Ovarian Cancer

Introduction

Ovarian cancer occurs when abnormal cells in the ovary begin to grow and divide in an unregulated way. This is called primary ovariancancer.However, cancer cells gradationally grow into the surrounding tissues, if not caught early. Occasionally the cells can spread beyond the ovary to the womb, abdomen and lungs. The cells also grow in these new places as secondary tumours. When cancer spreads like this, it's called metastasis.

The prevalence of ovarian cancer increases with age. The estimated age-adjusted prevalence varies from0.9 –to 8.4 per woman in various population-based cancer registries in India. There are several types of ovarian cancer. The most common type is epithelial ovarian cancer, which develops from the surface layer of cells in the ovary. This cancer type is rare in adolescent women and is generally found in women who have been through menopause.

Risk factor

In utmost cases, the causes of ovarian cancer are unknown. Still, some risk factors increase the chances of developing ovarian cancer, a few of which are mentioned below.

  • Women over the age of 50.
  • Being obese
  • Family history of ovarian, breast or colon cancer.
  • Medical conditions such as endometriosis
  • Use of hormone replacement therapy (HRT)
  • Tobacco smoking
Types

Epithelial ovarian cancer is the most common type of ovarian cancer. Primary peritoneal cancer and fallopian tube cancer are analogous to epithelial ovarian cancer and are treated in the same way. Rare types of ovarian cancer include germ cell tumours, stromal tumours and sarcomas.

Symptoms

There are very rare symptoms in early-stage ovarian cancer. In the advanced stage, ovarian cancer may cause some signs and symptoms that may include:

  • Lower abdominal pain or pelvic pain
  • Persistent bloating
  • Pain during sex
  • Feeling full quickly, or loss of appetite
  • A feeling that you want to pass urine urgently and more frequently
  • A distended ( swollen) abdomen.
Diagnosis

Ovarian cancer may be suspected if an ovary appears unusual on an ultrasound checkup. Abnormal blood tests similar to high levels of a protein called CA125 can make it more probable that it's malignant.

You are likely to be offered a CT scan (Computed tomography scan) of your abdomen and pelvis. Occasionally, you may be advised to have a biopsy (the taking of a small sample of tissue for examination). This may be done with you awake in theX-ray department or as a keyhole operation with a general anaesthetic.

If your abdomen is swollen with fluid (called ascites) you may be advised to have this drained. This is generally done under ultrasound guidance. The removed fluid may be checked for cancer cells.

Still, you will be referred to a specialist gynaecology cancer centre to plan treatment, if cancer is verified.

Treatment

Your treatment depends on various factors. These include what type of ovarian cancer you have, how large it is and whether it has spread to other parts or not, what the cancer cells look like under the microscope and your general health. Treatment includes surgery, chemotherapy, radiotherapy and supportive care.

  • Surgery : Utmost women will require surgery. The type of surgery will depend on the cancer stage and grade and your wishes. Surgery generally involves removing both ovaries and the fallopian tubes (called a bilateral salpingo-oophorectomy), the womb and cervix ( called a total hysterectomy) and the layer of adipose tissue in the abdomen known as the omentum ( called an omentectomy). Surgery may not always be possible because of where the cancer is or if you aren't well enough for anoperation.However, your healthcare team may recommend chemotherapy to shrink the tumour and relieve symptoms, If this is the case.
  • Supportive care : You may not be well enough to have the treatment/ s described above or you may decide againstanti-cancertreatment.However, you should discuss your wishes with your healthcare professionals, if so. You'll be offered treatment to relieve symptoms. This is known as supportive or palliative care.
  • Chemotherapy : Chemotherapy treats cancer by usinganti-cancer (cytotoxic) medicines to kill cancer cells. Ovarian cancer is generally very sensitive to chemotherapy. It's generally given after surgery. Occasionally it may be given before surgery, generally to help shrink the tumour and to make it easier to remove. This is called neoadjuvant chemotherapy. You'll generally be given the chemotherapy through a drip in your arm over several hours in the hospital. Most women have the treatment as an outpatient. A session of chemotherapy is followed by a period of rest to allow your body to recover. This is known as a cycle and often takes 3 weeks. Max women have six cycles of chemotherapy. There are some side effects of chemotherapy. These will depend on the medicines you have, the dose and your response to the medicine.
  • Radiotherapy : Radiotherapy is a treatment that uses high- high-energy shafts to target rapidly growing cancer cells. Radiotherapy isn't often used in the treatment of ovarian cancer but your healthcare team may recommend it in some circumstances such as for shrinking a secondary tumour and/ or for treatment of pain.
FOLLOW UP

You may not be well enough to have the treatment/ s described above or you may decide againstanti-cancertreatment.However, you should discuss your wishes with your healthcare professionals, if so. You'll be offered treatment to relieve symptoms. This is known as supportive or palliative care.

Busting myths about ovarian cancer

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