What is this condition?
This cancer attacks the ovaries, the organs in women that produce the hormones estrogen and progesterone. There are three main types of ovarian cancer: primary epithelial tumors (accounting for 90% of all ovarian cancers), germ cell tumors, and sex cord (stromal) tumors.
Prognosis depends on the type of cancer cell and the disease stage. Unfortunately, there are few early warning signs and the disease is often advanced by the time it’s diagnosed. About 40% of women with ovarian cancer survive for 5 years.
What causes it?
The exact cause of ovarian cancer isn’t known. Risk factors include a family history of ovarian, breast, or uterine cancer; infertility; celibacy; exposure to asbestos, talc, or industrial pollutants; and a high-fat diet.
Ovarian cancer spreads rapidly throughout the abdominal cavity and, occasionally, through the lymphatic system and the bloodstream. Generally, when it spreads outside the abdomen, it enters the chest cavity, where it may cause abnormal fluid buildup in the lungs. Spread to other sites is rare.
The symptoms or warning signs of ovarian cancer
Typically ovarian cancer smptoms vary with tumor size. Some women with earlystage disease experience vague stomach upset. As the cancer develops, symptoms become more distinct, including frequent urination, constipation, pelvic discomfort, and weight loss. In advanced disease fluid builds up in the abdomen. If the tumor ruptures or becomes twisted or infected, it may cause pain. In young women, this pain may be mistaken for appendicitis. Some older women experience postmenopausal bleeding and pain.
Some types of tumors cause feminizing effects, such as bleeding between periods in premenopausal women; other types cause masculinizing effects, such as developing masculine secondary sex characteristics. Ovarian cancer that has spread to other sites may cause different symptoms.
How is it diagnosed?
The doctor performs a pelvic exam and takes a complete history. Before surgery, the doctor will take a Pap smear (although this is positive in few women with ovarian cancer) and will order many different diagnostic tests. For example, a woman may undergo abdominal ultrasound, a computed tomography scan (commonly called a CAT scan), or X-rays. A test called lymphangiography (a special X-ray of the lymphatic system) helps to investigate lymph node involvement. Mammography may be used to rule out primary breast cancer.
Usually, a surgeon performs exploratory surgery, taking cell and tissue samples for analysis.
How is it treated?
Treatment involves a combination of surgery, chemotherapy and, in rare cases, radiation therapy - depending on the woman’s age and the disease stage. In most cases, treatment is aggressive: the surgeon removes the uterus, both fallopian tubes, both ovaries, the omentum (part of the abdominal wall lining), and the appendix. If the tumor has matted around other organs or spread to other vital organs, complete removal of the tumor is impossible.
In rare instances, for example - a young woman with an encapsulated tumor in one ovary - the surgeon may elect to remove only the diseased ovary.
Chemotherapy can prolong life in most women with ovarian cancer, but in those with advanced disease, it can only relieve symptoms. However, prolonged remissions are being achieved in some women.
Radiation therapy is generally not used for ovarian cancer because it depresses the bone marrow, which could make chemotherapy less effective. Radioisotopes have been used as secondary therapy, but they can cause intestinal problems such as blockages.
Intravenous administration of drugs called biological response modifiers - interleukin-2, interferon, and monoclonal antibodies - is currently being investigated.
What can a woman with ovarian cancer do?
If you are premenopausal and must have both ovaries removed, be aware that you’ll have an early menopause and may experience hot flashes, headaches, palpitations, insomnia, depression, and excessive perspiration.
Tagged under:estrogen, hormones progesterone