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Ovarian Cancer - Causes, Symptoms,Types, Risk Factors, Diagnosis, Treatment, and Prognosis

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Ovarian Cancer - Causes, Symptoms,Types, Risk Factors, Diagnosis, Treatment, and Prognosis

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Ovarian cancer is a common type of cancer that can affect women and is characterized by abnormal cell growth in the ovaries. Read this article to know more.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Neha Rathod

Published At March 25, 2021
Reviewed AtSeptember 11, 2023

What Is Ovarian Cancer?

Ovarian cancer refers to the condition where there is abnormal cell growth in the ovaries. It is a type of cancer that is very specific to the female reproductive system. Each female possesses a pair of ovaries, with one located on each side of the uterus. Ovaries are the specialized organs that produce eggs. Despite its small size, it plays a significant role in maintaining hormonal equilibrium by producing progesterone and estrogen.

If ovarian cancer is undetected or untreated, then it can spread to other parts of the abdomen and pelvis. After the spreading has occurred, the intensity of ovarian cancer becomes very hard to treat. A specialized treatment protocol will be recommended in these cases.

What Are the Causes of Ovarian Cancer?

The exact cause of the occurrence of ovarian cancer remains unidentified. After going through a lot of medical research, it has been assumed that genetic mutation in the DNA(Deoxyribonucleic Acid) is a cause of ovarian cancer. A familial history of ovarian cancer can also cause this condition. Any alterations in the gene might result in abnormal proliferation of the cells. This might result in the accumulation of an abnormal mass of the tumor. These abnormal cells should be easily eliminated from the body if the individual is healthy.

In unhealthy conditions, abnormal cells continue to survive the individual and result in severe conditions and complications. The most severe complication occurs when cancer starts spreading to other tissues by metastasis(a process by which cancer spreads to other sites distant from the site of origin).

What Are the Symptoms of Ovarian Cancer?

The various symptoms associated with ovarian cancer are:

  • Rapidly experiencing a sensation of fullness upon eating.
  • Abdominal bloating or swelling.
  • Discomfort or pain in the pelvis area.
  • Weight loss.
  • Increased urge to urinate.
  • Alterations in bowel habits might result in constipation.
  • Bleeding from the vagina.
  • Nausea and vomiting.
  • Abnormal patterns of periods.
  • Complete loss of appetite.
  • Back pain.

In other cases, certain severe symptoms could be noticed. They are:

  • Heartburn.
  • Fatigue.
  • Pain during sexual intercourse.
  • An inflammatory condition in the skin might result in skin rashes. This condition is known as dermatomyositis.

There are also possibilities for these symptoms to occur due to some other causes. It does not necessarily indicate the presence of ovarian cancer. For each woman, the signs and symptoms might vary due to hormonal differences and varied menstrual patterns. Some of the symptoms mentioned above might only be in mild degrees, so they can be treated very well.

What Are the Stages of Ovarian Cancer?

The stages of ovarian cancer are categorized below:

  • Stage 1: There are three sub-categories of stage 1. They are:

Stage 1A: The involvement of cancer occurs only in one ovary.

Stage 1B: The involvement of cancer occurs only in both ovaries.

Stage 1C: The cancer involvement is seen in tissues that stay outside the ovary.

  • Stage 2: In stage 2, cancer starts spreading to other structures around the pelvis. There are two sub-categories in this stage.

Stage 2A: In this stage, the spreading of the cancer is seen in the fallopian tubes or the uterus.

Stage 2B: In this stage, the spreading of the cancer is seen in the rectum or bladder.

  • Stage 3: There are three sub-categories for stage 3.

Stage 3A: The cancer involvement is seen up to the lining of the abdomen. There is also the involvement of the lymph nodes near the abdomen.

Stage 3B: Cancer that has spread to the other regions will become visible lesions and measure less than two centimeters.

Stage 3C: Cancer would have developed to the measurement of three or four inches. The external parts of the liver and spleen are involved. There is no involvement seen in the internal structures of the spleen and liver.

  • Stage 4: This is the most severe and last stage of cancer. There are two sub-categories in this stage. They are:

Stage 4A: In this stage, the cancer cells would have built up in the fluid that is found around the lungs.

Stage 4B: There is severe involvement of cancer in other regions like the brain, spleen, and liver.

How Does Ovarian Cancer Differ From Ovarian Cyst?

