical examination and imaging, including ultrasound and CT scans,” said Dr Rohan Lourie, Mater’s Director of Anatomical Pathology.

“These imaging tests can often tell if a mass or tumour is present, but a biopsy is then required to make a definitive diagnosis of ovarian cancer.

“The diagnosis of ovarian cancer then relies on the anatomical pathologists at Mater Pathology to examine the biopsy.”

Mater is the leading treatment and research centre for ovarian cancer in Queensland, treating around 130 of the 285 women who are diagnosed with the disease each year.

Tumours in the ovary can range from benign to malignant, including some with an uncertain malignant potential.

Malignant tumours, or carcinomas, are what are commonly known as ovarian cancer and can spread through the abdominal cavity and anywhere in the body. 

“Our role is to examine the tissue from the biopsy of a complete excision of the tumour under the microscope and decide what type of tumour it is and if it is benign or malignant,” Dr Lourie said.

There are more than 50 different types of tumour, which can occur in the ovaries or fallopian tubes. Most are benign but they can very closely resemble malignant tumours, either under the microscope or on imaging.

Mater’s team of seven anatomical pathologists and seven registrars use their knowledge, experience, and a variety of special laboratory techniques to determine which type of tumour may be present.

“Under the microscope some ovarian cancers can look similar to cancers from other organs, including the bladder and bowel, which may have spread from those organs,” Dr Lourie said.

“It is important to diagnose the correct tumour type as treatment varies. The special techniques pathologists use can aid in distinguishing the difference, but it can be very difficult.”

Anatomical pathologists also help in determining the stage of the cancer.

This often involves the examination of multiple different tissues including the other ovary, fallopian tubes, tissue from the abdominal cavity, biopsies from lymph nodes and even distant organs.

Deb Hornsby, General Manager of Mater Pathology, said Ovarian Cancer Awareness Month was an important opportunity to educate women about the symptoms of the disease – and to recognise the multi-disciplinary team that supports the 130 new patients Mater sees each year.

“Ovarian cancer is a silent killer because it is so often detected late – and this is why expert pathology is so important,” Ms Hornsby said.

“Physical examination and imaging can help with the diagnosis, but the final definitive diagnosis cannot be made without anatomical pathologists.

“Our team works behind closed doors and usually never meets the patients, but they a play a vital role in detecting this terrible disease and ensuring women get the best possible treatment.”
 

Pictured: Mater Consultant Pathologist Deborah Smith with Director of Anatomical Pathology Dr Rohan Lourie.