Ovarian Cancer
- Liz F
- Dec 28, 2022
- 7 min read
What is Ovarian cancer?
By definition, ovarian cancer is cancer that develops in the ovaries, therefore it can only occur in females. The word cancer can be described as an abnormal growth of cells in a part of the body. These cells that are growing uncontrollably form a tumor, and in ovarian cancer can put pressure on other organs. The ovaries are organs that are part of the female reproductive system, they produce eggs and hormones. Based on the stage and type of ovarian cancer, cancerous cells are typically present inside, near, or on the outside layer of ovaries.
Causes: There is not a specific cause of ovarian cancer, however there is a general cause of cancer. Ovarian cancer likely develops due to mutations in a cell’s DNA. The mutations give cells the ability to grow abnormally fast and multiply. This forms a mass of abnormal cells that could be cancerous tumors. While some mutations could be caused by factors such as radiation, ovarian cancer has no link to mutations prompted from environmental sources. Other than mutations in a cell’s DNA, researchers believe there are other factors linked to ovarian cancer. Some researchers think there could be a link between ovulation and the risk of ovarian cancer. Another theory is cancer-causing substances that enter the body. Researchers also believe the male hormone androgen could contribute to the risk of ovarian cancer. Some of those with ovarian cancer inherited mutations in certain genes that specifically increase the risk of ovarian cancer. This means that family history of cancers could be a contributor to ovarian cancer.
Diagnosis & Tests:
There are multiple ways females can be tested and diagnosed for ovarian cancer. The first way is a medical history and physical exam. This consists of being asked about family history of cancer and information about symptoms. In addition, a doctor will most likely do an examination of the pelvis to check for signs of fluid in the abdomen or enlarged ovaries that could point towards ovarian cancer. A pelvic exam is when a doctor inserts gloved fingers into the vagina while pressing a hand on the abdomen. The next step of diagnosis is a consultation with a specialist. This will occur if the previous pelvic test indicated ovarian cancer. The specialist someone would see is called a gynecologic oncologist. A gynecologic oncologist will be immense help if treatment for ovarian cancer is needed. Another way of diagnosis is imaging tests. Imaging tests are used to take pictures of the inside of the body, therefore showing if there is a mass in the pelvis. However, this test cannot determine if the mass is cancerous. On a brighter side, imaging testing is helpful in the case that cancer has spread to other organs, also known as metastasizing. Next, an ultrasound. Normally an ultrasound is done first when there is any reason to suspect a problem in the ovaries. Ultrasounds help to find an ovarian tumor, visualize the ovaries, and decide if the tumor is alarming by using sound waves to create an image. Diagnosing can also be done by a blood test. Blood tests could be done to test for indications of ovarian cancer. If diagnosis is still uncertain, surgery could be done. This would include removing an ovary and testing it for cancer. Some other factors of diagnosing ovarian cancer is regularly having a health exam, seeing a doctor if symptoms occur, or having a screening test done. All of these things can help the diagnosis of ovarian cancer be found sooner rather than later.
Symptoms:
Symptoms of ovarian cancer typically depend on how early or advanced the cancer is. Ovarian cancer at an early stage usually has no symptoms. However, advanced ovarian cancer can have few, nonspecific symptoms that more often than not are confused with common non cancerous conditions. That said, symptoms are more likely to occur if the cancer has spread. In general, the signs and symptoms of ovarian cancer are weight loss, frequent need to urinate, bowel habit changes, quickly feeling full while eating, discomfort in the pelvis area, and abdominal bloating or swelling. It is recommended to see one’s doctor if any of these symptoms occur. When these symptoms occur, it is more likely to be ovarian cancer if the symptoms are persistent, occur often, or are severe. Other symptoms of ovarian cancer could be back pain, fatigue, upset stomach, and changes in a female's period.
Risk Factors:
There are multiple factors that can increase the risk of developing ovarian cancer. The first risk factor is aging. Ovarian cancer is often found in women over or at the age of 63. As age increases, so does the risk for ovarian cancer. Another risk factor is being overweight. However, obesity is not related to aggressive ovarian cancer. Next, having children after the age of 35 or never carrying a pregnancy to term has been linked to a higher risk of ovarian cancer. Having breast cancer in the past is also a risk factor for ovarian cancer. Fertility drugs that contain in vitro fertilization show higher risk in borderline ovarian tumors. Another risk is having a family history of ovarian, breast, or colorectal cancer. The reason for this is because the mutation in genes is inherited through generations. The more people in someone’s family with these types of cancers can increase the risk even more. Additionally, a number of different syndromes are risk factors. These syndromes include family cancer syndrome, Peautz-Jeghers syndrome, and hereditary breast and ovarian cancer syndrome. That summarizes most of the main risk factors for ovarian cancer.
