How do I know if I am suffering from ovarian cancer? What are the warning signs and symptoms of cancer of ovaries? How is it caused? Am I a risk factor?
Basic insight into the ovarian cancer
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.
Generally 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 it 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:
1. Germ cell ovarian cancers – These cancers arise from the reproductive cells of the ovary. This is a rare type of ovarian cancer.
2. Stromal ovarian cancers – Such type of ovarian cancers arise within the cells that hold the ovaries together and those that produce the female hormones.
3. 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.
4. Epithelial ovarian cancers (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.
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 – Cell growth is limited to one of both ovaries. Stage 1 is further subdivided into three stages:
- Stage 1a – is confined to just one ovary.
- Stage 1b – 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 the disease to the uterus, fallopian tubes or some other areas in the pelvis, Stage 2 is further subdivided into three groups:
- Stage 2a – Spreads into the uterus or fallopian tubes.
- Stage 2b – Spreads into other tissues in the pelvis.
- Stage 2c – Spreads on the surface of one or both the ovaries.
Stage 3 – Spreads 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 – spreads beyond the pelvis into the lining of the abdomen.
- Stage 3b – cells are outside the liver or spleen. Growth is less than 2cms.
- Stage 3c – ells larger than 2cms are seen in the lining of the abdomen or in the lymph nodes of uterus, groin or abdomen.
Stage 4 – The growth is seen in one or both the ovaries and its spread 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.
Causes/ Risk Factors
Basically all women are at a risk of cancers of ovaries but there are few risk factors which can increase a woman’s chance of acquiring it. The exact cause regarding ovarian cancer is unknown though, some of the below mentioned risk factors can be the reason:
2. Increasing age.
3. Having endometriosis.
4. Use of few fertility drugs.
5. Habit of smoking tobacco.
6. Consuming a fat rich diet.
7. Beginning of menses at an early age.
8. Nulliparity (never getting pregnant).
9. Use of hormone replacement therapies.
10. Genital contact with talcum or asbestos.
11. Suffering with ovarian cysts and polycystic ovaries.
12. Genetic mutations of genes such as BRCA1 or BRCA2.
13. Family or personal history of colon, breast or ovarian cancer.
14. Attaining menopause (stoppage of menstrual cycles) at a late age.
Vague symptoms which cannot be easily recognised are seen in the early stages of the disease. Symptoms are mostly experienced if it has spread beyond the ovaries. Some of the common symptoms are:
4. Weight loss.
6. Early satiety.
7. Loss of appetite.
8. Pain in the back.
9. Changes in menses.
10. Shortness of breath.
11. Stomach disturbances.
12. Abdominal or pelvic pain.
13. Swelling in abdomen or legs.
14. Urge and frequency to urinate.
15. Pain during sexual intercourse.
There is increased chance of a woman’s recovery with the early diagnosis. Although there are no reliable screening tests to detect ovarian cancer, the following tests can be conducted to confirm the diagnosis:
2. MRI scan.
3. Colonoscopy (to examine the large intestine).
4. CA-125 – Cancer antigen 125 blood test (this is a marker).
5. Abdominal fluid aspiration (to check the fluid for cancer cells).
6. CT scan (to determine the spread to the adjacent lymph nodes).
7. PET scan (to determine the spread of the disease to the nearby lymph nodes).
8. Vaginal examination (to assess visible abnormalities in uterus and ovaries).
9. Chest X Ray (to assess the spread of cancer to the lungs and the surroundings).
10. Transvaginal Ultrasound (to detect size and texture of the ovaries & cysts, if any).
11. Laparoscopy and Endoscopy (to examine the ovaries and determine the spread of disease to the digestive system).
Treatment in every case and 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. Radiation therapy – High energy X-rays are used to shrink the tumours and to kill the infected cells.
3. Chemotherapy – In chemotherapy, chemicals which travel via the bloodstream are used to destroy the cells and to arrest the growth of cancerous cells. Chemotherapy is indicated in most of the cases post surgery. Doses and frequency of chemotherapy varies depending on the stage and type and also the type of chemotherapy advised.
A woman’s risk of developing ovarian cancer can be reduced by:
1. Adapting a healthy lifestyle.
2. Consuming birth control pills.
3. Conceiving and breastfeeding.
4. Performing hysterectomy (surgical removal of uterus).
5. Performing prophylactic oophorectomy (surgical removal of one or both the ovaries).
6. Performing tubal ligation (a surgical procedure in which the fallopian tubes are tied to prevent pregnancy).