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low-grade serous ovarian cancer

Low-grade serous ovarian cancer (LGSOC) is a rare ovarian cancer that can be hard to treat and disproportionately affects younger women. Half of all people diagnosed with LGSOC are younger than 47 years of age at the time of their diagnosis. It is not uncommon for people to get diagnosed in their 20s or 30s.

LGSOC is the fourth most common type of ovarian cancer. For every 100 people diagnosed with ovarian cancer, between two and six people will have LGSOC.

LGSOC (also known as low-grade serous carcinoma) develops in the serous epithelium, which lines the ovaries, fallopian tubes and peritoneum. When found in the peritoneum, it may be referred to as low-grade serous peritoneal cancer. LGSOC is a different cancer from the more common high-grade serous ovarian cancer.

When someone is diagnosed with LGSOC, the most common initial treatment is surgery, followed by either hormone therapy or chemotherapy, and then hormone therapy.

Low-grade serous ovarian cancer guide

The Ovarian Cancer Foundation New Zealand hosts a dedicated LGSOC website with resources and information for anyone with an LGSOC diagnosis globally.

On this site, we have a detailed guide to LGSOC that was developed in conjunction with some of the world’s leading experts in LGSOC. In this, you will find detailed information including:

  • What is low-grade serous ovarian cancer?
  • What are the symptoms, and how is it diagnosed?
  • Development and risk factors
  • Stages
  • Tips for medical appointments
  • Treatments and side effects
  • Monitoring
  • Treatments for recurrence
  • Survival statistics
  • LGSOC support groups

When reading the guide, please keep in mind the guide was designed to reflect international best practices, but the preference and availability of tests and treatments varies by country.

Below is a list of considerations for people with LGSOC in New Zealand that you can refer to while reading the LGSOC guide.

Please note: when we use the term “funded”, we mean publicly funded by the New Zealand Health System.

If you have questions, we encourage you to ask your gynae-oncologist or oncologist.

New Zealand Context

Please keep this in mind while reading our general LGSOC Guide

Preferred medical treatment for newly diagnosed people

In the guide, there are three medical treatment options listed for newly diagnosed people with LGSOC who are stage II-IV. While there isn’t enough research to say which of the three options works best, doctors in New Zealand (as well as doctors in Australia and North America) prefer the first two options. The third option mainly gets used in Europe.

You will get recommended one of the first two treatment options, which include hormone therapy. Both treatment options are funded in New Zealand. Your doctor might have a preference for which one they recommend, or they might let you choose.

Treatments in the guide may sometimes be funded

Some treatments mentioned in the guide are funded in New Zealand, and some are not. Core treatments for LGSOC are funded in New Zealand; these include chemotherapies like carboplatin and paclitaxel, and off-label treatments, including hormonal therapies letrozole, anastrozole and tamoxifen. Bevacizumab, which is funded in Australia, is not currently funded in New Zealand.

Off-label treatments you will read about in the guide that are not funded in New Zealand include MEK Inhibitors like trametinib, the hormone therapy fulvestrant and CDK4/6 inhibitors like abemaciclib. Off-label means a treatment has regulatory approval to treat a different condition but not ovarian cancer generally or low-grade serous specifically. LGSOC doesn’t have any specifically approved treatments yet.

Sometimes, your doctor may be able to get funding for an unfunded treatment through Pharmac’s Named Patient Pharmaceutical Assessment (NPPA) or the pharmaceutical company directly (compassionate access), but this is not always possible.

Clinical trial availability

As of November 2023, there are no LGSOC specific clinical trials available in New Zealand, but some may become available in the future. There may also be general cancer trials you can participate in. Ask your oncologist for more details or you can search the NZ clinical trials registry.

BRCA testing is sometimes funded

BRCA mutations are a type of genetic change that can pass from parent to child and increase the risk of ovarian and breast cancer.

In New Zealand, BRCA testing is funded if you have a 10% chance or greater of having the BRCA mutation. Your chance of having a BRCA mutation with LGSOC is less than this, so BRCA testing may not be funded, unless you have additional risk factors.

If BRCA testing is not funded and you still want to be tested, you can pay for the test yourself via a private genetic counselling provider.

The results of the test will not change your initial treatment, but if it is positive, it can affect your risk of breast cancer and other family member’s cancer risk. At least 94 in 100 people with LGSOC will have a negative test.

Genomic testing is not funded

Genomic testing looks for genetic changes in your cancer, specifically that may not be present elsewhere in your body. Changes sometimes found in LGSOC include KRAS/NRAS and BRAF mutations.

Genomic testing is not funded in New Zealand. If you want this test, you need to see an oncologist privately. They can send a sample of your cancer overseas to companies like Foundation One and Caris for testing. You may want to ask for a quote before you make an appointment for the test because it can be expensive.

The results of genomic testing will not change the initial treatment you receive but can have some implications for prognosis. If your cancer comes back, results can sometimes influence recommendations for treatments that are not funded and access to multi-cancer clinical trials.

Fertility treatment is usually funded

If fertility treatment to preserve your eggs or create embryos is an option for you, this is usually funded. If you need to use a surrogate in the future, the fertility treatment associated with this will also usually be funded.

More support is available

In addition to the online LGSOC support group discussed in the guide you can take advantage of our New Zealand support services.

Note

In the guide, there are three medical treatment options listed for newly diagnosed people with LGSOC who are stage II-IV. While there isn’t enough research to say which of the three options works best, doctors in New Zealand (as well as doctors in Australia and North America) prefer the first two options. The third option mainly gets used in Europe.

You will get recommended one of the first two treatment options, which include hormone therapy. Both treatment options are funded in New Zealand. Your doctor might have a preference for which one they recommend, or they might let you choose.

Find out more information about ovarian cancer.

Note: this content has been reviewed by a gynaecological cancer specialist in New Zealand. Information is provided for general use and should not be a substitute for professional medical advice.

Last reviewed: 16 January 2024