Ovarian cancer is one of the main types of cancer affecting women. It can be cured with adequate treatment if diagnosed at an early age. But in most cases, it's in the advanced stage of diagnosis when a multimodality approach will help in the treatment.
This comprehensive guide will provide a deep dive into ovarian cancer, including what it is, its types, symptoms, causes, stages, diagnosis, treatment options, and preventive measures.
We will also cover common questions about ovarian cancer, including survival rates, risk factors, and more.
Ovarian cancer occurs when malignant (cancerous) cells form in the tissues of the ovaries, which are a part of the female reproductive system. The ovaries are responsible for producing eggs and the hormones estrogen and progesterone.
Ovarian cancer is not a single disease but includes several different types based on the type of cell in the ovary that has become cancerous. The three main types of ovarian cancer include:
Epithelial Ovarian Cancer
Epithelial ovarian cancer is the most common type, accounting for approximately 90% of all ovarian cancer cases. This cancer begins in the thin layer of tissue (epithelium) that covers the ovaries.
Stromal tumors originate in the stromal cells, which are the supportive tissue of the ovaries. These tumors are less common but can still be cancerous. They may produce hormones, leading to symptoms like abnormal menstruation.
Germ-cell ovarian cancer develops from the reproductive cells of the ovary. Though rare, it is more common in younger women.
The symptoms of ovarian cancer can be vague and easily confused with other conditions, making early detection difficult. Common symptoms of ovarian cancer include:
- Abdominal bloating or swelling
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary urgency or frequency
- Fatigue
- Unexplained weight loss or weight gain
- Changes in bowel habits, such as constipation
It's important to consult a healthcare provider if these symptoms persist, as they may indicate ovarian cancer or another medical condition.
The exact cause of ovarian cancer is unknown. Still, several factors, such as genetic mutations, age, and hormone levels, can increase the risk of developing the disease. Some known causes include:
- Age: Women over the age of 50, especially those who have gone through menopause, are more likely to develop ovarian cancer.
- Family History: Women with a family history of ovarian cancer or other cancers, such as breast cancer, are at an increased risk.
- Hormonal Factors: Hormone replacement therapy or a high lifetime exposure to estrogen may increase the risk.
- Genetic Mutations: Inherited mutations in genes like BRCA1 and BRCA2 can significantly increase the risk of ovarian cancer.
Risk Factors for Ovarian Cancer
Several factors can increase a woman's risk of developing ovarian cancer:
- Family History: A history of ovarian or breast cancer in the family can significantly increase risk.
- Age: The risk increases with age, particularly after menopause.
- Reproductive History: Women who have never been pregnant or had children are at a higher risk.
- Endometriosis: Women with endometriosis have an increased risk of developing ovarian cancer.
- Obesity and Overweight: Being overweight may contribute to a higher risk of ovarian cancer.
The stage of ovarian cancer determines the extent of its spread and the best course of treatment. The staging system for ovarian cancer is as follows:
Cancer is confined to one or both ovaries. Symptoms in stage 1 ovarian cancer are often subtle, which makes early detection challenging. It may be diagnosed during evaluation for abdominal pain or incidentally when an adnexal mass is detected during an abdominal sonography.
The cancer has spread to other areas within the pelvis, such as the fallopian tubes or the uterus. Patients may present with abdominal discomfort, pelvic pain or abnormal vaginal discharge.
In this stage, the cancer has spread beyond the pelvis to the abdomen and lymph nodes. Stage III ovarian cancer symptoms may include increased bloating, early satiety, abdominal pain or abdominal distension.
At this stage, the cancer has spread to distant parts of the body, such as the liver or lungs. Stage IV ovarian cancer is the most advanced and requires aggressive treatment.
Diagnosing ovarian cancer involves a combination of tests and procedures to confirm the presence of cancer and determine its stage:
- Imaging Tests: Ultrasound is usually the initial evaluation. CT and MRI scans are commonly used to characterise the tumor and assess the extent of tumor. A PETCT scan will help to stage the tumor.
- Blood Tests: CA-125 is a tumor marker, and it's a blood test that can help detect elevated levels of a protein associated with ovarian cancer, although it is not definitive.
- Biopsy Evaluation: An image-guided (Ultrasound or CT-guided) procedure or a surgical procedure may be required to obtain a biopsy to establish a diagnosis.
- Laparoscopy: A minimally invasive procedure that allows doctors to view the ovaries and take samples of suspicious tissue.
Treatment for ovarian cancer depends on the stage, type, and location of the cancer, as well as the patient's overall health. Common treatments for ovarian cancer include:
Surgical removal of the ovaries is often the first step in treating ovarian cancer. Surgery may include the removal of the uterus and surrounding affected tissues, lymph nodes and omentum. Surgery helps in the treatment of ovarian cancer. Surgery also plays an essential role in the adequate staging of ovarian cancer.
Chemotherapy involves using drugs to kill cancer cells. Depending on the stage and extent of disease at presentation, chemotherapy may be administered either after surgery or before surgery. In some cases where surgery is not possible, chemotherapy may be the sole treatment for ovarian cancer.
Targeted therapy involves drugs that specifically target cancer cells without affecting normal cells. It is typically used for advanced ovarian cancer.
Radiation therapy uses high-energy rays to kill cancer cells. The role of radiation is limited in ovarian cancer. Radiation may be used in cases of residual disease or limited spread of cancer, which may not be removable by surgery. Radiation may also be used for relief of pain associated with advanced cancer.
Hormone therapy is sometimes used for cancers that are sensitive to hormones. This can include drugs that block estrogen or other hormones that promote cancer growth.
Ovarian Cancer Prevention
While there is no definitive way to prevent ovarian cancer, certain measures can reduce the risk, such as maintaining a healthy weight a healthy lifestyle, and considering genetic testing if there is a family history of ovarian cancer.
Common Questions About Ovarian Cancer
Ovarian cancer can affect women of any age, but it is most commonly diagnosed in women over the age of 50.
Is Ovarian Cancer Genetic?
Genetics play a significant role, and women with inherited gene mutations, such as BRCA1 and BRCA2, are at a higher risk.
Can You Live 20 Years with Ovarian Cancer?
The survival rate for ovarian cancer depends on the stage at diagnosis. If detected early, women can live for many years after treatment.
How to Detect Ovarian Cancer Early?
Regular check-ups and paying attention to the symptoms of ovarian cancer can help with early detection. However, there is no routine screening test for ovarian cancer.
What's the Ovarian Cancer Survival Rate?
The survival rate for ovarian cancer varies based on the stage at diagnosis. Women diagnosed at an early stage generally have a higher survival rate.
How Does Ovarian Cancer Spread?
Ovarian cancer typically spreads through the peritoneum (the lining of the abdomen). It may affect the lymph nodes, liver, and other organs.
Ovarian cancer is a complex and challenging disease but advances in treatment and early detection continue to improve the outlook for women diagnosed with it. Understanding the symptoms, causes, and treatment options for ovarian cancer is crucial for women to take proactive steps in managing their health. If you are concerned about ovarian cancer, speak with a healthcare provider who can guide you through testing, risk assessment, and treatment options.
By staying informed about ovarian cancer, including its causes, symptoms, and treatment, you can empower yourself to take charge of your health and seek timely care when needed.
