OVARIAN CANCER

Types of Ovarian Cancer

Ovarian cancer can be classified into three main types based on the cells where the cancer originates:

1. Epithelial Ovarian Cancer (EOC):
   • The most common type, making up about 90% of all ovarian cancers. It starts in the cells that cover the outer surface of the ovaries.
2. Germ Cell Ovarian Cancer:
   • This type begins in the cells that produce eggs. It is more common in younger women and can sometimes be treated successfully with surgery and chemotherapy.
3. Stromal Ovarian Cancer:
   • This type begins in the supportive tissue (stroma) of the ovary that produces hormones. It is less common and tends to be diagnosed at an earlier stage.

Risk Factors

Several factors may increase the risk of ovarian cancer, including:

• Age: Ovarian cancer is more common in women over the age of 50, particularly those who have gone through menopause.
• Family history: A family history of ovarian cancer or certain other cancers (such as breast cancer) may increase the risk, especially if there are inherited genetic mutations such as BRCA1 or BRCA2.
• Genetic mutations: Inherited mutations in genes like BRCA1, BRCA2, and others can significantly increase the risk of ovarian cancer.
• Hormonal factors: Use of hormone replacement therapy (HRT) after menopause or long-term use of fertility drugs may slightly increase the risk.
• Reproductive history: Women who have never had children or who had their first child later in life may be at increased risk.
• Endometriosis: Women with endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, may be at higher risk.
• Obesity: Overweight or obese women may have a slightly higher risk of ovarian cancer.

Symptoms

Ovarian cancer is often called a “silent” disease because its symptoms can be vague and are often mistaken for other, less serious conditions. Symptoms may include:

• Abdominal bloating or swelling
• Pelvic pain or pressure
• Difficulty eating or feeling full quickly
• Changes in bowel or urinary habits (e.g., constipation or frequent urination)
• Fatigue
• Unexplained weight loss or weight gain
• Back pain
• Menstrual irregularities

These symptoms can be caused by other conditions, so it is important to consult a healthcare provider for further evaluation, especially if they persist.

Diagnosis

Diagnosing ovarian cancer typically involves:

• Pelvic Exam: A doctor manually examines the ovaries for abnormalities.
• Imaging tests: Ultrasound, CT scans, or MRI may be used to get a clearer view of the ovaries and detect any masses or abnormalities.
• Blood tests: The CA-125 blood test measures the level of a protein often elevated in ovarian cancer. However, CA-125 is not specific to ovarian cancer and can be elevated in other conditions.
• Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis, where a sample of tissue is removed and examined under a microscope.

Stages of Ovarian Cancer

Ovarian cancer is staged based on how far the cancer has spread. The stages range from I to IV:

• Stage I: Cancer is confined to the ovaries.
• Stage II: Cancer has spread to the pelvis, including the uterus or fallopian tubes.
• Stage III: Cancer has spread beyond the pelvis to the abdominal lining or lymph nodes.
• Stage IV: Cancer has spread to distant organs, such as the lungs or liver.

Treatment

Treatment for ovarian cancer typically involves a combination of surgery and chemotherapy, but the specific approach depends on the type and stage of the cancer. Treatment options may include:

• Surgery: The main treatment for ovarian cancer. Surgery usually involves removing the ovaries (oophorectomy), fallopian tubes, uterus, and sometimes surrounding tissue or lymph nodes. In some cases, fertility-sparing surgery may be possible, especially in younger women with early-stage cancer.
• Chemotherapy: After surgery, chemotherapy is often used to kill any remaining cancer cells. It may also be used as the primary treatment in cases where surgery is not possible.
• Targeted therapy: Drugs that specifically target cancer cells or the mechanisms that enable cancer cells to grow may be used in some cases, particularly for cancers with specific genetic mutations, such as those involving BRCA mutations.
• Immunotherapy: A newer approach to treatment that uses the body’s immune system to fight cancer cells. This is still being explored in ovarian cancer treatment.
• Radiation therapy: This is rarely used for ovarian cancer but may be employed in certain cases.

Prognosis

The prognosis for ovarian cancer depends on several factors, including the stage of cancer at diagnosis, the patient’s overall health, and the response to treatment. When ovarian cancer is caught early (stage I), the prognosis is generally better, with a 5-year survival rate of over 90%. However, because the symptoms are often not noticeable in the early stages, many cases are diagnosed at later stages, where the survival rate drops significantly.

Prevention and Early Detection

There is currently no reliable screening test for ovarian cancer in women without symptoms or those at average risk. However, women at high risk due to genetic factors (such as BRCA mutations) may undergo more frequent monitoring with ultrasound and blood tests like CA-125. Some preventive measures may include:

• Oral contraceptives: Some studies suggest that using birth control pills for several years may lower the risk of ovarian cancer.
• Prophylactic surgery: For women with a very high genetic risk (such as those with BRCA mutations), the removal of the ovaries and fallopian tubes may be considered to prevent cancer.

Conclusion

Ovarian cancer is a serious but treatable disease, especially when diagnosed early. Understanding the risk factors, symptoms, and treatment options can help improve outcomes. If you or someone you know is concerned about ovarian cancer, it’s important to seek advice from a healthcare provider for proper evaluation and screening.