Ovarian Cancer

Ovarian cancer may refer to the abnormal growth of cells or uncontrolled division of cells in the ovaries. These abnormal cells multiply rapidly and can damage the body's healthy cells. Nowadays, ovarian cancer is the fifth most common cause of death among females worldwide. In several years, 22,530 females may be diagnosed with ovarian cancer, or a range of 13,980 females may lead to end up with ovarian cancer.

Associated Anatomy

Ovaries (egg-producing part of the female reproductive system)

Signs and Symptoms of Ovarian Cancer 

When ovarian cancer first grows, it may not cause any signs and symptoms. The symptoms of ovarian cancer are usually mistaken for other more common conditions.

Symptoms and some signs 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, such as constipation
• Frequent need to urinate

Causes of Ovarian Cancer 

These factors can cause ovarian cancer:

• By taking hormone replacement therapy
• A diseased condition in females known as Endometriosis
• Gene mutations or family history of ovarian cancer
• Never having a full-term pregnancy

Types of Ovarian Cancer

Depending on the type of cell where cancer starts, ovarian cancer may include these types:

• Epithelial ovarian cancer: This is the growth of abnormal cells that starts in the surface layer (covering the ovaries). It is the most ordinary form of ovarian cancer.
• Germ cell ovarian tumors: The abnormal growth of tumors starts in the egg cells (germ cells) of the ovaries. It is rare and usually affects girls and young women up to their early 30s.
• Sex cord-stromal tumors: These are the abnormal growth of the cells in the sex or stroma of the ovaries. It is a rarely occurring type of ovarian cancer.
• Borderline ovarian tumors: These are abnormal cell growth or tumors in the tissue covering the ovaries. They are commonly diagnosed at an early stage.

Various Stages of Ovarian Cancer

As soon as you've been diagnosed with ovarian cancer, your doctor will use the results of your tests and procedures to determine your cancer stage. Ovarian cancer can be classified into stages 1 through 4, often indicated by the Roman numerals I through IV. Cancer is confined to the ovaries if the lowest setting is used. Stage 4, on the other hand, traces cancer to distant organs.

Diagnosis and Tests Required For Ovarian Cancer

There are some tests and procedures which are used to diagnose ovarian cancer. These may include:

• Pelvic test: This is done by your doctor to sense (palpate) your pelvic organs. They also visually examine your vagina, cervix, and external genitalia.
• Imaging tests: Tests, like ultrasound or CT scans of your abdomen and pelvis, may help decide the size, structure, and shape of your ovaries.
• Blood tests: Ovarian cancer is detected by tumor markers in the blood. For example, a test to see ovarian cancer cells can detect a protein usually found on the surface of cancerous cells.

Ovarian Cancer Treatment 

The optimal treatment of ovarian cancer requires surgery, systemic treatment with precision cancer medicines or chemotherapy, and occasionally radiation therapy.

• Surgery is generally preferred for patients with ovarian cancer. When cancer is in its initial stages in women of child-bearing age with certain tumors, it may not be necessary to remove both the ovaries and uterus. Initially, it is done by obtaining a biopsy specimen to confirm the diagnosis, determine the stage of cancer, and provide local treatment of the tumor in the ovaries.
• Radiation therapy kills cancer cells with high-energy particles. Radiation therapy is rarely used as the primary treatment to treat ovarian cancer. However, it can treat areas where cancer has spread, either near the tumor or in a distant organ.
• Most often, chemotherapy (chemo) is a systemic treatment. The chemotherapy process can eliminate cancer cells left after surgery, those that have metastasized (spread), or those too large to be surgically removed.
• Hormone therapy treats cancer by either using hormones or drugs that block hormones. This systemic therapy is not generally used to treat epithelial ovarian cancer but is used more frequently to treat ovarian stromal tumors.

Ovarian Cancer Prevention

Primary Prevention

Ovarian cancer is a common type of disease in females, but you can reduce your risk of developing it through several different methods.

• By avoiding risk factors, such as staying at a healthy weight or not taking hormone therapy after menopause, you may be able to lower the risk of developing ovarian cancer.
• Oral contraceptives are associated with a 50% high risk of ovarian cancer for women who use them for five years or more. When women at average risk and BRCA mutation carriers use oral contraceptives (birth control pills), their chances of developing ovarian cancer increase.

Secondary Prevention

A hysterectomy without removal of the ovaries, as well as tubal ligation, may result in an increased risk of ovarian cancer. Therefore, it is not recommended.

Risk Factors Associated with Ovarian Cancer

• Family history: Close relative or family history of ovarian cancer increases a person's chance of developing ovarian cancer.
• Age: Almost 50% of ovarian cancer cases occur after 63 years.
• Breast cancer: Patients with a past of breast cancer seem to have a higher chance of ovarian cancer.
• Obesity and overweight are more common in inpatient patients with a body mass index (BMI) of over 30.
• Having children later: Women who have their first pregnancy after 35 have a higher chance of ovarian cancer.
• Taking hormone therapy after menopause.

Complications of Treatment

For most women with ovarian cancer, surgery is the primary treatment option.

Complications from surgery can include:

• Inflammation around the incision may result in fever, chills, sweats, coughing, shivering, as well as swelling or redness.
• You may experience some vaginal bleeding following your procedure.
• Swelling in the legs or the genital area may occur if your surgeon removes your lymph nodes.
• Ovarian cancer debulking surgery may include parts of the colon or bladder.
• You will not get pregnant if you have both your ovaries removed. Your doctor can tell you if you want to preserve your fertility or have other options.
• Menopause occurs early after surgery when your ovaries are removed.

Epidemiology

Among all cancers affecting the female reproductive system, ovarian cancer ranks the fifth leading cause of death for women.

• The risk of ovarian cancer in women is about 1 in 78 during their lifetimes.
• The risk of dying of ovarian cancer is about 1 in 108 during their lifetimes.

Prognosis

Expected Prognosis

Approximately three out of four women with ovarian cancer live for at least one year after diagnosis for all types of ovarian cancer combined. Women diagnosed before the age of 65 do better than older women when surviving ovarian cancer. Nearly half (46.2%) of women diagnosed with ovarian cancer are still alive at least five years after their diagnosis.

Natural Progression

More than 60% of women presenting with ovarian cancer already have stage III or IV cancer, or cancer has spread beyond the ovary. It is disproportionately deadly because the symptoms are vague and non-specific. Hence diagnosis is late. Due to the lack of a cost-effective screening test, more than half of women with ovarian cancer find out they have the disease in an advanced stage.

Pathophysiology

Women with malignant ovarian tumors are most likely to have epithelial ovarian cancer. Ovarian cancer is characterized by the fact that it originates with dedifferentiation of the cells overlying the ovary, which can then be incorporated into the ovary and proliferate. Neoplasms are classified morphologically by appearing on the epithelium, including clear cell, transitional, squamous, mixed, and undifferentiated tumors.

Frequently Asked Questions

Q1. What are The Best Hospitals for Ovarian Cancer Treatment in Mumbai?

Nanavati Max Hospital in Mumbai is considered one of the best hospitals for ovarian cancer treatment in the city, offering a range of advanced treatments and experienced specialists.