ovarian cancer

Ovarian cancer

Ovarian cancer introduction

Ovarian cancer begins in the ovaries, which produce eggs and hormones. It is the eighth most prevalent cancer in women and generally found late, making treatment difficult.

Ovarian cancer most often affects postmenopausal women. Ovarian cancer’s aetiology is unclear, however a family history of ovarian or breast cancer, gene abnormalities like BRCA1 and BRCA2, older age, and reproductive variables like never having been pregnant or having a late menopause may raise the risk.

Ovarian cancer is hard to identify early since it typically has vague or no signs. Thus, the illness is commonly detected after it has progressed beyond the ovaries to other pelvic organs or distant places in the body. As the condition advances, stomach bloating or swelling, pelvic discomfort, trouble eating or feeling full, and urine or stool changes may occur.

Medical history, physical exam, imaging (such as ultrasound or CT scan), and blood tests (including tumour markers like CA-125) are used to diagnose ovarian cancer. A pathologist examines a tissue sample from a biopsy to get the final diagnosis.

Surgery, chemotherapy, and targeted medicines may treat ovarian cancer, depending on its stage. Chemotherapy kills cancer cells outside the ovaries, and surgery removes as much of the tumour as feasible. Newer treatments like PARP inhibitors target cancer cells while protecting healthy cells.

Ovarian cancer research and treatment have dvanced. However, early identification and awareness improve results. Regular checkups, knowledge of symptoms, and genetic counselling for high-risk people may diagnose and prevent ovarian cancer.

symptoms

Early ovarian cancer symptoms might be vague. Some women have no symptoms. As cancer grows, several symptoms may occur:

Ovarian cancer patients often have abdominal bloating or edoema. Bloating may last all day and resist treatment.

Pelvic discomfort is another typical symptom. Pressure, pain, or a dull pelvic aching may occur.

Ovarian cancer patients may lose their appetite and feel content after eating tiny quantities. This feeling may arrive sooner than normal during a meal.

Ovarian cancer may alter urine and bowel patterns. Frequency, urgency, constipation, and diarrhoea may increase.

Ovarian cancer often causes lethargy. Even with rest, this weariness may persist.

Back discomfort: Some women have lower back pain without injury or activity.

Note that these symptoms may not be caused by ovarian cancer. If these symptoms are new, persistent, and frequent, see a doctor.

Routine gynecologic exams, including pelvic exams, may not identify early ovarian cancer. It’s vital to be aware of these signs and seek medical assistance if you notice any persistent or alarming bodily changes. Early identification and treatment improve ovarian cancer prognoses.

Causes

Age: After menopause, ovarian cancer risk rises. Ovarian cancer most often affects women over 50.

Family history and genetics: Ovarian cancer is more likely in women with a history of breast or ovarian cancer. Ovarian cancer is highly linked to BRCA1 and BRCA2 gene mutations.

Ovarian cancer risk increases for women with breast, colorectal, or uterine cancer.

Ovarian cancer risk may be affected by reproductive history. Never becoming pregnant, early menstruation, and late menopause are examples.

Hormone replacement treatment (HRT): Long-term estrogen-only HRT may raise the risk of ovarian cancer.

Endometriosis, a disorder in which uterine tissue develops outside the uterus, increases ovarian cancer risk.

Obesity: Obesity may raise ovarian cancer risk.

Having one or more risk factors does not guarantee ovarian cancer. Women without risk factors may also get the condition. Ovarian cancer’s causes and risk factors are still being studied.

If you’re worried about ovarian cancer, go to a doctor or genetic counsellor who can evaluate your personal and family history.

Diagnosis

Medical history and physical exam: Your doctor will discuss your symptoms, medical history, and ovarian cancer risk factors. To inspect your ovaries’ size and shape, they’ll do a pelvic exam.

Imaging tests: Transvaginal ultrasound, abdominal ultrasound, and pelvic CT scans may reveal ovarian masses and abnormalities. These tests can detect ovarian tumour size, location, and features.

Blood tests: Ovarian cancer patients commonly have increased CA-125 protein levels. This test may assist diagnose ovarian cancer, although CA-125 levels can also be raised in other illnesses.

