OVARIAN CANCER

What is Ovarian Cancer?

Ovarian cancer develops when atypical cells within the ovaries or fallopian tubes continue to grow and divide uncontrollably. These ovaries, which are essential components of the female reproductive system, take the shape of two rounded organs the size of walnuts and actively generate eggs throughout an individual’s reproductive lifespan.

Ovarian cancer can be classified into several types. The most common type is epithelial cancer, which begins in the cells that surround the ovary.

Furthermore, there are two interconnected types of epithelial cancer that can spread to the ovaries:

1. Follicular tube Cancer develops in the lining tissue of the fallopian tube. These long and slender tubes flank the uterus on both sides. During pregnancy, the uterus serves as the reproductive hub where fetal development takes place.
2. Primary peritoneal cancer develops in the tissue that covers the peritoneum. The peritoneum is the lining tissue that surrounds the organs in the abdominal cavity. Because these two cancers are similar to ovarian cancer, the treatment protocols are the same. As a result, some doctors consider these two variations to be types of ovarian cancer.

Furthermore, less common types of ovarian cancer include malignant germ cell tumors and stromal tumors.

Ovarian cancer is caused by changes (mutations) in the genetic material, specifically the DNA. The exact causes of these genetic changes are frequently unknown. The majority of ovarian cancers are caused by genetic mutations acquired throughout one’s life. In some cases, however, these genetic changes are inherited and present from birth. Such genetic changes are referred to as hereditary ovarian cancer when they are inherited. Ovarian cancer risk is increased by certain genetic mutations, such as BRCA1 and BRCA2. These mutations also increase the risk of developing breast and other cancers. Aside from genetics, lifestyle choices, and environmental factors all contribute to the risk of ovarian cancer. Let’s check some of the other reasons: –

1. Individuals who have a family history of ovarian cancer in their mother, daughter, or sister are more likely to develop the disease. They pass on mutations in the BRCA1 or BRCA2 genes.
2. Have other genetic disorders, such as Lynch syndrome.
3. Have an endometriosis
4. Had hormone replacement
5. Struggle with being overweight or obese.
6. Have a larger stature.
7. Are older, particularly postmenopausal women.

Ovarian Cancer Stages: There are four distinct stages of ovarian cancer, each denoted by a numerical value. Lower numbers correspond to less advanced stages of the disease, while higher numbers indicate more severe disease progression.

Stage I is divided into three sub-stages: IA, IB, and IC, which reflect the extent of cancer progression.

1. Stage IA: The cancer is limited to one ovary or one fallopian tube.
2. Stage IB: Cancer has spread to both the ovaries and the fallopian tubes.
3. Stage IC: Cancer has spread to the ovaries or fallopian tubes and has spread beyond these organs. This can happen on the surface of the organs or in the peritoneal cavity, which is the space around the ovaries.

Stage II is further classified based on cancer spread:

1. Stage IIA: The cancer has spread from the ovaries and fallopian tubes to the uterus.
2. Stage IIB: The cancer has spread to nearby pelvic structures.

Stage III is divided into three sub-stages based on the extent of cancer spread:

1. Stage IIIA: Cancer has spread beyond the pelvis, either to lymph nodes or to the abdomen on a microscopic level.
2. Stage IIIB: Tumours up to 2 centimeters in size that have infiltrated areas other than the pelvic area or lymph nodes.
3. Stage IIIC: Cancer has spread beyond the pelvis, with larger tumor sizes (greater than 2 centimeters) or infiltration of lymph nodes.

This stage may include effects on nearby organs such as the liver and spleen.

Stage IV: This is the most advanced stage of ovarian cancer:

1. Stage IVA: Cancer has spread to organs in close proximity to the lungs.
2. Stage IVB: The disease has spread to the groin or chest lymph nodes.

Staging is critical because it guides healthcare providers in developing an individualized treatment strategy. Discussions with your healthcare provider will shed light on the treatment options available for your specific situation.

Ovarian Cancer Warning Signs and Risk Factors

Ovarian Cancer Symptoms: Ovarian cancer frequently progresses and spreads within the abdominal cavity before exhibiting visible symptoms, making early detection difficult. Ovarian cancer symptoms may include:

1. Discomfort, pain, or bloating in the pelvis or abdomen.
2. Changes in eating habits, such as early satiety and decreased appetite.
3. Abnormal vaginal discharge or bleeding, particularly if it occurs outside of your regular menstrual cycle or after menopause.
4. Irregular bowel movements, such as diarrhea or constipation.
5. Abdominal enlargement.
6. Frequent urination (increased frequency of urination).

If any of the symptoms appear, it is best to consult with a healthcare professional right away.

If a genetic mutation linked to an increased risk of ovarian cancer is discovered, the doctor might suggest you consider having your ovaries removed as a cancer prevention measure.

Ovarian Cancer Diagnosis:

Determining the presence of ovarian cancer is a difficult task because, despite extensive research, no definitive ovarian cancer screening test has been developed. This inherent difficulty frequently leads to the complexities of early-stage diagnosis.

When ovarian cancer is suspected, your healthcare provider will investigate your symptoms and perform a pelvic examination. This meticulous examination includes a look for any abnormal growths or signs of organ enlargement.

