Ovarian Cancer

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Ovarian Cancer

Ovarian cancer is one of the most common gynecological problems. This type of cancer often does not cause any symptoms, which is why it leads to more deaths than any other cancer in the female reproductive system. If you or someone close to you has been affected by ovarian cancer, learning more about it can help you through the journey.

This section has information about what ovarian cancer is and the risk factors associated with this disease. You can also find out more about the different diagnostic tests for ovarian cancer, stages of cancer and the treatment options available.

Symptoms of ovarian cancer

Ovarian cancer doesn’t often cause symptoms in its early stages. Even when there are symptoms, it is difficult to detect because these can be mistaken for other more-common conditions. Signs and symptoms of ovarian cancer include:

  • Bloating and abdominal pressure
  • Persistent indigestion, gas or nausea
  • Changes in bladder habits, including a frequent need to urinate
  • Abdominal discomfort or pain, especially in the lower part of the abdomen
  • Trouble eating or feeling full quickly
  • A persistent lack of energy
  • Lower back pain
  • Sudden weight gain or loss
  • Abnormal vaginal bleeding
  • Constipation or menstrual changes
  • Pain during sex

Causes of ovarian cancer

Ovarian cancer is the uncontrolled growth of abnormal cells in the ovaries. Ovaries are the female reproductive organs responsible for producing eggs and the hormones estrogen, progesterone and testosterone. Women have two ovaries, one on each side of the uterus.

Ovarian cancer cells can form in 3 areas: an ovary’s surface, in an ovary’s egg-producing cells and in tissues with an ovary. Cancer cells most commonly appear on the surface of an ovary.

Ovarian cancer is difficult to detect, as the symptoms are often vague and similar to those in other non-cancer conditions affecting women. It often goes undetected until it has spread within the pelvis and abdomen. At these later stages, ovarian cancer is difficult to treat and can be fatal.

At the moment, there are no definitive screening tests for ovarian cancer, however genetic tests do exist that can identify women who are at greater risk for the disease.

Persistence of symptoms is key. If your symptoms are unrelenting and have not resolved with normal interventions, such as diet change, it is important to see your doctor. The National Ovarian Cancer Coalition describes that, as these symptoms are broad, only 19% of ovarian cancer in the United States is found in the early stages.

Diagnosis of ovarian cancer

Diagnosis of Ovarian CancerIf a doctor suspects ovarian cancer, he or she will order a series of tests and procedures. These include:

  • Physical exam: Your doctor will first ask you some questions and then examine you to look for signs of ovarian cancer. This will include a recto-vaginal pelvic exam, which allows your doctor to check the ovaries for lumps or changes in shape or size. During a recto-vaginal exam, the physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness. The Ovarian Cancer Research Fund advises every woman to undergo a rectal and vaginal pelvic examination at her annual check-up with her gynecologist.
  • Ultrasound: This test uses sound waves to produce images of the inside of the body on a video screen. During this procedure, a small probe is placed in the woman’s vagina or on the skin over her belly. Ultrasounds are useful in finding tumors and determining whether a mass is solid or a fluid-filled cyst.
  • CA-125 blood test: This blood test can indicate the presence of ovarian cancer, as women with the disease often have high levels of the CA-125 protein. The accuracy of this test is limited, however, because noncancerous conditions can also raise CA-125 levels.
  • Biopsy: If other tests point to the possibility of ovarian cancer, your doctor may recommend a biopsy to confirm if a growth in the pelvis is cancer. During a biopsy, a sample of tissue or fluid is removed to see if cancer cells are present. The sample is sent to the lab where it is looked at under the microscope.

Stages of ovarian cancer

Doctors use the results of your surgery to help determine how far the cancer has spread. This process is called staging. This is very important because ovarian cancers at different stages are treated differently. Stages of ovarian cancer include:

  • Stage I: The cancer is only confined to one or both ovaries.
  • Stage II: The cancer has spread to other locations in the pelvis, such as the uterus or fallopian tubes. It has not spread to lymph nodes, the lining of the belly or distant places.
  • Stage III: The cancer has spread beyond the pelvis or to the lymph nodes within the abdomen.
  • Stage IV: This is the most advanced stage. The cancer has spread to organs beyond the abdomen, such as the liver or the lungs.

Treatment options

After your diagnosis, a customised treatment plan will be developed taking into consideration the stage of your ovarian cancer, your age and your overall health. There are 3 main treatment types for ovarian cancer:

  • Surgery: Surgery is the most common method to treat ovarian cancer. In most cases, the surgeon removes the ovaries, fallopian tubes, uterus and cervix. Depending on how far the cancer has spread, they may also remove the thin tissue covering the stomach and intestines, as well as nearby lymph nodes. Less extensive surgery may be possible if your cancer was diagnosed at an early stage.
  • Chemotherapy: Chemotherapy uses chemicals to destroy cancer cells. It is used most often as a follow-up treatment to surgery to kill any remaining cancer cells. Chemotherapy may be infused directly into the abdomen, taken orally or injected into a vein.
  • Radiation therapy: Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. The radiation may come from outside the body or from radioactive materials placed into or near the tumor. This method is used less frequently as a treatment for ovarian cancer than surgery or chemotherapy.

Is prevention possible?

There is no known way to prevent ovarian cancer, but some factors appear to reduce your risk:

  • Taking birth control pills: According to Harvard Health , women who take birth control pills cut their risk of ovarian cancer in half. However, oral contraceptives do have side effects, so if you are thinking about takings these pills first discuss the pros and cons with your doctor.
  • Breast-feeding and pregnancy: Having one or more children, especially if the first is born before age 25, may decrease your risk. Breast-feeding also appears to reduce the risk of ovarian cancer.
  • Surgery: If you have a strong family history of ovarian and breast cancer, you may want to discuss the option of surgery with your doctor. Getting your tubes tied (tubal ligation) or having your uterus removed (hysterectomy) can both lower your chance of getting ovarian cancer. 
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