Symptoms of ovarian cancer in the early stages are often non-specific and mimic those of many digestive and bladder disorders.
Women have two ovaries, one on each side of the womb each about the size of an almond which produce eggs (ova) as well as the female sex hormones oestrogen and progesterone.
Ovarian cancer is a disease in which normal ovarian cells begin to grow in an uncontrolled, abnormal manner and produce tumours in one or both ovaries.
Types of ovarian cancer
Three basic types of ovarian tumours include:
- Epithelial tumours. About 85 percent to 90 percent of ovarian cancers.
- Germ cell tumours. These tumours occur in the egg-producing cells of the ovary and generally occur in younger women.
- Stromal tumours. These tumours develop in the oestrogen- and progesterone-producing tissue that holds the ovary together.
Causes
The causes of ovarian cancer remain unknown. It is believed to be multi-factorial which includes genetic and environmental factors.
Risk factors
Factors which may increase the risk of ovarian cancer include:
- Inherited gene mutations.
- The most significant risk factor for ovarian cancer is having an inherited mutation in genes called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) which are responsible for about 5 percent to 10 percent of ovarian cancers.
- Another inherited syndrome called hereditary non-polyposis colorectal cancer (HNPCC) is associated with increased risk of cancers of the uterine lining (endometrium), colon, ovary, stomach and small intestine.
- Family history. If you there is one first-degree relative (a mother, daughter or sister) with ovarian cancer the risk of developing cancer is 5 percent.
- Age. Ovarian cancer most often develops after menopause.
- Childbearing status. Women who have had at least one pregnancy and the use of oral contraceptives appear to offer some protection against ovarian cancer.
- Infertility increases the risk of ovarian cancer even without use of fertility drugs.
- Hormone replacement therapy (HRT) use for five or more years has been shown to significantly increase the risk of ovarian cancer.
- Obesity in early adulthood. Women who are obese at age 18 are at increased risk of developing ovarian cancer before menopause.
Symptoms
Women with ovarian cancer are more likely to consistently experience the following symptoms:
- Abdominal pressure, fullness, swelling or bloating
- Urinary urgency
- Pelvic discomfort or pain
Additional signs and symptoms may include:
- Persistent indigestion, gas or nausea
- Changes in bladder habits, including a frequent need to urinate
- Loss of appetite or unexplained weight loss
- Pain during intercourse (dyspareunia)
- Low back pain
Diagnosis
- Pelvic examination includes examination of the vagina, uterus, rectum and pelvis.
- Ultrasound uses high-frequency sound waves to produce images of the inside of the body to evaluate the size, shape and configuration of the ovaries.
- CA 125 blood test. CA 125 is a protein and many women with ovarian cancer have abnormally high levels of CA 125 in their blood. However, a number of noncancerous conditions also cause elevated CA 125 levels.
- Imaging tests may include computerized tomography (CT) and magnetic resonance imaging (MRI) and a chest X-ray to determine if cancer has spread to the lungs or to the pleural space surrounding the lungs.
Treatment
Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.
Surgery
Women with ovarian cancer often require a more extensive operation that includes removing ovaries, fallopian tubes, and the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue known as the omentum.
Chemotherapy
Chemotherapy involves the use of drugs designed to kill any remaining cancer cells after surgery.
Side effects include:
- abdominal pain
- nausea ,vomiting and
- infection.
Screening
Tests that may detect (find) ovarian cancer that are being studied include:
- Pelvic exam
- Transvaginal ultrasound
- CA-125 assay
Currently, there is no standard or routine screening test for ovarian cancer.
There is insufficient evidence to recommend for or against the screening of asymptomatic women at high risk of developing ovarian cancer.
Prevention
Some of the risk factors for developing ovarian cancer are modifiable, though some cannot be avoided. These include:
- Obesity: Excess body fat increases the risk of ovarian cancer. Diet, nutrition and physical activity during the teen years may play a role in prevention.
- Women at high risk of developing ovarian cancer such as those with strong family history or women carrying BRCA1 or BRCA2 mutation should consider having a cancer risk assessment by their health professional and advice on options available to reduce the risk of ovarian cancer.
http://www.hpb.gov.sg/diseases/article.aspx?id=596
