Ovarian cancer is one of the top cancers that affect women. The cancer can arise from any of the three types of cells found in the ovary. These are:
- The outer layer of the ovary called epithelium. A big percentage of ovarian cancers arise from these cells. Histology examination classifies cancer from this layer into a few other sub-types.
- Germ cells. These cells are responsible for ova production
- Stromal cells that form the ovary supporting structures.
Ordinarily, there are many swellings or tumors that are found in the ovary but in most cases they are not cancerous. But when such tumors cause symptoms and they have to be removed, they must be taken for histological examination to rule out presence of cancer.
Symptoms of ovarian cancer
Early symptoms are non-specific and difficult to associate with ovarian cancer. They can mimic other abdominal symptoms such as digestive system problems and menstrual disorders. Later as the disease progresses, more pronounced symptoms may be observed.
- Abdominal distension
- Lower abdominal or pelvic pains
- Loss of appetite
- Loss of weight
- Micturition problems
- Painful sexual intercourse
What causes ovarian cancer?
Like many cancers, the exact reason why there is an abnormal mutation in the DNA which starts a multiplication of abnormal cells is not fully understood. There are however, factors that have been identified as risks to the development of this cancer. Some of these are:
- Ovarian cancer is rare in women below 40 years.
- Use of fertility drugs
- Use of androgens (male hormones)
- Family history of ovarian cancer or breast cancer. The risk is high when a close female relation such as a sister, a mother or a daughter has been a victim of any of these hormone dependent cancers. This is due to inherited faulty genes referred to as BRCA1 and BRCA2 (Breast Cancer 1&2 genes)
- Low parity. A fertile woman sheds at least one egg a month. This process is traumatic to the uterus and it increases chances of cancer development from the egg detachment site. Contraceptive pills, high parity and prolonged periods of breastfeeding reduce these traumatic incidences and hence chances of developing ovarian cancer.
- Women on hormone replacement therapies.
Diagnosis of ovarian cancer
Routine examination may discover abnormal feeling of the ovaries and surrounding structures. More specific screening tests which are not very accurate are:
- Transvaginal ultra-sound
- Ca-125 test that suggests cancer presence but can also point to other non-cancerous conditions. However, the levels of Ca-125 can be used as markers to assess effectiveness of treatment. Dropping levels means that treatment is effective.
- Tissue biopsy can be done to confirm the presence and type of the ovarian cancer.
Treatment of ovarian cancer
Treatment usually employs more than one technique and will depend on many factors such as the type of ovarian cancer and the stage of the disease. Common strategies include:
- Surgery where the ovary and associated structures are removed. The invasiveness of the operation will be determined by whether the cancer has spread or it is localized.
- Chemotherapy is the use of cytotoxic (cancer cell killing) drugs. This can be a follow-up strategy after surgery or it can be used primarily in advanced cancer cases where surgery may be of little benefit.
- Post-treatment follow-up and support is recommended to help the patient cope with definite changes that ovarian cancer and treatment effects bring to their lives.
Healthy lifestyle incorporating a healthy diet and healthy weight has been shown to lower the risk of ovarian cancer.