Ovarian Cancer: Symptoms, Causes, Diagnosis and Treatment

Ovarian cancer is the fourth most common cancer in women. Ovarian cancer is when the normal cells in the ovary change and grow to form a tumour. Because the ovaries are located deep within the pelvis, an expanding tumour there might harm neighbouring organs. This can include the bladder or the bowel. The ovaries are two tiny oval-shaped organs on each side of your womb in your lower abdomen (pelvis). The ovaries produce oestrogen and progesterone, two female sex hormones that regulate menstrual cycles. There are several types of ovarian cancer, but the most common is epithelial ovarian cancer.

Types of Ovarian Cancer

1. Epithelial ovarian cancer - Ovarian cancer most frequently affects women between the ages of 45 and 59. This type of ovarian cancer develop from the surface (epithelium) of the ovary. Fallopian Tube Cancer and Primary Peritoneal Cancer are also included within this designation. The most frequent variety of epithelial ovarian cancer is High-Grade Serous Ovarian Cancer (HGSOC). The following are some of the rarer types of ovarian cancer:

• Serous Carcinomas, including Primary Peritoneal and Fallopian Tube
• Clear cell carcinoma
• Endometriod
• Mucinous

2. Germ cell ovarian cancer - It occurs when the ovaries reproductive cells are affected, and it is quite uncommon.

3. Stromal cell ovarian cancer - Ovarian cancer that originates from connective tissues is exceedingly uncommon.

4. Small cell ovarian carcinoma (SCCO) - The cells in SCCO are not yet clear whether they originated from ovarian epithelial cells, sex-cord stromal cells, or germ cells. It is a very rare form of ovarian cancer.

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Stages of Ovarian Cancer

The tests and scans you will undergo to determine the type and stage of your cancer will provide some information about the size of your tumor and whether it has spread (the stage). The FIGO Staging system to assess ovarian cancer. The following is a summary of the system:

• Stage 1: The cancer is only in the ovaries. Surgery is the main treatment but some women need chemotherapy.
• Stage 2: The cancer has spread outside the ovaries and is now found within the pelvic region. Treatment is surgery and chemotherapy.
• Stage 3: The cancer has spread outside the pelvis into the abdominal cavity or surrounding lymph nodes. Treatment is surgery and chemotherapy.
• Stage 4: The disease has spread to other parts of the body, such as the liver or lungs. The primary therapies are chemotherapy (typically first) and surgery.

Symptoms of Ovarian Cancer

Ovarian cancer is often difficult to recognize since it does not always produce obvious symptoms. Most common symptoms include:

• bloating
• pelvic or abdominal pain
• difficulty eating or feeling full quickly
• urinary urgency or frequency
• Vague indigestion or nausea
• changes in menstrual patterns
• Pain during sex
• Irregular periods or bleeding after menopause
• Tenderness in your stomach, back, or legs accompanied by aching or burning.

Causes of Ovarian Cancer

• family history of ovarian cancer
• Women having ovarian cysts
• being overweight or obese
• using fertility treatments
• taking hormone therapy after menopause
• Having a personal history of breast cancer or cervical cancer
• Women dealing with hormonal imbalance, such as increased levels of estrogen or androgen hormones

Diagnosis and testing for Ovarian Cancer

Ovarian cancer screening is a procedure in which you are examined for the disease without having any symptoms. There is no one-size-fits-all test for ovarian cancer. A physical examination, ultrasonography, blood tests, and biopsy are all used to determine the chances of having ovarian cancer.

Ovarian cancer risk may be higher in women who have a faulty BRCA gene mutation in their family. A referral to a gynaecologist for an ultrasound scan and a tumour-marker blood test called a ca125 is required if you want to be diagnosed with ovarian cancer. Every year after the age of 35, women at increased risk will be suggested the tests.

Tests performed for identifying ovarian cancer include:

• Ultrasound scan: A camera is positioned over your abdomen, to provide a picture of the tissues within your body. It may show any abnormalities.
• Transvaginal ultrascopy: A tiny probe is inserted into your vagina to obtain clear pictures of your womb and ovaries.
• Laproscopy: A tiny incision is made in your abdomen, and a slender flexible tube with a camera attached to it is inserted. it is used to obtain images of your ovaries, which are then looked at by a doctor (biopsy).
• CA125 blood test: A substance called CA125 is present in the blood of some women. It is a tumor marker for ovarian cancer, although it isn't present in all patients with this disease.
• Biopsy: A sample of the cells is removed and examined in a lab for signs of cancer. During a laparoscopy, the biopsy can be performed.

Treatments and Prognosis for Ovarian Cancer

The prognosis and treatment options depend on the following:

• The stage of the disease
• What sort of tissue does the tumor consist of
• The tumor's diameter
• The patient’s general health

Ovarian low malignant potential tumors have a good prognosis, especially if the tumor is discovered early.

1. Surgery followed by chemotherapeutic treatment is known as primary surgery and adjuvant chemotherapy.

2. Chemotherapy before and after surgery, also known as neoadjuvant chemotherapy with interval surgery (typically after 3 cycles of chemotherapy), is used to prepare patients for surgery by reducing the size of cancerous areas.

• In some cases, you may be eligible for HIPEC if surgery is done at the right time and type of ovarian cancer. The chemotherapy is placed within the abdomen for approximately 90 minutes after surgery, then removed before closure of the abdomen and called Hyperthermic Intraperitoneal Chemotherapy (HIPEC). In carefully selected women, HIPEC can extend survival and decrease surgical complications, according to several studies. However, it is not suitable for every patient.
• Chemotherapy uses anti-cancer drugs to destroy cancer. The drugs circulate throughout the body in the bloodstream. The most commonly used drugs are carboplatin and paclitaxel. Typically, you have chemotherapy once every three weeks, with the chemotherapy medicines on day 1 followed by a rest period to allow you to recover from any adverse effects. Each 3 week period is called a cycle of treatment.
• Targeted Cancer Drugs - It targets specific cells and modifies how they function in order for the body to combat cancer growth. They can assist women who have advanced ovarian cancer that has recurred after prior therapy. These treatments, while not curing the disease, can help to control it and allow some people to live longer by helping them live with their cancer.

If you experience any of these symptoms, it is important to see your doctor right away. ovarian cancer can be a very serious disease, but early diagnosis and treatment can often lead to a successful outcome.