Following this initial evaluation, your healthcare provider may recommend a series of additional diagnostic procedures, such as:

• Imaging Methods:

A variety of imaging methods are available, including:

1. Pelvic Ultrasound: This non-invasive procedure uses sound waves to produce visual images of your pelvic region, which aids in the detection of anomalies.
2. MRI (Magnetic Resonance Imaging): MRI generates detailed cross-sectional images that provide insight into potential abnormalities by utilizing powerful magnets and radio waves.
3. CT Scan (Computed Tomography): By combining X-ray and computer technology, CT scans create detailed images that aid in the detection of potentially cancerous growths.
4. PET Scan (Positron Emission Tomography): This advanced imaging technique uses a small amount of radioactive material to create detailed visuals of bodily functions and identify potential areas of concern.

• Blood Analysis: Blood tests are used to look for a biomarker known as CA-125. CA-125 levels in your bloodstream may be elevated, indicating the presence of cancer. However, while elevated CA-125 levels may indicate cancer, they can also be normal, even in the presence of cancer, and may be elevated due to a variety of non-cancerous conditions. As a result, blood tests are used in conjunction with other diagnostic tools to make an accurate diagnosis of ovarian cancer.
• Surgical Exploration: An ovarian cancer diagnosis can occur during surgery. Atypical growths are usually excised during the same surgical procedure if they are discovered. Laparoscopic surgery entails inserting a thin camera, known as a laparoscope, through a small abdominal incision. The surgeon can meticulously evaluate the cancerous condition, perform staging biopsies, and, in some cases, remove ovarian tumors using this scope and additional ports for instrument manipulation.

These diagnostic techniques work together to provide a comprehensive understanding of the ovarian cancer scenario, allowing for informed treatment and management decisions.

Ovarian Cancer Treatment Options:

Ovarian cancer treatments take a variety of forms:

1. Surgical Intervention: Surgery is used to remove as much cancerous tissue as possible.
2. Chemotherapy: Chemotherapy uses medications to target and eliminate cancer cells.
3. Targeted Therapy: This method uses drugs or substances that specifically target cancer cells while causing minimal damage to healthy cells.

Your doctor may recommend genetic testing to identify gene mutations that increase your risk of ovarian cancer. Based on your genetic profile, this information can help your provider develop an appropriate treatment strategy.

Preventing Ovarian Cancer:

While it is not possible to completely eliminate the risk of ovarian cancer, knowing your family history can empower you to address any increased susceptibility to the condition.

When a genetic mutation, such as the BRCA mutation, is discovered, your healthcare provider may recommend proactive measures to reduce risk. This could include choosing risk-reducing surgical procedures to remove the ovaries and fallopian tubes before they can develop cancer. If you are unsure whether you have the BRCA mutation or other genetic exception, speaking with your healthcare provider about genetic testing can provide clarity and pave the way for informed decisions.

Although complete prevention remains ambiguous, proactive management strategies based on genetic insights can significantly contribute to reducing the impact of ovarian cancer on your health. There are some strategies that may help reduce the risk:

1. Consider Birth Control Pills: Consult your doctor to see if oral contraception (birth control pills) is right for you. These pills have been shown to reduce the risk of developing ovarian cancer. However, it is critical to weigh the benefits against the potential risks, which your doctor can assist you in determining.
2. Consult Your Doctor About Risk Factors: Share your family history of breast and ovarian cancer with your healthcare provider. Your doctor can assess the implications for your individual cancer risk. You may be referred to a genetic counselor who can advise you on whether genetic testing is necessary or not.

Life After Ovarian Cancer: Your healthcare journey continues after treatment with regular appointments with your provider. Your provider will monitor any symptoms, address any concerns, and ensure that your recovery is progressing as expected during these visits. During this stage, you must pay close attention to your body and report any unusual developments to your healthcare provider as soon as possible. The cornerstone of post-treatment ovarian cancer care is ongoing observation.

Survival Rate:

Ovarian cancer has a five-year overall survival rate of 49%. This figure indicates that roughly 49% of people diagnosed with it survive five years after their diagnosis.

It’s critical to understand that survival rates are merely estimates. They are unable to predict the length of your survival or the outcome of your treatment. It is best to consult with your healthcare provider for personalized information on ovarian cancer survival rates and other related questions. They can provide a more nuanced understanding of your specific circumstances and guidance based on your individual medical journey.

When Should You See Your Doctor?

If you notice any potential signs (that are mentioned above) of ovarian cancer, such as abnormal lumps, abdominal discomfort, or bloating, make an appointment with your healthcare provider right away.

Key Inquiries to Ask Your Healthcare Provider

If you’ve been diagnosed with ovarian cancer, you should consider asking your doctor the following questions:

1. Tumour Site: Where exactly is the tumour in my body?
2. Area of Influence: Has the cancer spread, and how far has it spread?
3. Suggested Treatments: What treatment options do you recommend for my specific case?
4. Treatment Time: How long can I anticipate my treatment lasting?
5. Workability During Treatment: Will I be able to keep my work commitments during treatment?
6. Available Resources: Do I have access to any resources or support groups?

These questions help you gain a thorough understanding of your diagnosis, prognosis, treatment options, and potential impact on your daily life. Your healthcare provider can provide you with information that is specific to your situation, allowing you to make more informed decisions and navigate your ovarian cancer journey with greater confidence.

While the word “cancer” can elicit fear and concern, it is critical to recognize the significant medical advancements that have been made in transforming the landscape of cancer care. With the advancement of targeted therapies and immunotherapy, as well as advances in early detection and personalized medicine, there is renewed hope for improved treatment outcomes and quality of life for cancer patients. As researchers continue to unravel the complexities of cancer biology and the immune system, the trajectory of cancer treatment is shifting toward a future where early intervention, precision medicine, and innovative therapies hold the promise of further reducing the burden of this disease on individuals and their loved ones.