Ovarian Cancer

What Every Woman Needs To Know

Cancer refers to the development of abnormal cells that divide uncontrollably and destroy normal tissue. Cancer is also able to spread to other organ throughout the body. It is caused by changes (mutation) to the gene within cells. You may be born with a genetic mutation that you inherited from parents. This leads to rapid growth and failure to stop uncontrolled cell growth.  


Facts about ovarian cancer

Globally, ovarian cancer is the 7th cause of cancer deaths in females. It is the 6th leading cause of cancer deaths in females in Thailand after breast cancer, cervical cancer, lung cancer, liver cancer, and colon cancer. There are 2,600 new cases of ovarian cancer in 2013, and 50% of the patients or 4 patients per day died from this disease. Ovarian cancer often goes undetected until it has spread to other organs. Ovarian cancer can occur in women aged 20-80, but it is more common between the ages of 50-60 years


Causes

It is unclear what the causes of ovarian cancer are but there are factors that can increase the risk of the disease. 

  • Women who never carried a pregnancy to term
  • Beginning menstruation at an early age or starting menopause at a later age
  • Family history of ovarian cancer especially close relatives such as mother and sisters, Family history of any of the following cancers may indicate an increased risk: breast cancer, cervical cancer, and colon cancer
  • Environmental factors such as food and chemical substances etc. – The disease is more common in industrialized countries.
  • Women who had breast cancer, cervical cancer, or colon cancer
  • Women who use oral contraceptives for five or more years have about a lower risk of developing ovarian cancer

Signs and symptoms

Signs and symptoms of ovarian cancer may include frequent abdominal bloating and chronic abdominal pain that cannot be relieved by antacids. If the tumor is big, the symptoms may include abdominal swelling, discomfort in the pelvis area, and difficulty to pass urine or feces. In advanced stage patients, symptoms include fatigue, weight loss, and loss of appetite. 


Diagnosis

  1. Physical and pelvic examinations – palpable abnormalities in the uterus or ovaries
  2. Ultrasonography – help determine the size, shape and structure of your ovaries. This is useful in obese patients as it is difficult to palpate or find the abnormalities during physical examination.
  3. CT-scan – help determine the size, shape and structure of your ovaries, lymph nodes, and other abdominal organs
  4. Blood tests – can help determine your overall health

Stages of ovarian cancer

There are 4 stages of ovarian cancer.

  • Stage 1: Cancer cells affect only the ovary or ovaries and have not spread to another area.
  • Stage 2: The cancer has affected one or both ovaries and also other organs within the pelvis.
  • Stage 3: The cancer affects one or both ovaries and either the lining of the abdomen or lymph nodes in the pelvis and abdomen.
  • Stage 4: The cancer has spread to other parts of the body, outside the peritoneal cavity. These may include lung, liver, and brain.

Treatment

Treatment options depend on the type of ovarian cancer, its stage, and patient’s overall health. The treatment may include:

  1. Surgery
    During the procedure, usually, a vertical abdominal incision is made and the surgeon examines the organs within the pelvis and abdomen for signs of cancer. Samples of tissue and fluid are taken from the ovaries, fallopian tubes, lymph nodes, and the fat that covers abdominal organ. The surgeon will then attempt to remove as much of the cancerous tissue as possible. This procedure is termed surgical staging and is an important first step in the treatment of ovarian cancer.

    มะเร็งรังไข่ ภัยร้ายในสตรี
    Minimally invasive surgery With technological advancement, there is a new surgical treatment option called minimally invasive surgery. A small camera will be inserted through a small incision allowing the doctor to see the relevant area enlarged on a digital screen in the room. Because internal tissues have reduced exposure and the need for invasive instruments is decreased, patients also experience less blood loss, less pain, less scar tissue, and fewer complications post-surgery. This technique can be used in patients with a small tumor. However, the chosen surgical technique will depend on the patient’s condition.
  2. Chemotherapy
    Ovarian cancer usually responds well to chemotherapy. Chemotherapy is often used after surgery to kill any cancer cells that might remain. It can also be used before surgery to reduce the tumor size.
  3. Targeted therapy
    Targeted therapy can be used with chemotherapy in some patients.

Prevention

For women 30 – 35 years and over, annual physical examination and pelvic examination are important in order to detect the disease early. Also, make an appointment with your doctor if you have any signs or symptoms that worry you.