Ovarian Cancer

OVARIAN CANCER

Overview

Ovarian cancer begins in the woman's ovaries, the glands containing the germ cells or eggs. The ovaries are part of a woman's reproductive system and are located on each side of the uterus. They are almond-shaped and are about one and a half inches long. Every month, during ovulation, an egg is released from an ovary and moves to the uterus through a system called the fallopian tube. Ovaries are the primary source of women's sex hormones, estrogen and progesterone. These hormones influence breast growth, body shape, and body hair, and regulate the menstrual cycle and pregnancy. During menopause, the ovaries stop releasing eggs and producing sex hormones.

Ovarian cancer begins when cells in the ovary begin to change, grow uncontrollably, and eventually form a tumor. Tumors can be benign (noncancerous) or malignant (cancerous). Ovarian cysts, which form on the surface of the ovary are not cancerous.

There are three types of ovarian cancer.

Epithelial carcinoma: - Epithelial tumors make up 85% to 90% of ovarian cancers. They begin in cells on the outer surface of the ovary. Because they are difficult to diagnose, 70% of ovarian cancers are not found until the disease has reached an advanced stage and moved from the ovaries into another part of the body, most commonly the abdomen.

Germ cell tumors: - This uncommon type of ovarian cancer develops in the egg-producing cells of the ovaries.

Stromal tumors: - This rare form of ovarian cancer develops in the connective tissue cells that hold the ovaries together and produce female hormones. 

Risk factors

(a) Age: - Risk of developing ovarian cancer increases with age. The disease most often occurs in women over age 50.

(b) Family history: - Ovarian cancer risk increases for women who have a first-degree relative (mother, daughter, sister) who has had ovarian cancer. The risk is increased when two or more such relatives have had the disease.  

(c) Genetics: - A mutation in the BRCA1 or BRCA2 gene is associated with increased risk of ovarian cancer. Women with the condition of hereditary nonpolyposis colon cancer also have an increased risk of developing ovarian cancer.

(d) Ethnicity: - Women of North American, Northern European, or Jewish heritage are at increased risk for ovarian cancer.

(e) Reproductive history: - Women, who have never had children, have unexplained infertility, have not taken birth control pills, or had their first child after the ages of 30 are at increased risk for ovarian cancer. Also, women who started menstruation before age 12 and/or go through menopause later in life are at increased risk for ovarian cancer.

(f) Hormones: - Women who have taken estrogen-only hormone replacement therapy after menopause are at higher risk for ovarian cancer. Fertility drugs may be associated with a higher risk of ovarian cancer.

Symptoms

(i) Abdominal or pelvic discomfort or pain.

(ii) Persistent indigestion, gas, nausea, diarrhea, or constipation.

(iii) Frequent or urgent need to urinate.

(iv) Abdominal or pelvic pressure, swelling, or bloating.

(v) Loss of appetite, feeling of fullness even after a light meal.

(vi) Unexplained weight loss or gain, especially in the abdominal area.

(vii) Abnormal bleeding from the vagina.

(viii) Pain during intercourse.

(ix) Constant tiredness, lower back pain.

Diagnosis

(1) Pelvic Exam

(2) Ultrasound

(3) Ca 125 Assessment

(4) Barium enema

(5) Intravenous pyelogram

(6) Ct Scan

(7) Biopsy

Stages

(a) Stage I: - In Stage I The Cancer is found in one or both of the ovaries and has not spread.

(b) Stage II: - In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis.

(c) Stage III: - In stage III, cancer is found in one or both ovaries and has spread to other parts of the abdomen.

(d) Stage IV: - In stage IV, cancer is found in one or both ovaries and has metastasized beyond the abdomen to other parts of the body. Cancer is found in the tissues of the liver.