Overview of Ovarian Cancer
Ovarian cancer is a malignant tumor that affects the ovaries, the organs that produce eggs in women. It can also metastasize to other areas of the body, such as the lungs and lymph nodes. Ovarian cancer can range in severity and can either be benign or malignant.
It is important to understand the signs and symptoms of ovarian cancer, as well as the steps necessary to get tested for it.
Though the exact causes of ovarian cancer are still unknown, a variety of different factors may increase the risk of developing the disease. These include:
- Genetic mutations: Certain genetic mutations due to inherited genes may increase one’s risk of developing ovarian cancer. Mutations in BRCA1 and BRCA2 genes, for example, may have a link to the development of ovarian cancer.
- Hormonal factors: Women with higher levels of exposure to certain hormones, such as estrogen and progesterone, may be more likely to develop ovarian cancer later in life. A history of endometriosis or use of fertility drugs can also contribute to this elevated risk.
- Age: Older women are at greater risk for developing ovarian cancer than younger women. The average age at diagnosis is 63 years old.
- Reproductive history: Women who do not have children naturally (either through adoption or using fertility treatments) are at higher risk for developing ovarian cancer than those who have had natural childbirths throughout their lives. Women who took oral contraceptives for at least five years have a slightly lower risk than those who have never taken them before.
Furthermore, women with a family history of breast or colorectal cancers may be more likely to develop ovarian cancer as well due to common genetic mutations between these diseases that often create similar pathways within cells if triggered.
Ovarian cancer is an often-silent disease, which means that symptoms may not be noticeable or may go completely unnoticed. Potential red flags include bloating or pressure in the abdomen, feeling full quickly while eating, and pelvic pain. Urinary frequency and constipation are also potential symptoms of ovarian cancer; in fact, some women may mistake the urge to urinate more often as a sign of a urinary infection instead of a possible symptom of ovarian cancer.
It is important to note that many of these symptoms can also indicate issues that are not related to cancer, but should be discussed with your doctor if they persist as they may point to an underlying problem.
Risk factors for developing ovarian cancer include age, family history, and lifestyle choices. Women over the age of 50 are at increased risk for ovarian cancer, with the highest rates occurring in post-menopausal women. Similarly, having a first- or second-degree relative with a prior diagnosis of ovarian or breast cancer increases the likelihood of developing ovarian cancer. Other lifestyle choices may also increase risk such as obesity and smoking.
Certain groups may also fall into higher risk categories more easily such as women who are infertile, have never had children, use fertility drugs and/or those who take oral contraceptive pills for over five years. While any woman can develop ovarian cancer regardless of her background or lifestyle choices, understanding the various factors that could increase risk can help inform a strategy to detect it early when it is most treatable.
Ovarian cancer is often difficult to diagnose in its early stages due to its nonspecific symptoms. To detect whether one has ovarian cancer, doctors often perform diagnostic tests such as imaging tests, blood tests, and surgical biopsies.
Let us take a look at the various diagnostic tests available:
A pelvic exam is an important part of diagnosing and treating ovarian cancer. This procedure involves the insertion of one or two fingers into the vagina of the patient so that a doctor can feel for any signs or symptoms associated with the disease. The doctor will also use a speculum to examine and photograph the pelvic organs.
Depending on the results of this examination and any other factors, your doctor may choose to perform diagnostic imaging, such as ultrasound and x-rays, or even tissue biopsies to determine if cancer is present or to rule out other conditions. Pelvic exams are generally considered safe and effective in diagnosing ovarian cancer.
A transvaginal ultrasound is a type of imaging test used to diagnose ovarian cancer. During this test, a wand or probe is placed in the vagina and sends out sound waves, which are reflected back and interpreted on a screen. This type of ultrasound helps the doctor view organs, including those that may contain an abnormality that needs to be diagnosed.
A radiologist (a doctor who specializes in medical imaging) or gynecologist usually performs the procedure in their office or clinic. The patient will be asked to undress from the waist down before lying on their back with their legs slightly apart for the scan. This makes it easier for the doctor to place the probe into the vagina and obtain images of various organs such as ovaries, fallopian tubes, and bladder. During physiological imaging studies, contrast dye is sometimes used; however this is not required for ovarian cancer diagnosis.
