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OVARIAN CANCER

Cancer, Women's Health / By

OVARIAN CANCER

Ovarian cancer is a type of cancer arising from the ovary.

  • The ovaries are two female reproductive gland that produces eggs (ova), one on each side of the uterus.
  • The ovaries also produce the female hormones estrogen and progesterone.
  • Ovarian cancer results in an abnormal cell that has the potential to invade, multiply or spread to other parts of the body.
  • An estimated 1.2 million cases of ovarian cancer were recorded in 2015 leading to 161,100 deaths worldwide.
  • Among the gynecologic cancers, ovarian cancer has the highest rate of deaths.
  • Early-stage ovarian cancer in which the cancerous cell is still confined to the ovary is more likely to be treated successfully but at the late stage where it has spread to the pelvis and abdomen, it becomes more difficult to treat and is frequently fatal.
  • The ovaries are made up of three types of cell.
  • The three types of ovarian cancer are determined by the type of cell where cancer begins.
  • Epithelial tumors begin in the thin layer of the tissue that covers the outside of the ovaries. It is the most common type of ovarian cancer and accounts for 90% of ovarian cancers.
  • Stromal cell tumors begin in the tissue that contains the hormone-producing cells. These tumors are diagnosed at an early stage than other ovarian tumors and it accounts for about 7% of ovarian cancers.
  • Germ cell tumors begin in the egg-producing cells. These are rare and tend to occur in younger women.

CAUSES

The exact cause of ovarian cancer is not clear, though doctors have recognized certain factors that may increase the risk of the disease.

Several risk factor for developing ovarian cancer has been identified, they include:

  • A family history of ovarian cancer
  • Long-term use of estrogen hormone replacement therapy
  • Inherited gene mutations especially people with hereditary nonpolyposis colon cancer (Lynch syndrome) and those with BRCA-1 and BRCA-2 genetic abnormalities
  • Obesity
  • Older age
  • Early menstruation
  • Late menopause
  • Women who have no history of a full term pregnancy
  • Smoking

SYMPTOMS

In the early stage, little or no symptoms are present. In the advanced stage, ovarian cancer may cause symptoms that are often mistaken for other conditions.

Symptoms are:

  • Abdominal bloating
  • Weight loss
  • Pain in the pelvis, lower abdomen, or the lower part of the body
  • Changes in bowel habits, such as constipation
  • Urgent and frequent need to urinate
  • Feeling full rapidly when eating
  • Back pain
  • Irregular menstruations
  • Pain or bleeding during or after sexual intercourse
  • Heartburn
  • Nausea
  • Fatigue
  • Diarrhea
  • Loss of appetite

DIAGNOSIS AND TREATMENT

The doctor will review your family history and medical history and carry out certain tests which include:

  • The pelvic exam to check for any palpable abnormalities in the ovary and uterus.
  • Transvaginal ultrasound to detect tumors in the reproductive organ including the ovaries
  • CT scan of the pelvis and abdomen to visualize the size, shape, and structure of the ovaries.
  • Blood test to check for elevated level of cancer antigen 125 (CA- 125).
  • Biopsy, where a small tissue is removed from the ovary and the sample, is analyzed in the laboratory under a microscope.

The stages of the cancer are determined based on how far cancer has spread. This will help the doctor to determine the best treatment option

Stage 1, cancer has affected one or both ovaries

Stage 2, cancer has affected one or both ovaries and other pelvic structures such as the uterus, bladder, fallopian tubes, or rectum

Stage 3, cancer has affected one or both ovaries and has spread beyond the pelvis to either the lining of the abdomen or the lymph nodes at the back of the abdomen

Stage 4, the cancer cell has metastasized beyond the pelvis, abdomen and lymph nodes to the liver or lungs, spleen and the fluid around the lungs.

TREATMENT

Treatment usually involves surgery and chemotherapy.

The surgical operation may be carried out to remove one ovary, both ovaries, both ovaries and uterus depending on the stage.

If your cancer is advanced, surgery may be recommended after chemotherapy to remove as much of the cancer cell as possible

Chemotherapy involves using medication injected intravenously or taken orally to kill the cancer cell.

Targeted therapies that use medication to target specific pathways or vulnerabilities present in the cancer cell may be effective. These medicines include bevacizumab (Avastin) and olaparib (Lynparza). Olaparib is only used in people with mutations in BRCA gene

Supportive care that aims to improve the quality of life for people with cancer and their families is helpful. If combined with all of the other treatments, people with cancer may live longer and feel better.