Ovarian cancer – Symptoms , Diagnosis, Treatments, and More

Cancer that affects the ovaries (the organs that store the eggs) is called Ovarian cancer.

The symptoms of Ovarian cancer are very vague; hence by the time cancer is diagnosed, it would have already spread to the inner lining of the abdomen and pelvis and to adjacent organs, including the liver and lungs.

Cancer ovary can occur to anyone, but like any cancer, it also has certain risk factors:

• Age more than 50 years (mostly occurs)
• People who have close relatives with a history of breast cancer and colon cancer 
• People who have had their first period early (early menarche) and late cessation of periods (late menopause)
• Obesity

Cancer prevention

• Pregnancy
• Breastfeeding
• Oral contraceptive use ( >5 years, risk reduced by 50%)
• Early screening in people with family history and personal history of breast, uterus and colon cancer.
• Risk-reducing surgery in people with family history and personal history of tumour-causing genes (BRCA1&2)/TP53, HNPCC: Removal of uterus, ovaries and tubes, once childbearing is completed (maximum at the age of 40 years).
• Tubal ligation: Permanent family planning method where the connection between fallopian tubes, ovaries and uterus is cut off to prevent future pregnancies. 
• Healthy eating and regular exercise.

Symptoms of Ovarian cancer

As the symptoms of Ovarian cancer are very non-specific and vague, they often mimic symptoms of indigestion. So it is important to educate patients and the public that if such symptoms are occurring more frequently ( >12 times in a month), they need prompt medical attention.

Other symptoms of Ovarian cancer can include:

• indigestion
• constipation or diarrhoea
• feeling full or bloated
• back pain
• feeling tired all the time
• loss of hunger
• loss of weight ( >5kgs in a month without diet or exercise)
• Heavy and irregular bleeding, especially after menopause.

Diagnosis of Ovarian cancer

• Clinical examination by a doctor
• Ultrasound of abdomen and pelvis
• Certain proteins secreted by the tumour: CA125, CEA, Ca19-9, Beta Hcg and Alpha-fetoprotein
• Biopsy: Needle test to extract part of the tissue and send for examination
• MRI/CT pelvis
• PET scan
• Chest X-ray

Treatment of Ovarian cancer

Treatment for Ovarian cancer will depend on the stage at which it is diagnosed and the type of cancer. Other factors like age and general condition to be taken into account.

There are multiple modalities of treatment like surgery, anti-cancer drugs, medicines that target immunity to treat cancer cells and Hormonal drugs.

Surgery 

• Surgery involves removal of the uterus, ovaries with cancer, the lining of the pelvic and abdominal cavity and biopsy from layers of tissues covering and connecting the intestine. In advanced cases, removal of the affected part of the intestine, spleen and part of the liver. Removal of lymph nodes around the intestine and major blood vessels.

In advanced cases, removal of the affected part of the intestine, spleen and part of the liver. Removal of lymph nodes around the intestine and major blood vessels.

In advanced cases, a few cycles of anticancer drugs are given before surgery and then it is done for better response.

Certain patients will require chemotherapy (anti-cancer) treatment even after the completion of the surgery.

Chemotherapy

It is given in the vein (a blood vessel) inside the abdominal cavity through a small port inserted using a laparoscope/HIPEC.

Other therapies include drugs that target the immune system against cancer and hormonal therapy.

Follow up 

As most Ovarian cancer is diagnosed at a later stage, there is a high chance that it will come back again and even after complete treatment. The patient will be on a strict follow-up for up to 10 years in early cases.

Conclusion

Awareness regarding women’s health is taking its round among the general population. But still, cases go unidentified, leading to an increased death rate. Women should be more aware and responsible regarding their own health, giving it a priority and not shy away, especially when it comes to reproductive health. 

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