Ovarian cancer is diagnosed through biopsy. The ovary or suspicious region is sampled for lab analysis. Laparoscopy, laparotomy, or image-guided fine-needle aspiration may conduct the biopsy.

A pathologist analyses the biopsy sample under a microscope. The pathologist will search for signs of ovarian cancer cells and may use immunohistochemistry to confirm the diagnosis and identify the subtype.

Ovarian cancer staging determines disease severity and treatment options. Staging may use chest X-rays, PET-CT scans, and surgical exploration to determine cancer spread.

If you have symptoms or concerns regarding ovarian cancer, see a doctor or gynecologic oncologist. They will help you diagnose and choose a therapy.

Types

Epithelial ovarian cancer accounts for 90% of cases. Ovarian surface cells generate it. Epithelial ovarian cancer subtypes include serous, mucinous, endometrioid, clear cell, and undifferentiated.

Germ cell tumours develop from ovarian egg-producing cells. These tumours are frequent in younger women and have a favourable prognosis. Dygerminoma, teratoma, yolk sac tumour, embryonal carcinoma, and choriocarcinoma are germ cell tumours.

Sex cord-stromal tumours grow from connective tissue cells that keep the ovary together and create female hormones. Granulosa and Sertoli-Leydig cell tumours are sex cord-stromal tumours.

Small cell carcinoma of the ovary (SCCO): This uncommon and aggressive ovarian cancer often affects young women. Specialised therapy is needed for its bad prognosis.

Ovarian cancer therapy depends on kind and stage. Ovarian cancer type determines therapy and prognosis. Histopathology, immunohistochemistry, and molecular testing are used to diagnose and classify tumours.

If you or someone you know has ovarian cancer, visit a healthcare expert, such as a gynecologic oncologist, who may prescribe therapy depending on the disease’s kind and stage.

Treatment

Surgery: Ovarian cancer is often treated by removing the tumour and surrounding tissues. Depending on the malignancy stage, surgery may remove one or both ovaries, the fallopian tubes, the uterus (complete hysterectomy), adjacent lymph nodes, and other afflicted tissues in the abdomen or pelvic. Debulking surgery removes as much tumour as feasible to optimise following therapies.

Chemotherapy: Drugs destroy cancer cells. It is commonly used after surgery to kill any leftover cancer cells and prevent recurrence. Ovarian cancer treatment is usually given intravenously but may be delivered intraperitoneally. Ovarian cancer stage and subtype determine chemotherapy medications and duration.

Targeted therapies: Cancer-targeting drugs spare healthy cells. Targeted medicines like PARP inhibitors have showed promise in treating ovarian cancer with BRCA gene mutations. These medicines kill cancer cells by preventing DNA repair.

Radiation therapy: X-rays or other radiation destroy cancer cells. It is seldom used to treat ovarian cancer, however it may be advised for palliative reasons or to target localised malignancy.

Ovarian cancer patients may participate in clinical studies. Clinical trials test novel medicines or combinations. They provide access to novel treatments and enhance ovarian cancer research.

Ovarian cancer treatment generally involves gynecologic oncologists, medical oncologists, radiation oncologists, and other experts. The stage and kind of cancer, the patient’s health, and their choices will determine the treatment approach.

To choose the best ovarian cancer therapy, review choices, side effects, and results with the healthcare team.

Prevention

Some methods may minimise the risk of ovarian cancer or identify it early. Precautions include:

Oral contraceptives minimise ovarian cancer risk. Discuss oral contraceptives with your doctor.

Pregnancy and breastfeeding: Ovarian cancer risk may be decreased in women who have had one or more full-term pregnancies and nursed.

Ovarian cancer risk may be reduced by tubal ligation or hysterectomy. These operations have long-term effects and should be addressed with a doctor.

Genetic counselling and testing: If your family has ovarian or breast cancer or other risk factors, consider genetic counselling and testing. Genetic testing may detect BRCA1 and BRCA2 gene mutations that raise ovarian cancer risk. Genetic risk may inform screening and prevention.

Ovarian cancer symptoms include stomach bloating, pelvic discomfort, and changes in urine or stool habits. Consult a doctor if symptoms continue. Gynecologic and pelvic exams may also discover problems early.