Treatment:
Luckily, ovarian cancer can be treated. The first way of treatment is surgery, as surgery can treat most cancers. There are multiple ways to treat this cancer through surgery. One way is operating to remove one ovary. This surgery is meant for early stage cancer that has yet to spread past one of the ovaries. This type of surgery has the possibility for the woman to still have babies. If the cancer has spread to both ovaries, then surgery will remove both ovaries. Since the uterus will still be intact this procedure keeps the possibility to have children using frozen embryos, frozen eggs, or donor eggs. In the case that the cancer has spread beyond both ovaries, the surgical procedure will remove the ovaries, the fallopian tubes, the uterus, the lymph nodes that are nearby and a fold of fatty abdominal tissue. If the cancer is advanced, chemotherapy will likely be done before surgery and the procedure will be intended to remove as much of the cancer as possible. As mentioned, chemotherapy is usually used before or after surgery. Chemotherapy treatment is the treatment of drugs that kill cancer cells. Another treatment is targeted therapy. Targeted therapy is the usage of medications that attack specific parts of the cancer cells. Ovarian cancer that returns is usually treated with targeted therapy. Lastly, supportive or palliative care. Palliative care helps to relieve pain, treat symptoms, and provide support to those with a serious illness. Palliative care might be used when patients are undergoing treatment such as chemotherapy or surgery. That covers the treatments of ovarian cancer!
Prevention:
There is not necessarily a way to prevent all types of ovarian cancer, but there are ways to lower the risk of epithelial ovarian cancer. The first way is avoiding risk factors such as keeping one’s weight at a healthy place or not using hormone replacement after menopause. The next way is using oral contraceptives also known as birth control pills. However, birth control pills can increase the risk of breast cancer so it is important to consider all the side effects. Another way to reduce the risk is gynecologic surgery. Despite this, these surgeries such as a tubal ligation or hysterectomy, they cannot be performed just to reduce the risk. If a woman is close or past menopause, it might be recommended that both of her ovaries are removed which will reduce the risk of the cancer. For average women who don’t want their ovaries removed, the fallopian tubes or uterus could be removed. Keep in mind that all of these procedures will only be done for logical medical needs. For those who have a family history of ovarian cancer or the BRCA mutation, prevention is different. If one has family history, they should have genetic counseling and testing. This will help to see if there is a mutation in the gene that increases the risk of ovarian cancer. If a woman has a mutation in the BRCA1 gene or the BRCA2 gene, some ways to reduce her risk of ovarian cancer is oral contraceptives or tubal ligation. Additionally, a woman who is at high risk might have her ovaries and fallopian tubes even if cancer isn’t suspected. This procedure is usually done after a woman has finished having children. Unfortunately, this surgery will only lower the risk, it will not completely prevent it. Studies have shown that the risk of ovarian cancer in women who have yet to go through menopause with the BRCA mutation who have their ovaries removed is lowered by about 90%. That summarizes all the ways to reduce the risk of ovarian cancer, however one looking to reduce their risk should consult with their doctor to determine what is best for them.
Prognosis:
In general, the survival rate for cancer is typically 5 years, but it depends on the type and stage of the cancer. Keep in mind that these rates might not be specific to everyone, so consulting with one’s doctor is the best idea. For epithelial ovarian cancer, the 5 year survival rate at stage 1 is 90%, 70% for stage 2, 39% for stage 3, and 17% for stage 4. For ovarian stromal tumors, the 5 year survival rate for stage 1 is 95%, 78% for stage 2, 65% for stage 3, and 35% for stage 4. Lastly, for germ cell tumors in the ovary, the 5 year survival rate for stage 1 is 98%, 94% for stage 2, 87% for stage 3, and 69% for stage 4. To make more sense of this, stage 1 is when the cancer hasn’t spread past the ovaries. Stage 2 is when the cancer is in one ovary, both ovaries, or has spread somewhere in the pelvis. Stage 3 is when the cancer is in one ovary or both ovaries, in addition to being in the lining or lymph nodes of the abdomen. In stage 4 the cancer is advanced and has spread to other organs or parts of the body. Overall, prognosis for ovarian cancer will vary based on the type of ovarian cancer and its stage.
Sources:
Comments