Description

Ovarian cancer is a tumor of cells that form in the ovaries. The cells multiply rapidly and can invade and destroy healthy body tissue.

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.

The ovarian cancer treatment usually involves surgery and chemotherapy.

Symptoms

When ovarian cancer is developed, which may not cause any noticeable symptoms. When the ovarian cancer symptoms occur, usually attributed to other, more common conditions.

The signs and symptoms of ovarian cancer may include:

  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Discomfort in the pelvic area
  • Fatigue
  • Back pain
  • Changes in bowel habits, like constipation
  • A frequent need to urinate

When to see a doctor

Make an appointment with your doctor if you have any of the signs or symptoms that worry you.

Causes

It is not clear what causes ovarian cancer, but doctors have identified factors that may increase the risk of the disease.

Doctors know that the ovarian cancer starts when cells in or near the ovaries develop changes (mutations) in the DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes that tell the cells to grow and multiply quickly, creating a mass (tumor) of the cancer cells. The cancer cells to continue living when healthy cells would die. They can invade nearby tissues and break off from an initial tumor to spread (metastasize) to other parts of the body.

Types of ovarian cancer

The type of cell where the cancer begins determines the type of ovarian cancer that you have and help your doctor determine what treatments are best for you. Ovarian cancer include:

  • Epithelial ovarian cancer. This type is the most common. Includes several subtypes, including carcinoma, serous carcinoma and mucinous.
  • Stromal tumors. These rare tumors are generally diagnosed at an earlier stage than other types of ovarian cancer.
  • Germ cell tumors. These rare types of ovarian cancer tend to occur at a younger age.

Risk factors

Factors that may increase your risk of ovarian cancer include:

  • Advanced age. The risk of ovarian cancer increases with age. It is most often diagnosed in older adults.
  • Inherited gene changes.A small percentage of ovarian cancers are caused by gene changes that you inherit from your parents. The genes that increase the risk of ovarian cancer includeBRCA1andBRCA2. These genes also increase the risk of breast cancer. Several other changes in genes are known to increase the risk of ovarian cancer, including changes in genes associated with Lynch syndrome and the genesBRIP1,RAD51CandRAD51D.
  • Family history of ovarian cancer. If you have blood relatives who have been diagnosed with ovarian cancer, you may have an increased risk of the disease.
  • Being overweight or obese. Being overweight or obese increases the risk of ovarian cancer.
  • Postmenopausal hormone replacement therapy. Take the hormone replacement therapy for the control of signs and symptoms of menopause can increase the risk of ovarian cancer.
  • The Endometriosis. Endometriosis is an often painful disorder in which tissue similar to the tissue that lines the inside of the uterus grows outside of the uterus.
  • Age when menstruation began and ended. Onset of menstruation at an early age or after menopause at an older age, or both, can increase the risk of ovarian cancer.
  • Never having been pregnant. If you have ever been pregnant, you may have an increased risk of ovarian cancer.

Inherited gene changes. A small percentage of ovarian cancers are caused by gene changes that you inherit from your parents. The genes that increase the risk of ovarian cancer include BRCA1 and BRCA2 . These genes also increase the risk of breast cancer.

Several other changes in genes are known to increase the risk of ovarian cancer, including changes in genes associated with Lynch syndrome and genes BRIP1 , RAD51C and RAD51D .

Prevention

There is No sure way to prevent ovarian cancer. But there are ways to reduce the risk:

  • Consider the possibility of taking birth control pills. Ask your doctor if birth control pills (oral contraceptives) may be right for you. Birth control pills reduces the risk of ovarian cancer. But these drugs have risks, so discuss whether the benefits outweigh the risks on the basis of your situation.
  • The analysis of risk factors with your doctor. If you have a family history of cancer of the breast and ovary, discuss this with your doctor. Your doctor can determine what this may mean for their own cancer risk. You may be referred to a genetic counselor who can help you decide if genetic testing may be right for you. If you are found to have a change in the gene that increases the risk of ovarian cancer, you may consider surgery to remove the ovaries to prevent cancer.

Diagnosis

Tests and procedures used to diagnose ovarian cancer include:

  • Pelvic exam. During a pelvic exam, the doctor inserts gloved fingers into your vagina and simultaneously presses a hand on your abdomen to feel (palpate) your pelvic organs. The doctor also visually examines your external genitalia, vagina and cervix.
  • Imaging tests. Tests such as ultrasound or computed tomography of the abdomen and pelvis, may help determine the size, shape and structure of your ovaries.
  • Blood tests.Blood tests may include organ function tests that can help determine your overall state of health. Your doctor may also perform a blood test for tumor markers that indicate that the ovarian cancer. For example, a cancer antigen (CA) 125 test can detect a protein that is often found on the surface of ovarian cancer cells. These tests can tell your doctor if you have cancer, but they can provide clues about your diagnosis and prognosis.
  • Surgery. Sometimes, your doctor may not be sure of his diagnosis until they undergo surgery to remove an ovary and have been tried and tested for signs of cancer.
  • The genetic testing. Your doctor may recommend testing a sample of blood to look for changes in genes that increase the risk of ovarian cancer. Knowing that you've inherited a change in your DNA to help your doctor make decisions about your treatment plan. You can share the information with their blood relatives, such as their brethren and their sons, because they also have a higher risk of having those same changes in the genes.