The results of this test can help doctors confirm a diagnosis of ovarian cancer as well as monitor treatment progress once diagnosis has been made. In fact, transvaginal ultrasound has become an important tool in diagnosing many other types of conditions besides ovarian cancer such as uterine fibroids and endometriosis. Therefore it is important to talk with your doctor about your symptoms before deciding if this test would be beneficial for you; however it can provide helpful diagnostic information for many potential conditions.
CA-125 Blood Test
The CA-125 blood test is commonly used to help diagnose and monitor certain types of cancer. It is most often used to detect ovarian cancer, or as an aid to track the progress of certain treatments. The CA-125 test measures the level of a protein called Cancer Antigen 125 (CA-125) in the blood. Elevated levels of this protein can be an indicator that there may be cancer cells present in the body, though it is important to note that not all cancers will cause a rise in CA-125 levels.
The CA-125 test can also help doctors evaluate how well cancer treatments are working, as well as how likely it is for a person’s cancer to return. It can also be used as part of routine screenings for those with a higher risk for developing certain cancers, such as:
- Women over 50 who have had ovarian cysts previously.
It is always advisable to discuss any specific questions or concerns you may have about getting tested with your doctor before proceeding with the examination.
A biopsy is used to determine if ovarian cancer is present in the body. It is a minimally invasive procedure in which a sample of the suspicious tissue from either the ovaries or other affected areas is removed and examined to detect any malignancy.
This begins with a physical examination, including pelvic exams and ultrasound imaging. Once any possible tumors are detected, specimens are collected and analyzed under a microscope. A biopsy can be done either through laparotomy, where an abdominal incision (cut) and surgical operation are used, or laparoscopy, where camera-guided insertion of instruments allows the doctor to look into your abdomen without making any cuts.
If a diagnosis of ovarian cancer is made after examination of biopsy tissues, further testing may be done in order to determine the exact type and extent of disease.
If you are concerned that you may be at risk of ovarian cancer, the first step is to get tested. As there is currently no standard screening test for early detection of ovarian cancer, diagnosis is made through a combination of physical exams, medical imaging, and laboratory tests.
In this article, we will explore the various treatment options available:
Surgery is the primary treatment for ovarian cancer. A surgical procedure is usually recommended to diagnose, stage, and treat the disease. Depending on the stage of the ovarian cancer, a specific type of surgery may be recommended.
Early-stage ovarian cancers are treated with either a debulking or a cytoreductive surgery, which is designed to remove as much of the tumor tissue as possible. If a tumor cannot be completely removed, it can be surgically reduced in size (debulking), allowing chemotherapy and radiation to reach further into tissue that may have been untouched by surgery.
The goal of advanced-stage ovarian cancer is often palliative care which involves treatments such as chemotherapy and radiation that are intended to reduce symptoms and improve quality of life. It also involves surgeries that are intended to reduce pain or provide relief from pressure on other organs such as:
- Draining fluid from an accumulated ascites or pleural effusion.
- In some cases, palliative surgeries may also help reduce or slow tumor growth or extend life expectancy in patients with advanced-stage ovarian cancer.
Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. Chemotherapy works by interfering with the cancer cell’s ability to grow and divide. This type of treatment is usually administered intravenously, or through an injection, although some forms are available in pill form. It often requires multiple sessions and different combinations of medications in order to effectively treat the cancer.
Chemotherapy may be used alone or combined with other treatments such as radiation therapy, surgery, targeted therapy, immunotherapy, and hormones or biologics. Depending on the type of cancer and stage of disease at diagnosis, different combinations may be used in order to obtain best possible outcomes for the patient’s health.
Side effects from chemotherapy may include:
- Hair loss
- Nausea and vomiting
- Skin reactions
- More serious toxicity such as heart damage or decreased red blood cell counts.
Patients also need to be monitored closely for potential development of infections from this form of treatment due to its effect on cells in the body that help with immunity against certain organisms.
Radiotherapy is a form of treatment used to destroy cancer cells. It is most often used to treat ovarian cancer that has spread to other parts of the body. This type of treatment involves using external radiations, usually a high energy beam, which is directed towards the tumor and cancerous cells. This serves to damage the cancerous cells and prevent further growth and/or spread. It also helps alleviate symptoms caused by the tumor.
