Ovarian Cancer

Ovarian Cancer

Ovarian cancer (ovary cancer or cancer of the ovaries) begins in the ovaries. Ovaries are the reproductive organs found in women. The ovary produces a egg for reproduction. The egg travel through the fallopian tube to the uterus where the fertilized egg enters and develops into an embryo. 

The ovaries also produce female hormones – estrogen and progesterone. Ovarian cancer is becoming a common problem in aging women. The odds of developing cancer cells in the ovaries are about 4% of all other cancers in women. However, it is a rapidly growing cancer and is becoming the leading cause of death in women. In about three-quarters of women, it is diagnosed in the third or fourth stage.

Ovarian Cancer Types

  • Epithelial Ovarian Cancer

About 90 percent of tumors that occur in the ovaries are epithelial and this is the most common type of ovarian cancer. 

  • Ovarian Teratoma

It is a type of germ cell tumor. Having a cancerous teratoma is a rare condition and occurs most often in women between the ages of 20 and 25.

  • Granulosa Tumor Of the Ovary

It is a type of stromal tumor and is diagnosed in only 5% of women with ovarian cancer.

  • Primary Peritoneal Cancer

This is a rare cancer of the peritoneum. It is similar to epithelial cancer, the most common type of ovarian cancer.

  • Fallopian Tube Cancer

This cancer is rare. There is only a 1% chance of cancer occurring in the female reproductive system.

  • Borderline Ovarian Tumors

These tumors are abnormal cells that form in the tissues covering the ovaries. These are not cancerous and are usually cured with surgery.


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Stages of Ovarian Cancer

The stage of any cancer determines how far it has spread and the best method of treatment.

Stage 1: Cancer can be found in one or both ovaries.

Stage 2: Cancer has spread upto the pelvis.

Stage 3: Cancer has reached upto the abdomen.

Stage 4: Cancer has spread beyond the abdomen or to other organs.

 

 

Symptoms of Ovarian Cancer

Ovarian cancer can show the following symptoms: 

  • Vaginal bleeding (especially if you’ve been through menopause) or abnormal vaginal discharge. 
  • Pain or pressure in the pelvic area. 
  • Abdominal or back pain. 
  • Abdominal distension. 
  • Feeling full quickly or having trouble eating. 
  • Frequent urge to urinate or constipation. 

All these symptoms can also be due to some other problem other than cancer. Be sure to see your doctor if any abnormality occurs.

 

 

Causes of Ovarian Cancer

Ovarian cancer, like any other cancer, results from the irregular and uncontrolled multiplication and division of cells. Although no one knows what is the root cause of cancer.

The following are some of the factors that increase the risk of ovarian cancer:

  • Genetics

If a close relative of yours has had ovarian cancer or breast cancer, then you are at a higher risk of developing ovarian cancer.

  • Age

Most cases have been found in women over 65 years of age.

  • A high number of total lifetime Ovulations

The number of times a woman ovulates in her lifetime is related to ovarian cancer: the more times a woman has conceived, the lower the risk. Women who have never taken birth control pills are at higher risk. Women who start having periods at an early age are at increased risk. Those who have late menopause are also at higher risk.

  • Fertility Treatment 

Some studies have found an association between fertility treatments and the risk of ovarian cancer, although it is not known whether the risk increases with fertility or by treatment.

  • Breast Cancer

Such women who have already been diagnosed with breast cancer have an increased risk of developing ovarian cancer.

  • Hormone Replacement Therapy

Hormone replacement therapy also increases the risk of ovarian cancer.

  • Excess obesity 

Obesity increases the risk of this cancer like other diseases.

  • Endometriosis

Women who have been diagnosed with endometriosis have a 30 percent increased risk of developing ovarian cancer.

 

Prevention

  • To prevent this problem from happening, women should have regular check-ups on their blood-calcium rate. If the rates are high, then the risk of getting ovarian cancer is high. This risk can be avoided by keeping this rate normal.
  • Birth control pills not only reduce the risk of ovarian cancer, but they also reduce the risk of this disease for up to 30 years after discontinuing the drug.
  • Women in whose family any member has ever had colon cancer, prostate cancer, or uterine cancer, then women should take care of the symptoms and get regular check-ups done.
  • Tubal ligation (ligation of the fallopian tubes) and hysterectomy can also reduce the risk of developing this cancer.
  • Maintaining a healthy weight reduces the risk of ovarian cancer to some extent.
  • Do exercise
  • Do not smoke, use tobacco, alcohol, etc.

