Ovarian cancer is a disease in which the cells in the ovaries become abnormaland start to grow uncontrollably, forming tumors. The ovaries are a pair ofalmond-shaped organs that lie in the pelvis on either side of the uterus. Theovaries produce and release an egg each month during the menstrual cycle. Inaddition, they also produce the female hormones estrogen and progesterone, which regulate and maintain the secondary female sexual characteristics.
Ovarian cancer can develop at any age, but more than half the cases are amongwomen who are 65 years or older. It is difficult to diagnose ovarian cancerearly, because often there are no warning symptoms and the disease grows relatively quickly. In addition, the ovaries are situated deep in the pelvis and,therefore, small tumors cannot be detected easily during a routine physicalexamination.
The actual cause of ovarian cancer is not known, but several factors are known to increase one's chances of developing the disease. These are called riskfactors. Age may be considered a risk factor for ovarian cancer, because theincidence of the disease increases with age. Half of all cases are diagnosedafter age 65. Race may be another risk factor for the disease, since the incidence of the disease is noted to be the highest among white women and lowestamong blacks. A high-fat diet may have something to do with an increased incidence of ovarian cancer, because when Asian women move to the more affluent western countries and adopt a diet that is rich in fat, the incidence of ovarian cancer among them rises.
A family history of ovarian cancer may also put a woman at an increased riskfor developing the disease. It is believed that the longer a woman ovulates,the higher is her risk of ovarian cancer. Therefore, starting to menstruate at a very early age (before age 12) and late menopause seems to put women at ahigher risk for ovarian cancer.
Ovarian cancer has no specific signs or symptoms in the early stages of the disease. The patient may complain of the following symptoms: pain or swellingin the abdomen, bloating, and general feeling of abdominal discomfort, constipation, nausea or vomiting loss of appetite, fatigue. There may be unexplained weight gain due to an accumulation of fluid in the abdomen and sometimes post-menopausal women may have vaginal bleeding.
If ovarian cancer is suspected, the physician typically begins the diagnosisby taking a complete medical history to assess all the risk factors. A thorough pelvic examination is conducted. Blood tests to determine the level of a particular blood protein, CA125, may be ordered. This protein is usually elevated when a woman has ovarian cancer. However, it is not a definitive test.
In order to determine if the tumor is benign or cancerous, minor surgery maybe necessary. A piece of the tissue is removed and microscopically examined to determine whether the tumor was benign or malignant. Standard imaging techniques such as computed tomography scans (CT scans) and magnetic resonance imaging (MRI) may be used to determine if the disease has spread to other partsof the body.
The cornerstone of treatment for ovarian cancer is surgery. It is aimed at removing as much of the cancer as possible. Chemotherapy, which involves the use of anticancer drugs to kill the cancer cells, is usually administered afterthe surgery to destroy any remaining cancer. Radiation therapy is not routinely used for ovarian cancer.
The type of surgery depends on the extent of spread of the disease. In most procedures, the ovaries, uterus, and fallopian tubes are completely removed. In rare cases, if the cancer is not very aggressive and the woman is young andhas not had children, a more conservative approach may be adopted. Only oneovary may be removed, and, if possible, the fallopian tubes and the uterus may be left intact.
Most often ovarian cancer is not diagnosed until it is in an advanced stage,making it the most deadly of all the female reproductive cancers. More than 50% of the women who are diagnosed with the disease die within five years.
Since there is no known cause for ovarian cancer, it is not possible to prevent the disease. Nevertheless, there are ways to reduce one's risks of developing the disease. Having one or more children, preferably having the first before age 30, and breastfeeding may decrease one's risk of developing the disease.
There are no simple tests or screening procedures to detect ovarian cancer inits early stages. High-risk women are therefore advised to undergo periodicscreening with the transvaginal ultrasound or a blood test for CA125 protein.The American Cancer Society recommends annual pelvic examinations for all women after age 40, in order to increase the chances of early detection of ovarian cancer.