What is Ovarian Cancer
Before answering what is ovarian cancer, it is best to define the function of the ovaries. The ovaries are part of the female reproductive system located in the pelvis. Each ovary is as big as an almond. The ovaries are responsible for the production of female hormones estrogen and progesterone. They also release eggs that travel from an ovary through the fallopian tube to the uterus or womb. During menopause, the ovaries stop releasing eggs and produce lower hormone levels.
Ovarian cysts may be benign or cancerous. They may be found on the surface or inside the ovary. A cyst consists of fluid. Sometimes, it may contain solid tissue. Most ovarian cysts are benign and go away with time. Some cysts do not go away and get larger. Tests are done to make sure these are not cancer.
Ovarian cancer may be a result of metastasis from a primary cancer elsewhere. In such case, it is called a secondary cancer. Primary cancers are usually breast and gastrointestinal cancer.
Ovarian cancer may invade, shed, or spread to other organs: Malignant ovarian tumors may grow and invade organs next to the ovaries like the fallopian tubes and the uterus. Cancer cells may shed from the main ovarian tumor leading to new tumors (called seeds or implants) forming on the surface of nearby organs and tissues. Cancer cells may spread through the lymphatic system to the lymph nodes in the pelvis, abdomen, and chest. They may also spread through the bloodstream reaching the liver or lungs.
When cancer spreads from its original place to a different part of the body, the cells show similar abnormality as that of the original cancer. So if ovarian cancer reaches the liver, they are treated as ovarian cancer and not liver cancer. Experts call the new tumor metastatic or “distant” disease.
What is ovarian cancer’s main cause? The main reason why a woman develops ovarian cancer is not clearly defined. Risk factors, though, may guide women as to who are more at risk to ovarian cancer. Risk factors are characteristics that increase one’s chance of developing the disease. Family history, personal history, age, no record of pregnancy, and menopausal hormone therapy are some of the risk factors associated with ovarian cancer. Women who have direct relatives with ovarian or other forms of cancer have an increased risk of the disease. Women, who have had any form of cancer, current or treated, are at greater risk. Most women are over 55 years old when diagnosed with ovarian cancer. Older women who have not experienced pregnancy have an increased risk of ovarian cancer. Women who take estrogen for over 10 years may have an increased risk. Other risk factors which are not scientifically verified include intake of fertility drugs, use of talcum powder, and obesity. Having any of the risk factors does not conclude that a woman will have ovarian cancer.
Ovarian cancer can be classified according to histology of the tumor from a pathology report. Histology covers aspects under clinical treatment, management, and prognosis. Surface epithelial-stromal tumour (ovarian epithelial carcinoma), including serous tumour, endemetrioid tumor, and mucinous cystadenocarcinoma, is the most common type of ovarian cancer. Sex cord stromal tumor includes estrogen-producing granulose cell tumor and virilizing Sertoli-Leydig cell tumor (arrhenoblastama). Germ cell tumor occur more in younger women. Mixed tumors contain combined elements of the mentioned classes of tumor histology.
Ovarian cancer does not display symptoms during early stages but as it grows, symptoms may include: pain in the abdomen, pelvis, legs or back, bloated or swollen abdomen, nausea, indigestion, constipation, diarrhea, and fatigue. Less common symptoms include: shortness of breath, frequent urination, unusual vaginal bleeding during periods, or bleeding after menopause. Early stages (stages I and II) are difficult to diagnose until it develops to later stages (stages III and IV). This is because, oftentimes, symptoms are not due to cancer. Also, most of the common symptoms are non-specific.
If an ovarian malignancy is suspected, laboratory tests can assist diagnosis. These are complete blood count (CBC) and serum electrolyte tests. Serum BHCG level should be measured in females suspected to be pregnant. Serum alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) is measured among young girls and adolescents with suspected tumors. The younger the patient, the greater possibility of malignant germ cell tumor. CA-125 is a blood test helpful in differential diagnosis and tracking growth of the disease. But due to low sensitivity and specificity, it is not an effective method for screening early-stage ovarian cancer.
Ovarian cancer is definitely diagnosed through a surgical procedure that will allow examination inside the abdomen. Laparotomy is an open procedure or keyhole surgery involving incision through the abdominal wall. Suspicious areas and fluid from the abdominal cavity are taken out and sent for microscopic analysis. If cancer is present, the same procedure may determine stage.
Treatment choices have varied expected results. The most common treatment methods for ovarian cancer are surgery and chemotherapy. Radiation is used rarely. Cancer treatment may be directed to cancer cells in the pelvis, abdomen, or entire body. Local therapy such as surgery and radiation remove ovarian cancer in the pelvis. When metastases to other parts are present, local therapy may be used to control the disease in those areas. Intraperitoneal chemotherapy is directed into the abdomen and pelvis through a thin tube with drugs that destroy or control cancer in the abdomen and pelvis. Systematic chemotherapy is taken orally or injected into a vein with the aim for drugs to enter the blood stream and destroy or control cancer throughout the body.
What is ovarian cancer patient faced with? Women with ovarian cancer make decisions about their medical care. Coping with the disease requires knowledge about ovarian cancer. Diagnosis is associated with shock and stress. It is helpful to have access to information when they are needed and the doctors and nurses may assist in explaining things that are related to the person’s condition. Having family members and friends willing to support cancer patients give emotional comfort while going through the consequences faced with having cancer.
A gynecologic oncologist is a surgeon who specializes in treating ovarian cancer. They work with other medical practitioners including gynecologists, medical oncologists, and radiation oncologists.
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