Blood tests. Blood tests may include organ function tests that can help determine your overall state of health.

Your doctor may also perform a blood test for tumor markers that indicate that the ovarian cancer. For example, a cancer antigen (CA) 125 test can detect a protein that is often found on the surface of ovarian cancer cells. These tests can tell your doctor if you have cancer, but they can provide clues about your diagnosis and prognosis.

Once you have confirmed that you have ovarian cancer, your doctor will use the information from the tests and procedures to assign the cancer a stage. The stages of ovarian cancer in the range of 1 to 4, which is often indicated with Roman numerals from I to IV. The lowest stage indicates that the cancer is confined to the ovaries. In stage 4, the cancer has spread to distant areas of the body.

Treatment

Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy. Other treatments may be used in certain situations.

Surgery

Operations to remove the ovarian cancer include:

  • Surgery to remove an ovary. For early-stage cancer that has not spread beyond the ovary, the surgery may involve removal of the affected ovary and its fallopian tube. This procedure may preserve your ability to have children.
  • Surgery to remove both ovaries. If the cancer is present in the ovary, but there are additional signs of cancer, the surgeon may remove both ovaries and fallopian tubes. This procedure leaves your uterus intact, so you may still be able to get pregnant using your own frozen embryos or eggs or eggs of a donor.
  • Surgery to remove both ovaries and the uterus. If your cancer is more extensive, or if you do not want to preserve their ability to have children, the surgeon will remove the ovaries, the fallopian tubes, the uterus, nearby lymph nodes and a fold of abdominal fat tissue (omentum).
  • Surgery for advanced cancer. If the cancer is advanced, your doctor may recommend surgery to remove as much of the cancer as possible. Sometimes chemotherapy is given before or after surgery in this situation.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill fast-growing cells in the body, including cancer cells. Chemotherapy drugs can be injected into a vein or taken by mouth.

Chemotherapy is often used after surgery to destroy any cancer cells that may remain. It can also be used before surgery.

In certain situations, chemotherapy drugs can be heated up and is infused into the abdomen during surgery (chemotherapy intraperitoneal hyperthermic). The drugs are left in place for a certain amount of time before they are drained. Then, the operation has been completed.

Targeted therapy

Targeted drug treatments focus on specific weaknesses present within the cancer cells. By attacking these weaknesses, targeted drug treatments can cause cancer cells to die.

If you are considering targeted therapy for ovarian cancer, the doctor may examine your cancer cells to determine that the targeted therapy is more likely to have an effect on your cancer.

Hormone therapy

Hormone therapy uses drugs to block the effects of the hormone estrogen in ovarian cancer cells. Some ovarian cancer cells, estrogen use to help them grow, so that the blockade of oestrogen may help to control the cancer.

Hormone therapy may be a treatment option for some types of slow growth of ovarian cancers. It can also be an option if the cancer comes back after treatment.

Immunotherapy

Immunotherapy uses the immune system to fight cancer. The body's disease-fighting immune system may not attack the cancer cells because they produce proteins that help to hide from the immune system cells. Immunotherapy works by interfering with that process.

Immunotherapy may be an option for the treatment of ovarian cancer in certain situations.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on the relief of pain and other symptoms of a serious disease. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery and chemotherapy.

When palliative care is used along with all other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life of people with cancer and their families. This form of care that is offered alongside curative or other treatments you may be receiving.

Coping and support

A diagnosis of ovarian cancer can be overwhelming. In the time that you're going to find ways to cope with your feelings, but in the meantime, you may find it helpful to:

  • Find someone to talk to. You can feel comfortable talking about your feelings with a friend or family member, or you may prefer formal meeting with a support group. Support groups for families of people with cancer are also available.
  • We're going to help people. Treatments for cancer can be exhausting. Let people know what would be most useful to you.
  • Set reasonable goals. Having goals helps you feel in control and can give you a sense of purpose. But choose your targets that you can achieve.
  • Take time for yourself. Eat well, relax and get plenty of rest can help to combat the stress and fatigue of cancer.

Preparing for your appointment

Start by making an appointment with your family doctor or gynecologist if you have signs or symptoms that worry you.

If your doctor suspects that you have ovarian cancer, you may be referred to a specialist in female reproductive cancer (gynecologic oncologist). A gynecologic oncologist is an obstetrician-gynecologist (OB-GYN) who has additional training in the diagnosis and treatment of ovarian cancer and other gynecologic cancers.

What you can do

  • Be aware of any pre-appointment restrictions, such as not eating solid foods on the day before your appointment.
  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any major changes or factors of stress in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write questions to ask their doctor.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatments are available, and what side effects can I expect?
  • What is the prognosis?
  • If you still want to have kids, what options are available for me?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor may ask you a series of questions. Be prepared to respond to them can make the time to go over points you want to spend more time. You may ask:

  • When did you first begin to experience the symptoms, and how severe are they?
  • The symptoms been continuous or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • Do you have any relatives with ovarian or breast cancer?
  • There are other types of cancer in your family history?
Symptoms and treatment of Ovarian cancer