Ovarian Cancer: Information on Causes, Diagnosis & Treatments
Ovarian cancer involves abnormal cancer cells that grow out of control in the ovaries. The condition produces few symptoms in its initial stage and often goes undetected until it has metastasized (spread) into the abdomen and pelvic area. However, by this point, the cancer is often fatal because at this stage it is now difficult to control. However, when ovarian Cancer respondents initial stage, affected treatments produced highly successful results.
The ovaries consist of two small glands on both sides of the uterus. Each plan produces estrogen and other female sex hormones along with ova (eggs) that are stored and released during menstruation. Most ovarian cancers develop on the outer lining (epithelium) of the ovary.
According to statistics maintained by the American Cancer Society and National Cancer Institute, ovarian cancer ranks eighth in all cancer suffered by American women, not including non-melanoma skin cancer. In addition, it ranks fifth among all cancers that kill women in the United States, and has the highest number of deaths among all gynecological cancers included cervical and uterine.
There are more than 22,000 cases of ovarian cancer diagnosed in the United States every year and approximately 14,000 associated deaths. However, if the cancer is diagnosed early before a tumor or cancerous mass can metastasize, a woman with the condition has a 94% chance of being alive after five years.
Who Is at Risk for Ovarian Cancer?
While anyone can develop ovarian cancer, there are known risk factors associated with the disease that increase the chances of developing the condition. These risk factors involve:
- Age – Typically, women between 50 and 60 years of age are at the greatest risk of developing ovarian cancer compared to other ages.
- Women who have never become pregnant
- Estrogen Hormone Replacement Therapy (EHRT) and increased potential risk of ovarian cancer, especially when given in large doses over a long-term.
- Women who have used talcum powder or talc based personal care products.
- Women who have used an IUD (intrauterine device)
- Genetic Predisposition – A small percentage of women who develop ovarian cancer acquired the disease through one of two inherited gene mutations (BRCA1 and BRCA2). Other groups of women develop ovarian cancer after suffering from Lynch syndrome, the gene mutation related to colon cancer.
- Women who have undergone fertility treatments
- Women who suffer from polycystic ovarian syndrome
Medical Science has yet to determine exactly what causes ovarian cancer. However, it is known that the cancer cells are the result of a genetic abnormality that causes normal cells to grow out of control. Typically, normal cells are born, thrive, reproduce and die off to allow the new cells to follow the cycle of cellular life. Alternatively, cancer cells multiply quickly without dying off, allowing for the formation of a tumor (mass). When allowed to invade nearby tissue, some cancerous cells can break away from the tumor and metastasize to distant locations throughout the body.
Ovarian Cancer Types
Doctors categorize ovarian cancer in three distinct types that include:
- Epithelial Tumors – These types of tumors start on the ovary's outer thin layer of tissue. Approximately nine out of every ten cases of ovarian cancer are this type.
- Germ Cell Tumors – This type of ovarian cancer involves egg-producing cells that become cancerous. Younger women are highly susceptible to germ cell tumor ovarian cancer.
- Stromal Tumors – Hormone-producing cells that make up ovarian tissue can grow uncontrollably causing the development of stromal tumors. Approximately seven out of every 100 cases of ovarian cancer develop as stromal tumors. This form of ovarian cancer is usually diagnosed while in its initial stage.
Many cases of ovarian cancer go undetected until its later stage because there are usually no symptoms during its initial development. Unfortunately, ovarian cancer in its most advanced age is often mistaken for less serious benign problems including irritable bowel or constipation.
Many of the common symptoms associated with ovarian cancer, especially during late-stage development, include:
- Unexpected weight loss
- Abdominal swelling or bloating
- Increased frequency to urinate
- Pelvis area discomfort
- Unexpectedly feeling full while eating
- Unfamiliar constipation or other changes in bowel routines
Women with a history of breast cancer and ovarian cancer in the family should discuss at length the risks of developing ovarian cancer with their health care provider. The doctor may recommend genetic counseling to discuss and rule out gene mutations that likely increase the potential risk of developing both forms of cancer. Ruling out a genetic mutation is important because it is rarely the cause of ovarian cancer in patients suffering from the condition.
Diagnosing Ovarian Cancer
Oftentimes, doctors will misdiagnose ovarian cancer believing it is a case of constipation or irritable bowel syndrome. However, accurate diagnoses of the disease require a comprehensive pelvic examination that involves:
- Carefully inspecting the exterior area of the genitals
- The doctor will insert gloved fingers into the patient's vagina while pressing the other hand down on the abdomen simultaneously to palpate the ovaries and uterus.
- Inspecting the interior of the vagina after inserting a speculum device to perform a visual examination to find or identify any abnormality
To conclusively diagnose the condition the doctor will likely recommend numerous procedures and tests that include:
- Comprehensive Blood Test Panel – The doctor will likely recommend a list of blood tests to provide answers on what's going on inside the body and to identify CA 125, a protein associated with the surface of ovarian cancer cells.
- Imaging Testing – The doctor may recommend a CT (computerized tomography) scan and/or an ultrasound on the patient's pelvis and abdomen. The results of the test can provide information on the shape, size, and structure of the patient's ovaries.
- Surgical Procedures – The doctor may remove some abdominal fluid and/or a tissue sample for more accurate diagnoses of ovarian cancer. Sometimes, the biopsy and abdominal fluid will be acquired through a robotics surgery or minimally invasive procedure. If the cancer is identified, the surgeon may perform surgery immediately to remove as much of the cancerous mass or tumor as possible.
After an accurate diagnosis of ovarian cancer is confirmed, the doctor will stage the condition to determine the progression of the disease, the treatment required and the prognosis.
- Stage I – At this stage, the cancer remains isolated in one or both ovaries
- Stage II – If cancer progresses, the cancerous cells have metastasized to other areas of the pelvis
- Stage III – As the cancer progresses, it metastasizes to the abdomen
- Stage IV – In the most advanced age, the cancer has now metastasized outside the abdomen.
Treating the Condition
Usually, once the cancer is initially diagnosed, it is often in its most advanced stage, where cancer cells have metastasized to other areas at distant sites in the body. This can include finding ovarian cancer cells in the breasts, lungs, liver, heart, or brain. Doctors will typically treat the condition using a combination of chemotherapy and surgical procedures.
- Surgery – A surgeon may need to remove both ovaries along with the uterus and fallopian tubes as well as neighboring lymph nodes or any area where the cancer has spread.
- Chemotherapy – Once the surgical procedure is done, the surgeon will likely follow-up treatment with chemotherapy to ensure that all the remaining cancer cells are destroyed.
The chemical medications can be injected into the abdominal cavity or vein, or both.