Healthy living: A healthy lifestyle may reduce the risk of numerous malignancies, including ovarian cancer. This includes eating a balanced diet full of fruits, vegetables, and whole grains, exercising regularly, keeping a healthy weight, and not smoking.

These preventative actions may lower ovarian cancer risk, but they do not guarantee protection. Ovarian cancer may develop in women with or without risk factors. Early detection and treatment need regular monitoring and awareness.

A healthcare expert or gynecologic oncologist may evaluate your risk of ovarian cancer and provide personalised advice.

Medication

Ovarian cancer medicines exist. Chemotherapy and targeted treatments employ these drugs. These ovarian cancer drugs are regularly used:

Ovarian cancer treatment frequently includes chemotherapy. Chemotherapy may include:

Platinum-based drugs: Cisplatin, carboplatin. These medications destroy fast-dividing cancer cells.

Taxanes: Platinum-based medications often combine with paclitaxel or docetaxel. Taxanes impede cell division.

Doxorubicin, topotecan, and gemcitabine may be employed depending on the scenario.

Targeted therapies: These newer drugs target cancer cells by blocking tumor-growth chemicals or pathways. PARP inhibitors may help ovarian cancer patients with BRCA gene mutations. Olaparib, niraparib, and rucaparib are PARP inhibitors for ovarian cancer.

Angiogenesis inhibitors: These medications prevent tumor-feeding blood vessels from forming. Angiogenesis inhibitor bevacizumab is used alongside chemotherapy for advanced ovarian cancer.

Hormone therapy: Granulosa cell tumours are hormone-sensitive ovarian cancers. To suppress hormone effects on the tumour, aromatase inhibitors (letrozole) or anti-estrogens (fulvestrant) may be utilised.

Immunotherapy: An new cancer treatment, immunotherapy stimulates the immune system to recognise and fight cancer cells. In ovarian cancer patients with certain molecular features, immune checkpoint medicines like pembrolizumab have showed potential.

FAQs

Ovarian cancer risk factors?
A: Family history of ovarian or breast cancer, BRCA1 and BRCA2 gene mutations, age, personal cancer history, and reproductive variables are risk factors for ovarian cancer.

Ovarian cancer symptoms?
Early-stage ovarian cancer may not have symptoms. As the condition advances, stomach bloating, pelvic discomfort, trouble eating or feeling full, urine or bowel problems, exhaustion, and back pain are frequent symptoms.

Ovarian cancer diagnosis: how?
A: Diagnosis usually requires medical history review, physical examination (including pelvic exam), imaging tests (ultrasound, CT scan), blood tests (such as CA-125), and a biopsy to study the ovarian tissue under a microscope.

Ovarian cancer therapy options?
A: Surgery to remove the tumour and associated tissues, chemotherapy to kill cancer cells, tailored medicines that target cancer cells, radiation therapy in certain circumstances, and clinical trials are treatment possibilities.

Ovarian cancer prevention?
A: Ovarian cancer cannot be prevented, although several steps may lower the risk. Oral contraceptives, full-term pregnancies, nursing, tubal ligation or hysterectomy (consult with a healthcare expert), genetic counselling and testing if high risk, and a healthy lifestyle are all options.

Ovarian cancer prognosis?
A: Ovarian cancer prognosis varies on stage of diagnosis, tumour type and grade, patient age and health, and therapy response. Early detection and treatment improve results.

Ovarian cancer: genetic?
A: BRCA1 and BRCA2 gene mutations may cause ovarian cancer. Most ovarian cancer instances are sporadic and unrelated.

Ovarian cancer instances differ, therefore it’s best to visit a doctor for personalised advice.

Myth vs fact

Myth: Older women get ovarian cancer.
Fact: Young women may have ovarian cancer, even though the risk rises with age. All women should know the signs and seek medical help if needed.

Myth: Ovarian cancer usually shows signs.
Early-stage ovarian cancer may not create symptoms. The symptoms are unclear and sometimes misdiagnosed. Ovarian cancer is typically detected late. If symptoms continue or worsen, visit a doctor.

