Ovarian Cancer

Ovarian cancer begins in the ovaries, which are two almond-shaped glands located on either side of the uterus. The ovaries produce the female hormones, estrogen and progesterone, and release eggs during a woman’s reproductive years (the time from her first menstrual period through menopause). Ovarian cancer is the eighth most common cancer in women, not including skin cancer. Types of Ovarian Cancer There are more than 30 ovarian cancer types. They are grouped into three categories based on where they begin growing in the ovary: Epithelial ovarian cancer originates in the layer of cells that cover the ovary and the entire abdominal cavity. This is the most common ovarian cancer type, accounting for roughly 90 percent of all cases. Germ cell ovarian cancer begins in the egg-producing cells inside the ovaries. Teens and women in their 20s are more likely to have this type of ovarian cancer. Sex cord-stromal ovarian cancer originates in the connective tissue of the ovaries, which also produces the female sex hormones. All three ovarian cancer types may also spread to other areas of the body, referred to as metastatic ovarian cancer. RISK FACTORS The exact causes of ovarian cancer are not known. The likelihood of developing the disease may be higher if a woman has one or more of the following ovarian cancer risk factors.

  • Age – Two-thirds of women diagnosed with ovarian cancer are age 55 or older.
  • Family History – Women with a mother, sister, grandmother or aunt who has had ovarian cancer have a higher risk of developing it.
  • Genetic Mutations – Some women who develop ovarian cancer have an inherited mutation on one of two genes called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). Women with the BRCA1 mutation, have a 35 to 70 percent higher risk of ovarian cancer. Women with the BRCA2 mutation have a 10 to 30 percent higher risk. However, the vast majority of women who are diagnosed with ovarian cancer don’t have either mutation. If you are concerned about this risk factor for ovarian cancer, you can discuss getting tested for both of the BRCA mutations with your OB-GYN.
  • Breast, Colorectal or Endometrial Cancer – Women who’ve been diagnosed with one of these cancers have a higher risk of developing ovarian cancer.
  • Childbearing Status – Women who have delivered at least one child, especially before age 30, are at a lower risk for developing the disease. The more children a woman has, the more her ovarian cancer risk declines. Women who breastfeed further reduce their risk.
  • Obesity – Women with a body mass index (BMI) of 30 or greater may have a higher risk of developing ovarian cancer.
Symptoms The signs of ovarian cancer may be different for each woman and any one of these symptoms may be caused by other, benign conditions. Because of the ovaries’ proximity to the bladder and the intestines, gastrointestinal symptoms often occur. When present, common symptoms of ovarian cancer may include:
  • Persistent abdominal bloating, indigestion or nausea
  • Changes in appetite – often a loss of appetite, or feeling full sooner
  • Feelings of pressure in the pelvis or lower back
  • Needing to urinate more frequently
  • Changes in bowel movements
  • Increased abdominal girth
  • Feeling tired or low energy
Diagnosis Ovarian cancer typically does not cause symptoms in the early stages. Instead, it is often detected once the disease has progressed and a pelvic mass has been discovered. The following tests are often the first step in diagnosing ovarian cancer:
  • Pelvic Exam: Your doctor may examine the abdomen and pelvic area for any nodules or bumps, which are explored in greater detail with imaging technology.
  • CA-125 Test: Your doctor will perform this blood test to measure the level of a protein called CA-125 in the blood. High amounts of CA-125 may indicate ovarian cancer, as well as less serious conditions, such as endometriosis or inflammation in the abdomen. We combine this test with other screening methods.
Treatment in Ovarian Cancer The treatment must be surgery to remove the tumor and the reproductive tracts together the lymph glands and deposits seen in the peritoneum. Adjuvant chemotherapy is often recommended after surgery for women with moderate or high-grade ovarian cancer. There is strong evidence to lower the relapse rate with benefit in overall survival of the patients. However despite treatment with chemotherapy, patients still have recurrent or refractory disease. The marked difference in survival among the patients depends on the factors such as age, stage, and tissue type. In stage I disease, the overall five-year survival rate approaches 93% percent. However, most of the cases are not in the early stage. The five-year survival rate in stage III & IV will be less than 10%. The overall survival rate for women with ovarian cancer is between 35 to 47 percent. It is not easy to live with ovarian cancer. It presents many new challenges for the patients & their family and friends. The most important part of living with ovarian cancer is to live in the present not in the past. Live every single day to it's fullest. With treatment, your Oncologist will help you to try to "live a normal life."