The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries, each about the size of an almond, produce eggs (ova) as well as the hormones estrogen and progesterone. Ovarian cancer is a type of cancer that begins in the ovaries. It when abnormal cells in the ovary begin to multiply out of control and form a tumor. If left untreated, the tumor can spread to other parts of the body and cause more problems.
The rate at which women are diagnosed with ovarian cancer has been slowly falling over the past 20 years. This cancer mainly develops in older women. About half of the women who are diagnosed with the cancer are 63 years or older. It is more common in white women than African-American women. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 78, and her lifetime chance of dying from the disease is about 1 in 108.
Causes and Risk Factors
Ovarian cancer ranks as the 5th leading cause of cancer-related deaths in women, accounting for more deaths than any other cancer of the female reproductive system.
It’s not clear what causes ovarian cancer, though doctors have identified factors that can increase the risk of the disease.
In general, cancer begins when a cell develops errors (mutations) in its DNA. The mutations tell the cell to grow and multiply quickly, creating a mass (tumor) of abnormal cells. The abnormal cells continue living when healthy cells would die. They can invade nearby tissues and break off from an initial tumor to spread elsewhere in the body (metastasize).
Risk factors for developing ovarian cancer include:
- Older age: This cancer can occur at any age but is most common in women ages 50 to 60 years.
- Inherited gene mutations: A small percentage of ovarian cancers are caused by gene mutations you inherit from your parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer.
- Family history: People with two or more close relatives with ovarian cancer have an increased risk of the disease.
- Estrogen hormone replacement therapy: especially with long-term use and in large doses.
- Age when menstruation started and ended: Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of the cancer.
What Are The Early Symptoms?
Many women easily overlook the early symptoms of ovarian cancer because they’re similar to other common illnesses and they also tend to come and go. However, it is important that the condiyion be diagnosed early enough so as to commence treatment as soon as possible. The early symptoms that can help detect this cancer in its early stages may include:
- Abdominal bloating, pressure, and pain.
- Abnormal fullness after eating
- Increase in frequency of urination.
- Having an increased urge to urinate.
If you have any of these symptoms, endeavour to see your doctor to properly examine the cause of your symptoms. Ovarian cancer can also cause other symptoms, such as:
- back pain.
- menstrual irregularities.
- painful intercourse.
- dermatomyositis (a rare inflammatory disease that can cause skin rash, muscle weakness, and inflamed muscles).
These symptoms may occur for any number of reasons. They aren’t necessarily due to ovarian cancer. Many women have some of these problems at one time or another. These types of symptoms are often temporary and respond to simple treatments in most cases.
How is Ovarian Cancer Diagnosed?
Most women have advanced disease at the time of diagnosis because ovarian cancer may have no symptoms in its early stages, or the symptoms may be missed. In order to diagnose you, your doctor will evaluate your symptoms, carryout physical examination and may also do the following tests:
- Transvaginal ultrasound (TVUS): This is a type of imaging test that uses sound waves to detect tumors in the reproductive organs, including the ovaries. However, TVUS can’t help your doctor determine whether tumors are cancerous.
- Abdominal and pelvic CT scan: If you’re allergic to dye, they may order a pelvic MRI scan.
- Blood test: to measure cancer antigen 125 (CA-125) levels. This is a biomarker that is used to assess treatment response for ovarian cancer and other reproductive organ cancers. However, menstruation, uterine fibroid, and uterine cancer can also affect levels of CA-125 in the blood.
- Biopsy: This involves removing a small sample of tissue from the ovary and analyzing the sample under a microscope. A biopsy is the only way your doctor can confirm whether you have ovarian cancer.
How Ovarian Cancer is Treated
The majority of women with the disease fail conventional chemotherapy.
However, personalized immunotherapy using the patient’s tumor to derive cancer vaccines and cell–based therapeutics is a promising new approach to treat ovarian cancer. Generally, treatment will depend on many factors, including the type, stage, and grade of the cancer. The doctor will also consider the individual’s age and overall health, their personal preferences, as well as accessibility and affordability of treatment.
Some of the treatment options available are:
- Surgery: The choice will depend on the type of cancer and how far it has spread. Surgical options include a hysterectomy, removing one or both ovaries, and removing affected lymph nodes. A doctor will discuss suitable options with the individual.
- Chemotherapy: These drugs aim to kill cancer cells. If a person takes chemotherapy drugs by mouth or as an injection or infusion, they will affect the whole body. Another option is intraperitoneal chemotherapy. In this case, a tube delivers the drug directly to the body area affected by cancer. Chemotherapy can have widespread adverse effects, especially if it affects the whole body.
- Targeted therapy: Some treatments target specific cells that help promote cancer growth. Examples include monoclonal antibody therapy and angiongenesis inhibitors. Targeted therapy aims to limit the adverse effects by targeting specific functions.
- Radiation therapy: This technique uses X-rays to kills cancer cells. One way to do this is by introducing a radioactive liquid into the peritoneum. This may help people with advanced ovarian cancer.
- Immunotherapy (biotherapy): This aims to boost the immune system’s ability to defend the body against cancer. Vaccine therapy involves injecting substances that will find and kill a tumor. It may help people with advanced ovarian cancer.
Can Ovarian Cancer Be Prevented?
There are no proven ways to totally eliminate your risk of developing ovarian cancer. However, there are steps you can take to lower your risk. Factors that have been shown to lower your risk of developing ovarian cancer include:
- taking oral birth control pills.
- surgical procedures on your reproductive organs (like a tubal ligation or hysterectomy).
- American Cancer Society – Can ovarian cancer be found early?
- Laughlin-Tommaso SK. (2018). Can ovarian cancer be detected by a Pap test?
- Herzog TJ, et al. (2016). First-line chemotherapy for advanced (stage III or IV) epithelial ovarian, fallopian tubal, and peritoneal cancer.