Myth: Hysterectomy prevents ovarian cancer.
Fact: Hysterectomy reduces the chance of some forms of ovarian cancer, but it does not eradicate it. Fallopian tubes and residual ovarian tissue may develop ovarian cancer. Discuss surgery risks and advantages with a doctor.

Myth: Ovarian cancer invariably kills.
Ovarian cancer is not always lethal. Ovarian cancer prognoses vary on stage, tumour kind and grade, and therapy response. Early detection and treatment increase success rates.

Myth: Screenings detect ovarian cancer easily.
Fact: There are no accurate ovarian cancer screening tests. Imaging techniques cannot diagnose ovarian cancer due to its vague symptoms. It’s vital to know the signs and get medical help if needed.

Myth: Rare ovarian cancer.
Ovarian cancer is rare but not uncommon. It is a prevalent gynaecological malignancy and a primary cause of cancer mortality in women. Know the hazards, symptoms, and preventative strategies.

terms

Ovarian cancer develops in the ovaries, which generate eggs.

Epithelial cells: Organ-lining cells, including ovaries. These cells cause epithelial ovarian cancer, the most prevalent kind.

Ovarian germ cells produce eggs. These cells cause ovarian germ cell tumours.

Fallopian tubes: Ovaries-uterus tubes. They transfer eggs and may cause ovarian cancer.

Tumour: An unregulated cell growth mass of tissue. Ovarian cancer involves ovarian growth.

Metastasis: Cancer spreading from its origin. Ovarian cancer may spread.

CA-125: Blood-measurable cancer antigen 125. CA-125 levels may indicate ovarian cancer, although they are not diagnostic.

BRCA1/BRCA2: Genes that create tumor-suppressing proteins. These gene mutations enhance ovarian and breast cancer risk.

Debulking Surgery: Removing as much tumour as feasible. Initial advanced ovarian cancer therapy generally includes it.

Chemotherapy: Drug treatment of cancer cells. Ovarian cancer treatments include intravenous or abdominal chemotherapy.

High-energy radiation to destroy cancer cells or shrink tumours. Radiation therapy may be used to treat ovarian cancer in rare circumstances.

Immunotherapy: Induces the immune system to attack cancer cells. It’s an emerging ovarian cancer therapy.

PARP Inhibitors: Anti-PARP drugs. PARP inhibitors cure BRCA-associated ovarian cancer.

Angiogenesis inhibitors prevent new blood vessel growth. They may be used with chemotherapy for advanced ovarian cancer.

Hormone therapy slows or stops cancer cell proliferation. It may treat rare hormone-sensitive ovarian cancers.

Clinical trials: Studying novel medicines or combinations. Clinical trials provide new treatments and advance ovarian cancer research.

Surveillance: Post-treatment surveillance for ovarian cancer recurrence.

Palliative Care: Treatment of advanced ovarian cancer symptoms and quality of life.

Biopsy: Diagnostic tissue sampling. Biopsies may detect and characterise ovarian cancer.

Staging: Assessing cancer spread. Size, lymph node involvement, and metastatic stage ovarian cancer.

Epithelial ovarian cancer and primary peritoneal carcinoma are comparable.

Rare fallopian tube cancer. Epithelial ovarian cancer therapy and prognosis are comparable.

Blood test for BRCA1 and BRCA2 gene mutations. It predicts ovarian and breast cancer.

Chemoresistance: Cancer cells’ resistance to chemotherapy medicines, which complicates treatment.

Genetic counselling: Informs people about their genetic risk for illnesses like ovarian cancer and their testing choices.

Recurrence: Cancer returning after therapy. Recurring ovarian cancer requires further therapy.

Prognosis: A disease’s expected prognosis, including survival and recovery. Stage, grade, and therapy response affect ovarian cancer prognosis.

Postmenopausal women utilise hormone replacement therapy (HRT) to replenish oestrogen and progesterone. HRT may treat menopausal symptoms, however ovarian cancer risk should be evaluated with a doctor.

Risk-Reducing Surgery: Ovarian cancer prevention surgeries such bilateral salpingo-oophorectomy.

Gynecologic oncologists diagnose and treat gynecologic malignancies, including ovarian cancer.

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