 

Diagnosis of Ovarian Cancer

Diagnosis of ovarian cancer involves a medical history (past medical problems) and a physical examination.

Physical examination should include a pelvic exam and rectal exam.

Blood tests are also done, which may include:

  • Complete blood count
  • cancer antigen 125 level test
  • HCG level test
  • alpha-fetoprotein test
  • Lactate dehydrogenase level test Tests for Inhibin, Estrogen, and Testosterone levels
  • kidney test

Other diagnostic studies may also be done:

  • Biopsy

A biopsy is necessary to determine the presence of cancer. Cancer cells are tested by taking a small sample of the ovary.

  • Imaging Test

Various types of imaging tests such as CT scans, MRI, or PET scans can detect any changes in the ovaries.

  • Test for Metastasis

The doctor will also check that cancer has not spread to other organs (this is called metastasis), for which the following tests may be done:

    1. Urine test
    2. Chest x-ray 
    3. Barium enema

 

 

Treatment of Ovarian Cancer

Surgery, chemotherapy, or a combination of surgery and chemotherapy, and sometimes radiotherapy, are used in the treatment of this cancer. The type of treatment is decided according to the type, stage of ovarian cancer, and the general health condition of the patient.

  • Surgery

Surgery is usually the first treatment method for patients with ovarian cancer. If only one ovary is removed during surgery, there is still a chance that the woman can become a mother. However, if both ovaries are removed, pregnancy cannot be done. 

  • Chemotherapy

In the chemo, cancer cells are destroyed using drugs. Treatment consists of about 3-6 chemotherapy sessions spaced over 3-4 weeks to give the patient time to recover.

  • Hormone Therapy 

Hormone therapy may be added to the treatment plan to prevent estrogen from reaching the cancer cells. Reducing the supply of estrogen can prevent the growth of cancer cells.

  • Medicines and Targeted Therapy 

New drugs are being developed that target cancer cells specifically. These drugs are Bevacizumab (Avastin) and Olaparib (Lynparza). Its advantage over chemotherapy is that it reduces damage to normal cells.

  • Radiation therapy 

This procedure is considered less effective in the treatment of ovarian cancer. It can be used if there are signs of cancer in the reproductive system or to treat early cancer symptoms.

 

 

Risk and Complications

The techniques adopted for the treatment of ovarian cancer can also have side effects. Complications from chemotherapy are:

Chemotherapy can also affect normal and healthy cells, such as red and white blood cells, and hair follicles. The severity and type of side effects depend on the drug being used and the general health condition of the patient.

Side effects may be:

        • nausea,
        • vomiting and diarrhea
        • hair fall
        • loss of appetite
        • mouth ulcers
        • anemia
        • infection

In most cases, damaged healthy cells heal on their own after treatment is complete.

 

Some FAQ

1. What food to avoid during ovarian cancer?

  • High-fat food
  • Protein-rich diet
  • Red Meat
  • Dairy products
  • Caffeine and Carbonated Soda

Other things to keep in mind:

  • Eat a healthy diet.
  • Do exercise
  • Laziness can make the problem worse.
  • Do not consume alcohol, smoking, tobacco, etc.
  • Avoid stress.

2. What diet to follow during Ovarian Cancer?

  • Leafy vegetables like broccoli, spinach, cabbage, cauliflower, turnip, mustard greens, etc.
  • Colorful vegetables like tomatoes, carrots, etc.
  • Whole grains are the source of carbohydrates from which  nutritious vitamins, minerals, fiber, etc. are obtained.
  • Soy (soybeans, soy milk, soy, yogurt, tofu, etc.).
  • Ginger
  • green tea
  • Linseed

(Disclaimer: The information in this part of the article is for educational purposes only. All results must be clinically correlated with patient data in order to make an accurate diagnosis.)


References

  1. Doubeni CA et al. Diagnosis and Management of Ovarian Cancer. Am Fam Physician. 
  2. National Cancer Institute. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms
  3. National Cancer Institute. Bethesda (MD): U.S. Department of Health and Human Services; Ovarian, Fallopian Tube, and Primary Peritoneal Cancer—Patient Version

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