The majority of ovarian cyst is only benign cysts. A small part of the ovarian cysts can be cancerous. An ovarian cyst is nothing but a collection of air or fluid in the ovary. The fluid can be collected in the areas surrounding the ovary also. As a result of the normal pattern of ovulation, ovarian cysts might occur.

When the eggs are released from the ovary, any mild symptoms might occur. If ovulation does not happen at all, then it is an indication that the ovarian cyst is in a dangerous condition. It is a normal phenomenon for women to stop ovulating after the period of menopause. This menopause usually happens after 40 to 45 years of age.

If ovulation stops at a much earlier stage, then it is a red flag. The cyst can be treated easily by exercises and medications. Ovarian cancer cannot be cured with the help of exercise, so a patient will be recommended for cancer treatment modalities like chemotherapy and radiation therapy.

What Are the Types of Ovarian Cancer?

The various types of ovarian cancer are:

1. Epithelial Tumors: It begins in the thin layer of tissue. It encloses the ovaries. Greater than 90 percent of ovarian cancers are identified to be epithelial tumors.

2. Stromal Tumors: It starts in the ovarian tissue. It affects the hormone-producing cells. These cancers are usually identified at an earlier stage compared to ovarian tumors. Only a few cases are reported to be stromal tumors.

3. Germ Cell Tumors: Younger women are most commonly affected by this type of cancer. They are found in egg-producing cells.

What Are the Risk Factors for Ovarian Cancer?

The risk factors linked with ovarian cancer are:

  • Age: Age plays a vital role in deciding the severity of ovarian cancer. There are possibilities for the condition of ovarian cancer to manifest at any age. The highest incidence is seen in women who are more than 50 to 60 years of age.
  • Hormone Replacement Therapy: Patients who have a hormonal imbalance or dysfunction of a particular hormone would be recommended to go for hormone replacement therapy.
  • Genetic Mutations: If genetic mutations are identified in the breast cancer gene, this might increase the risk of ovarian cancer. Both breast cancer gene one and breast cancer gene two can increase the risk.
  • Lynch syndrome: The occurrence of conditions like Lynch syndrome(a hereditary disorder that increases the risk of cancer development) can increase the risk.
  • Starting Time and Ending Time of the Menstrual Cycle: If an individual begins the menstrual cycle at a much earlier stage, then it serves as a risk factor. Stopping the menstrual cycle at an earlier age can also increase the risk.

How Is Ovarian Cancer Diagnosed?

The doctor might recommend a pelvic examination to identify ovarian cancer. This will help the doctor in identifying the irregularities. If the tumor is very small, then it is difficult to identify them. In such cases, the doctor will recommend the following test.

1. Transvaginal Ultrasound: It is a type of imaging technique that uses the help of soundwaves to identify the tumors that are present in the reproductive organs like the ovaries. The main drawback of this method is that it cannot identify whether the tumor is benign or malignant.

2. CT (Computed Tomography): Scan of pelvis.

3. MRI (Magnetic Resonance Imaging): MRI scan of the pelvis.

4. Blood Examination: Blood examination to count the level of cancer antigen 125. This test is the biomarker for the identification of response from ovarian cancer.

5. Biopsy: A small tissue piece is removed as a sample and sent to the laboratory for diagnosis under the microscope.

What Are the Treatment Options?

The treatment will be regulated by the doctor on the severity of cancer and the age of the patient. The most widely recommended treatment options for ovarian cancer are:

  • Hormone therapy.
  • Targeted drug therapy.
  • Chemotherapy.
  • Surgical options: Surgery is the most successful treatment for ovarian cancer. The goal of the surgery is to remove the tumor along with the complete removal of the uterus.

Is Preservation of Fertility Necessary for Ovarian Cancer Patients?

Patients with ovarian cancer might undergo several treatment procedures that can have a direct influence on the reproductive capacity of the women. It might end up in challenging situations by making it difficult for a woman to get pregnant. Therefore, the preservation of fertility is necessary. Oocyte freezing, embryo freezing, surgery, and ovarian suppression are some options available to preserve fertility.

Conclusion

The prognosis for ovarian cancer is good if the cancer is identified in the initial stages. If it is identified in the later stage, then the patient is expected to survive only for five years approximately. If cancer has not spread to other regions, then the survival rate is more than 90 percent. If the lymph nodes are involved, and there is damage to the liver and lungs, then the prognosis is considered to be poor in such cases.

Frequently Asked Questions

1.

How Can We Survive Ovarian Cancer?

