A Brief Overview About Ovarian Cancer

As we all know that ovaries are present in women. On each side of the uterus, there is one found. They constitute a part of the reproductive system in females and produce sex hormone progesterone and estrogen and also produce eggs. 

These almond-shaped and small organs can result in cancer beginning in the cells among its three layers:

Epithelial Layer: It is a thin layer of tissues that covers the ovaries’ outside.

Stromal Layer: Consists of ovaries and produces the hormones.

Germ Layer: Makes the eggs.

Signs and Symptoms

Ovarian cancer is known for its absence of presenting symptoms. But, this disease can lead to irritable bowel syndrome, premenstrual syndrome, and urinary tract infection. 

Common signs and symptoms of ovarian cancer are:

• Abdominal swelling or bloating
• Pelvic discomfort, pain, and pressure
• Unexpected and abnormal vaginal bleeding
• Early satiety
• Weight loss
• Alteration in the bowel and urinary habits
• Fatigue
• Lower back pain
• Shortness of breath, and 
• Pain during intercourse

Risk Factors

There is no known cause of ovarian cancer. But, several risk factors are there, which lead to the development of cancer. 

The most common risk factors for ovarian cancer are:

Increasing Age: 50% of ovarian cancers are detected in females with 63 years of age and older.

Being Obese and Overweight: Ovarian cancer is common in females having BMI (Body Mass Index) equal to 30 kg/m2 or more. 

Family History: If a woman’s sister, aunt, mother, or grandmother ever had this cancer, there is more probability of being diagnosed with it. 

Genetic Mutations: The BRCA2 and BRCA1 genes increase the chances of breast cancer; however, increase the probability of ovarian cancer. 

It is essential to remember that if you have any of these factors, it does not mean that you will be detected with cancer. A lot of females will get ovarian cancer without any of the above risk factors. 

Screening

Screening is a test which is used for finding out disease before causing any symptoms. In other words, the screening test aims to diagnose the early disease when the treatment is curable. 

In addition to a pelvic examination, the screening test for this cancer are:

The CA-125 Blood Test: Measures the CA-125 amount in the blood. There is an increased level of protein with a lot of women having ovarian cancer. 

Transvaginal Ultrasound: It uses the sound waves for diagnosing the ovarian tumors. 

Prevention

Nowadays, there is no way of preventing ovarian cancer. But, there are measures you can do for reducing the probability. The measures are:

• Maintaining a healthy weight
• Oral contraceptives
• Avoiding HRT – particularly estrogen 
• Giving Birth
• Gynaecological surgery

When to See a Doctor

If you are facing any signs and symptoms of cancer, you can fix an appointment with your physician to talk about your concerns. 

As per research in the American Journal of Preventive Medicine, the symptoms with an increased correlation to ovarian cancer included: 

• Abdominal bloating
• Pelvic/abdominal pain
• Abdominal mass
• Abdominal distention, and 
• Decrease in appetite

Diagnosis

If ovarian cancer is diagnosed early, there are increased chances of successful treatment. 

The primary steps in the diagnosis of ovarian cancer must include a detailed physical examination and medical history by your doctor. 

Medical History

The doctor may inquire you a series of questions as a part of medical history, like:

• Symptoms and their durations
• The severity of symptoms and their control if any
• Family history of ovarian or breast cancer
• Pregnancy
• Any surgery or HRT

Physical Examination

The next step is a physical examination. It includes calculation of rectal examination and BMI, must be carried to see any signs and symptoms of the disease. There is a particular focus on the pelvic exam. The doctor will do a gloved pelvic examination which checks your external genitalia, pelvic organs, cervix and vagina for abnormalities. 

The Pap test is not used for screening or diagnosing ovarian cancer. Hence it is not a part of treatment. 

Blood and Imaging Tests

If the suspicion of your doctor remains piqued, the doctor may ask you to go for more test such as blood and imaging tests. 

There is an increase in CA-125 with ovarian cancer. Therefore this blood test is highly suggested. Other tests include:

• Alpha-fetoprotein
• Human chorionic gonadotropin
• Human epididymis protein 4
• Lactate dehydrogenase
• Estrogen Levels
• Inhibin A/B
• Testosterone Levels

All of the above biomarkers have the chances to be increased in the case of ovarian cancer. 

The imaging tests that are beneficial for diagnosing the ovarian cancer are:

• CT Scan (Computed Tomography Scan)
• Transvaginal Ultrasound
• PET Scan (Positron Emission Tomography)
• MRI (Magnetic Resonance Imaging)

Stages

The stage of disease gives an understanding of how much it spread from the site of the primary tumor. As a result, the ovarian cancer stage is among is the essential factors of the treatment plan. 

The below-mentioned factors are considered while determining the stage:

• Tumor size
• Whether the tumor has invaded tissues or not
• Whether cancer has undergone metastasis or not

Depending on the observations, there are four stages of ovarian cancer:

Stage I: Limited to one or both ovaries

Stage II: Limited to the pelvis

Stage III: Reach to the abdomen, including the lymph nodes or organs

Stage IV: Reach to the distant organs or parts of the body, involving lymph nodes. 

Types

As mentioned above, three different types of cells consist of ovary – the germ, stromal, and epithelial. 

The three major types of ovarian cancer are:

Germ Cell Carcinoma: It is a rare type of ovarian cancer. It includes less than 2% of the cases.

Stromal Carcinoma: This cancer is less common. It is almost 7%, and it is diagnosed at an early stage.

Epithelial Carcinoma: it is the most common type. This Carcinoma is 90% of all the cases. 

Treatments

Treatment options of ovarian cancer may be categorized as systemic treatments and local treatment. Radiation therapy and surgery are included in the local procedures, while systemic treatment includes hormone therapy, targeted therapy, and chemotherapy. 

The Verdict

In the U.S., ovarian cancer is the leading cause of death in women. The earlier diagnosis leads to better treatment. There is a need for more research, which can lead to more productive screening, prevention, and treatment programs.