How do I know if I am suffering from ovarian cancer?
What are the warning signs and symptoms of cancer of ovaries? How is cancer of ovaries caused? Am I a risk factor for cancer of ovaries?
Basic insight into the Cancers of Ovaries
Ovarian cancer also known as cancer of the ovaries is a condition in which malignant (cancerous) cells are found in the ovaries.
Ovaries are the female reproductive glands that produce eggs (ova) for reproduction. They are also the chief source of female hormones estrogen and progesterone. There is one ovary on each side of the uterus. This type of cancer is a rare kind of cancer which arises from different types of cells within the ovaries. Hence, there are different types of ovarian cancers. Epithelial ovarian cancers are the most common type of ovarian cancers.
Generally the ovarian cancers are diagnosed in the later stages as there are no reliable early signs and symptoms of ovarian cancer and the symptoms are all vague. The earlier the ovarian cancer is detected and treated, higher shall be the survival rate.
There are several different types of ovarian cancers classified depending on the type of cells and the tissue of origin. Types of ovarian cancers are as follows:-
1. Epithelial ovarian cancer (EOC) – Epithelial (outer lining of the ovary) cancer of the ovaries is the most common type of ovarian cancer. This type of cancer includes ovarian, fallopian tube, and primary peritoneal cancer.
2. Ovarian low malignant potential Tumor (OLMPT) – This type of ovarian cancer possess some of the microscopic features of cancer but they fail to spread like typical cancers.
3. Germ cell ovarian cancers – These cancers arise from the reproductive cells of the ovary. This is a rare type of ovarian cancer.
4. Stromal ovarian cancers – Such type of ovarian cancers arise within the cells that hold the ovaries together and those that produce the female hormones.
It is essential to determine the stage of ovarian cancer as stage shall be helpful in establishing the treatment and prognosis of cancer. There are four stages of ovarian cancer which are as follows:
Stage 1 – Cancer growth is limited to one of both ovaries. Stage 1 is further subdivided into three stages:
- Stage 1a – Cancer is confined to just one ovary.
- Stage 1b – Cancer is confined to both the ovaries.
- Stage 1c – Either 1a or 1b with cancer cells on the outside of the ovary.
Stage 2 – Spread of cancer to the uterus, fallopian tubes or some other areas in the pelvis, Stage 2 is further subdivided into three groups:
- Stage 2a – Spread of cancer into the uterus or fallopian tubes.
- Stage 2b – Spread of cancer into other tissues in the pelvis.
- Stage 2c – Spread of cancer on the surface of one or both the ovaries.
Stage 3 – Spread of cancer into the lining of the abdomen, or to the lymph nodes in the groin, abdomen or behind the uterus. Most of the cancer of ovaries is diagnosed in this stage. Stage 3 is further sub-classified into 3:
- Stage 3a – Spread of cancer beyond the pelvis into the lining of the abdomen.
- Stage 3b – Cancer cells are outside the liver or spleen. Growth is less than 2cms.
- Stage 3c – Cancer cells larger than 2cms are seen in the lining of the abdomen or in the lymph nodes of uterus, groin or abdomen.
Stage 4 – Cancer growth is seen in one or both the ovaries and spread of cancer to distant organs is seen. Spread takes place beyond the pelvis, abdomen, and lymph nodes to the liver or lungs. This stage is the most advanced stage of ovarian cancer.
Causes/ Risk Factors
Basically all women are at a risk to ovarian cancer but there are few risk factors which can increase a woman’s chance of acquiring cancer of ovaries. The exact cause regarding ovarian cancer is unknown though, some of the below mentioned risk factors can be a reason for ovarian cancers:
- Genetic mutations of genes such as BRCA1 or BRCA2.
- Increasing age.
- Family or personal history of colon, breast or ovarian cancer.
- Beginning of menses at an early age.
- Attaining menopause (stoppage of menstrual cycles) at a late age.
- Nulliparity (never getting pregnant).
- Use of hormone replacement therapies.
- Use of few fertility drugs.
- Having endometriosis.
- Suffering with ovarian cysts & polycystic ovaries.
- Habit of smoking tobacco.
- Consuming a fat rich diet.
- Genital contact with talcum or asbestos.
Vague symptoms which cannot be easily recognised are seen in the early stages of ovarian cancer. Symptoms are mostly experienced when the disease has spread beyond the ovaries. Some of the common symptoms of cancers of ovaries are as follows:
- Abdominal or pelvic pain.
- Urge and frequency to urinate.
- Pain in the back.
- Stomach disturbances.
- Changes in menses.
- Weight loss.
- Swelling in abdomen or legs.
- Early satiety.
- Shortness of breath.
- Pain during sexual intercourse.
- Loss of appetite.
There is increased chance of a woman’s recovery with the early diagnosis of ovarian cancer. Although there are no reliable screening tests to detect ovarian cancer, the following tests can be conducted to confirm the diagnosis of ovarian cancer:
- Vaginal examination (to assess visible abnormalities in uterus & ovaries).
- CA-125 – cancer antigen 125 blood test (this is a cancer marker).
- Transvaginal Ultrasound (to detect size & texture of the ovaries & cysts, if any).
- Laparoscopy & possible Endoscopy (to examine the ovaries and determine the spread of cancer to the digestive system).
- Colonoscopy (to examine the large intestine).
- Abdominal fluid aspiration (to check the fluid for cancer cells).
- Chest X Ray (to assess the spread of cancer to the lungs & the surroundings).
- CT scan (to determine the spread of cancer to the adjacent lymph nodes).
- MRI scan.
- PET scan (to determine the spread of cancer to the nearby lymph nodes).
Treatment in every case of ovarian cancer shall differ as the treatment is dependent on few factors namely, type; stage; age of the patient and general health of the patient. Ovarian cancers can be treated through the following options:
1. Surgery – Cancerous growths are removed through surgery.
2. Chemotherapy – In chemotherapy, chemicals which travel via the bloodstream are used to destroy the cancer cells and to arrest the growth of cancer cells. Chemotherapy is indicated in most of the cases post surgery. Doses and frequency of chemotherapy varies depending on the stage and type of cancer and also the type of chemotherapy advised.
3. Radiation therapy – High energy X-rays are used to shrink the tumours and to kill the cancer cells.
A woman’s risk of developing ovarian cancer can be reduced by:
- Consuming birth control pills.
- Performing tubal ligation (a surgical procedure in which the fallopian tubes are tied to prevent pregnancy).
- Performing hysterectomy (surgical removal of uterus).
- Conceiving and breastfeeding.
- Performing prophylactic oophorectomy (surgical removal of one or both the ovaries).
- Adapting a healthy lifestyle.