Survival depends on the type and stage of ovarian cancer. Women who are diagnosed to have ovarian cancer below 65 years of age can survive better than older women. Almost 95% of women in stage 1, 70% of women in stage 2, 25% of women in stage 3, and 15% of women in stage 4 will survive ovarian cancer for more than five years when they are diagnosed.

2.

Can Ovarian Cancer Go Undetected For Years?

Women go undetected for ovarian cancer for years, as it is difficult to conclude with its existence. Normally, the ovarian cancer symptoms can be known about five months or only before the diagnosis as their symptoms are vague. Patients often present late in ovarian cancer with related abdominal discomfort, so there is no accurate way to identify in early cases.

3.

What Does Late-Stage Ovarian Cancer Feel Like?

Late-stage ovarian cancer signs are vague abdominal discomfort, frequent urination, low back pain, bloating, altered bowel habits, ascites, kidney pain, constipation, and weight loss. Occasionally, peritoneal deposits are palpable as an omental cake and nodules in the umbilicus.

4.

Where Do You Feel Ovarian Cancer Pain?

The ovary is located in the lower abdomen, and if ovarian cancer persists, a vague abdominal discomfort followed by sharp pains below the belly button and pelvis, bloating sensations, and back pains can be experienced. There will be pelvic pain, and this pain also presents with bloating, which feels like menstrual cramps. So it is crucial to check if women start with any of these symptoms.

5.

How Long Does It Take For Ovarian Cancer to Spread?

Ovarian cancers are not slow-growing. They grow fast and tend to spread sooner. Ovarian cancers are aggressive and spread from one stage to another within a few months. It starts to progress from early stages to advanced stages within a very assertive year than malignancies.

6.

Do We Bleed With Ovarian Cancer?

The signs and symptoms of ovarian cancer are bleeding before, during, or after menstruation which is not normal. Bleeding also mainly occurs after menopause. There will be a discharge from the vagina that is usually blood-colored, clear, and foul-smelling.

7.

Do Cancer Patients Emit an Odor?

There are distinct smells for certain diseases which affect our metabolism. Ovarian cancer does not affect our metabolism, but cancer itself has a metabolism and produces an odor. The vaginal discharges are foul-smelling, and this kind of discharge is suggestive of ovarian cancer as cancer-specific chemicals usually circulate throughout the body.

8.

Do Ovarian Cancer Symptoms Get Worse With Menstruation?

Ovarian cancer affects menstruation. Menstrual periods include the bleeding that is heavier or can be an irregular period. Pain during the period is unusual, and the flow will be more than usual. They usually start to miss the period, and missing the period is an early symptom of ovarian cancer.

9.

How Is Ovarian Cancer Diagnosed?

Initially, a workup for patients with ovarian cancer includes imaging in the form of ultrasound and computed tomography. Serum levels of the tumor markers are often diagnosed. Surgery plays a key role in the diagnosis, staging, and treatment of ovarian cancer. In early cases, palpation, intraoperative washing, and biopsies are generally performed to define the disease extent.

10.

Can Ovarian Cancer Be Treated Without Surgery?

Ovarian cancer can be treated without surgery only for specific patients who have minimal pain and minimal reoccurrence. Radiation therapy is used to treat women with these symptoms as radiation therapy cannot be given for all types of cancer despite their clinical stage.

11.

What Is the Management of Ovarian Cancer?

Surgery followed by chemotherapy with Carboplatin and Carboplatin plus paclitaxel is the treatment of choice. Surgery should include removal of the tumor along with total hysterectomy and omentectomy. Treatments can include further Platinum-paclitaxel combination, Liposomal doxorubicin. These regimens are associated with a response rate of 10 to 40 %, as ovarian cancers do not go away completely.

12.

How to Lower the Risk of Ovarian Cancer?

The risks of ovarian cancer can be reduced by reducing the consumption of oral contraceptives. Women who consume emergency oral contraceptives for a longer duration period of 3 or more years are likely to be affected and develop ovarian cancer.

13.

Can Stage 3 Ovarian Cancer Be Cured?

There are fewer chances to cure stage 3 ovarian cancer as the cancer cells have spread outside the pelvis. The treatment options are surgery and chemotherapy. Chemotherapy can be given after surgery and chemotherapy before and after surgery, depending on the extent of the disease. Bevacizumab with chemotherapy is given in some cases, but all these treatments can shrink the cancer cells and slow down their mutation. It might not be possible to perform surgery as cancer cells have reached different parts of the body.
Dr. Neha Rathod
Dr. Neha Rathod

Obstetrics and Gynecology

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cancerovarian cystsovarian cancer
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