Ovarian Cancer

Understanding Ovarian Cancer

Estimated Reading Time: 10 Minutes

Ovarian cancer originates in or on the surface of the ovaries. Since early symptoms are often vague or absent, the disease can go undetected until it has spread to nearby pelvic structures such as the fallopian tubes. While ovarian cancer can affect women of any age, it is most commonly diagnosed in postmenopausal women. This article provides a comprehensive overview of risk factors, symptoms, diagnostic approaches, treatment options, and implications for fertility.

Types of Ovarian Cancer

There are three major categories of ovarian cancer, each based on the type of cells affected:

• Epithelial Ovarian Carcinoma: The most common type, accounting for about 90% of cases. It begins in the outer layer of ovarian cells.

• Stromal Tumors: These rare tumors develop in hormone-producing ovarian cells and represent around 7% of ovarian cancers.

• Germ Cell Tumors: Typically found in younger women under 30, these cancers arise from the egg-producing cells of the ovary.

Globally, ovarian cancer is the eighth most prevalent cancer among women, with approximately 19,880 new cases estimated in the U.S. for 2022. About 1.1% of women are expected to be diagnosed during their lifetime.

Common Signs and Symptoms of Ovarian Cancer

Ovarian cancer often goes undiagnosed in its early stages due to nonspecific symptoms. Around 65% of cases are detected at an advanced stage.

Early Symptoms to Watch For

These symptoms tend to be persistent and can easily be mistaken for other less serious conditions:

• Frequent bloating

• Pelvic or abdominal discomfort

• Feeling full quickly after eating

• Increased urgency or frequency of urination

Symptoms in Later Stages

As the disease progresses, additional symptoms may include:

• Indigestion or gas

• Constipation or diarrhea

• Unusual vaginal bleeding

• Shortness of breath

• Persistent fatigue

• Abnormal discharge (especially post-menopause)

What Causes Ovarian Cancer?

The precise cause remains unknown, but it’s believed to result from a combination of genetic, environmental, and lifestyle influences.

Risk Factors for Developing Ovarian Cancer

The risk of ovarian cancer increases with age, particularly after 63. Key risk factors include:

• Family history (mother, sister, aunt, or grandmother with ovarian cancer)

• Inherited genetic mutations like BRCA1, BRCA2, or Lynch syndrome

• A personal history of breast, uterine, or colon cancer

• Conditions such as endometriosis

• Infertility or never having been pregnant

Note: Having risk factors doesn’t guarantee a cancer diagnosis, and ovarian cancer can occur even without them.

How Ovarian Cancer Is Diagnosed

Diagnosis typically begins with a thorough review of personal and family medical history, followed by a physical and pelvic examination.

Imaging Tests

• Transvaginal Ultrasound: Uses sound waves to visualize the ovaries and surrounding organs.

• CT, MRI, and PET Scans: Help detect tumors and assess cancer spread.

Blood Tests

• CA-125 Test: Detects high levels of cancer antigen 125, often elevated in epithelial ovarian cancers.

• Inhibin and hCG: Used to identify germ cell tumors.

• CEA and CA 19-9: Help detect mucinous ovarian cancer subtypes.

Laparoscopy

A minimally invasive surgery using a small incision and a camera to examine the ovaries and potentially collect biopsy samples.

Can a Pap Smear Detect Ovarian Cancer?

No, Pap smears are designed to screen for cervical cancer, not ovarian. However, pelvic exams remain essential in identifying abnormalities that could indicate ovarian cancer.

Ovarian Cysts vs. Ovarian Cancer

Ovarian cysts are fluid-filled sacs often harmless and self-resolving. In contrast, ovarian cancer results from genetic mutations and can invade surrounding tissues if untreated.

Stages of Ovarian Cancer

Ovarian cancer is categorized into four stages:

• Stage 1: Confined to one or both ovaries

• Stage 2: Spread within the pelvic region

• Stage 3: Spread to the abdominal lining or lymph nodes

• Stage 4: Spread to distant organs like the liver or lungs

Treatment Options for Ovarian Cancer

Treatment plans depend on cancer stage, type, and overall patient health. Most patients receive a combination of therapies.

Surgical Intervention

Goals include removing as much of the cancer as possible. Common procedures include:

• Salpingo-oophorectomy: Removal of one or both ovaries and fallopian tubes

• Hysterectomy: Removal of the uterus and cervix

• Omentectomy: Removal of abdominal lining tissue

• Lymph Node Biopsy: Checks if cancer has reached lymph nodes

• Debulking Surgery: Removes cancer from affected organs like the spleen or bladder

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells or prevent their spread. It may be administered:

• Intravenously (IV)

• Orally (in pill form)

• Intraperitoneally (directly into the abdomen)

Radiation Therapy

Less commonly used, radiation delivers high-energy rays to kill cancer cells. In some cases, it’s administered via a catheter directly into the abdominal cavity.

Targeted Therapy

These drugs attack specific cancer cell functions. Types include:

• Angiogenesis Inhibitors: Block blood vessel growth in tumors

• PARP Inhibitors: Especially effective in patients with BRCA mutations

• NTRK Inhibitors: For cancers with mutations in NTRK genes when other treatments fail

Hormone Therapy

Used mainly for stromal tumors, hormone therapy aims to block hormones that promote cancer growth. Options include:

• GnRH agonists

• Aromatase inhibitors

• Tamoxifen

Preserving Fertility During Ovarian Cancer Treatment

Some women diagnosed in early stages may opt for fertility-sparing treatments. These can include:

• Keeping one healthy ovary and fallopian tube

• Preserving the uterus for future pregnancies

Your eligibility depends on the type, stage, and spread of the cancer.

💡 Frequently Asked Questions

What Causes Ovarian Cancer?

A mix of genetic and lifestyle factors is believed to contribute, although a specific cause often isn’t identified.

Can a Pap Smear Detect Ovarian Cancer?

No, Pap smears screen for cervical cancer. A pelvic exam remains vital for detecting ovarian abnormalities.

Can Ovarian Cancer Be Prevented?

While it can’t always be prevented, risk-reducing strategies include maintaining a healthy weight, considering oral contraceptives, and regular gynecological checkups if you’re at high genetic risk.

✅ Key Takeaways

• Ovarian cancer is most common in postmenopausal women and often goes unnoticed until advanced.

• Symptoms may include bloating, abdominal pain, and unusual bleeding.

• Diagnosis involves imaging, blood tests, and sometimes surgery.

• Treatment options include surgery, chemotherapy, radiation, targeted therapy, and hormone therapy.

• Early detection significantly increases treatment success and fertility preservation options.

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