While it can have some side effects such as fatigue, nausea or skin irritation, these can be managed with medication and lifestyle modifications. Radiotherapy can be administered in short treatments over a few weeks or for longer periods depending on individual needs, with follow up visits recommended routinely to assess progress and potential changes in treatment plans.
Radiotherapy can be an effective way to manage advanced stages of ovarian cancer after surgery has been completed or when surgery is not possible/not thought to be beneficial due to the tumor’s location or size, when combined with systemic therapy regimes (hormonal therapies).
Ovarian cancer is preventable, no matter your age or family history. Prevention strategies mainly focus on identifying risk factors and changing lifestyle habits that can increase risk. Testing for ovarian cancer can help detect the disease in its early stages when the chances of successful treatment are highest.
In this section, we will discuss the different tests available to diagnose ovarian cancer:
A healthy diet can help reduce your risk for ovarian cancer and other diseases. Eating plenty of fruits, vegetables, and whole grains can provide many essential vitamins and minerals that can help boost your overall health. Additionally, being mindful of what fats you eat can also be beneficial. Opting for unsaturated fats like vegetable oils, nuts, and avocado instead of animal-fats like butter or lard is linked to improved ovarian health.
As with other cancers, maintaining a healthy weight is important in preventing the development of ovarian cancer. Therefore, limiting added sugars in your diet as well as reducing processed foods should also be incorporated into your routine.
Living an overall healthy lifestyle through proper nutrition and regular physical activity may help lower the chance of developing ovarian cancer.
Taking part in regular physical activity may reduce the risk of developing ovarian cancer and can increase the chances of detecting it early. Research suggests that Regular physical activity has a number of benefits for women’s health, including reducing your risk for some cancers and helping to maintain body weight.
Getting 30 minutes or more of physical activity most days is recommended for all individuals, regardless of age or gender. For more effective prevention, 60 minutes or more is ideal and should include both aerobic exercises (e.g., walking, running, cycling) and different types of strength-training exercises (e.g., weights). Low to moderate levels of exercise are associated with significantly reduced risks compared to no physical activity at all.
It is important to note that exercise alone may not be sufficient for preventing ovarian cancer – maintaining a healthy weight through diet and exercise as well as screening tests can help reduce your risk even further. Molecular analysis such as tissue sampling or result analysis from Endocervical Protocol Transferral (EPT) may also help detect ovarian cancer early and aid in the prevention process.
Avoiding smoking is the most important factor in lowering your risk of ovarian cancer. Tobacco smoke causes genetic damage that could lead to ovarian cancer and other cancers in the body. Quitting smoking reduces the risk, and it is never too late to quit and benefit from doing so.
Other lifestyle changes such as:
- Avoiding processed or barbecued foods
- Limiting alcohol consumption
- Exercising regularly
- Maintaining a healthy weight
- Eating organic foods
- Taking nutritional supplements
can also contribute to a lower risk of developing ovarian cancer.
Genetic testing is a type of screening tool that involves taking a sample of your blood, saliva or cells and assessing it for mutations in certain genes. Mutations in certain genes may indicate a higher risk for developing ovarian cancer. Current advancements are making genetic testing more readily available, but it’s important to speak with your doctor about whether this type of screening would be beneficial for you.
Women who have the BRCA1 and BRCA2 gene mutations may be advised to undergo genetic testing for early-onset (premenopausal) ovarian cancer. Other gene mutations that can increase your risk of ovarian cancer include HNPCC and Lynch Syndrome, which require additional therapies or strategies to help detect or reduce the risk of ovarian cancer. Generally, experts recommend these tests for women with a family history or personal history of breast or ovarian cancers, particularly if those individuals are under the age of 50 years old (or earlier depending on family history).
If you had genetic testing done in the past and found out you have an increased risk of developing ovarian cancer, additional screening tests—such as ultrasound imaging—may be recommended by your doctor every six to twelve months. Depending on what is found during these screenings, you may need to consider other options such as prophylactic surgery (removal of one or both ovaries). Discussing all possible options with your doctor is important not only so that they can help you decide what’s right for you but also because it may provide earlier warning if something changes inside your body.