Ovaries are reproductive glands that form ova or egg and also produce female hormones progesterone and estrogen. Ovarian cancer is the result of abnormal and uncontrolled division of ovarian cells that begin to invade side tissues if untreated and form metastatic ovarian cancer. Almost twenty percent of ovarian cancer is diagnosed at early stage. Ovarian cancer has warning signs but early symptoms are ambiguous that can be easily treated whereas last stage of cancer is difficult to treat. In 2020 almost twenty one thousand cases of ovarian cancer are diagnosed in United States. In Pakistan 13.6% women are diagnosed with ovarian cancer.
Three different types of cells make ovaries that develop different kind of tumors like epithelial tumor, stromal tumor and germ cell tumor.
• Epithelial tumor: it forms outer layer of tissue of ovaries. About 90% of ovarian cancers are epithelial tumors.
• Stromal tumor: hormone producing cells of ovaries develop stromal tumor. Almost 7% of ovarian cancers are stromal tumor.
• Germ cell tumor: egg or ova producing cell develop germ cell tumor that is rare.
What signs are shown by ovarian cancer patients?
Following early symptoms include
• Difficulty in eating
• Abdominal pain and pressure
• Abnormal feeling of fullness after eating something
• Loss of weight
• Increase urge to urinate
• Increase urination
Some of the other signs are:
• Back pain
• Heart burn
• Irregularities in menstruation
• Severe feeling of pain during intercourse
• dermatomyositis (a rare inflammatory disorder that can cause skin rash, weakness and inflammation of muscles)
Symptoms vary and depend upon the types of ovarian tumor. If tumor remains untreatable then symptoms become worse and cause many complications. If someone experience new signs or no signs must consult doctor.
Exact risk factors are unknown however following are some factors that may increase the possibilities of ovarian cancer:
• Age: Any age of woman may have ovarian cancer but women between 50 s and 60s ages are at high risk of having ovarian cancer.
• Family history: the person having two or more close relatives with ovarian cancer are at high risk of getting ovarian cancer.
• Obesity or being overweighed: obesity may increase the risk of ovarian cancer.
• Drugs or therapies: use of fertility drugs or hormonal therapies like estrogen replacement therapy may increase the risk of ovarian cancer.
• Inherited gene mutation: mutated gene inherited from parents may increase small percent of ovarian cancer. Genetic mutations in breast cancer genes (BRCA1) and (BRCA2) are known to increase the risk of ovarian cancer.
• Endometriosis: the disorder in which tissue similar to tissue that form outer layer of uterine cavity.
How to diagnose ovarian cancer?
Your doctor will recommend you pelvic exam that discover the irregularities but small tumors are difficult to feel. During rectovaginal pelvic examination your doctor may diagnose irregularities of ovarian cancer. Your doctor may suggest you following tests:
• Abdominal and pelvic CT scan: your doctor may recommend you pelvic MRI scan.
• Transvaginal ultrasound (TVUS): It is some kind of imaging test in which sound waves are used to diagnose tumors including tumors but TVUS cannot be helpful in determining whether its tumor are cancerous or not.
• Blood test: it is used to measure cancer antigen 125 (CA-125) levels. This CA-125 is used as biomarker to detect the ovarian cancer and other cancers of reproductive organ.
• Biopsy: it is removing of small portion of tissue from ovary and analyzed under microscope. Biopsy is the best way from that your doctor diagnoses tumor or cancer.
Are there stages of ovarian cancer? If yes then what types of that?
There are four stages of ovarian cance\r:
Stage 1: it has further three sub-stages that are following:
1. Cancer is localized to one ovary
2. Cancer is in both ovaries
3. Cancer also invades outside the ovaries.
Stage 2: it has two sub-stages;
1. Cancer cells invade to uterus or fallopian tube
2. Cancer cells spread to bladder or rectum
Stage 3: it has three sub-stages;
1. Cancer cells spread microscopically to pelvis, abdomen and abdominal lymph nodes
2. Cancer invade beyond the pelvis lining to abdominal lining that can easily view by naked eye
3. Deposition of cancer cells on abdomen are ¾ of an inch that can be seen on abdomen or outside the liver or spleen.
Stage 4: cancer cells spread beyond the pelvis, abdomen, and lymph nodes to liver or lung. It has further two sub-stages
1. Cancer cells are spread to fluid that covers the lungs
2. Last stage in that cancer cells invade to spleen and liver or even distant organ such as skin or brain
The treatment depends upon the stage and situation how far the cancer has invaded. It includes
• Surgery to remove the cancer cells
• Hormonal therapy
• Targeted therapy
How to prevent the ovarian cancer?
Ovarian cancer cannot be prevented completely but lowers the risk of this disease. A study shows the women who have following common things have lower chances of developing ovarian cancer.
• Who have been pregnant
• They have taken a kind of hormonal birth control
• They have their tubal ligation
• They have breast-fed
• They’ve had a hysterectomy(surgery to remove uterus and sometime ovaries and cervix)
• Who take routinely exercise
• Who avoid carcinogens
• Who follow healthy life style