Ovarian cancer arises from abnormal gene mutations affecting cell growth in the ovaries. The ovaries are two almond-sized organs located on either side of the uterus. They produce eggs (ova) and the hormones estrogen and progesterone, which influence female traits like breast development and body shape.
Early-stage ovarian cancer symptoms include:
• Bloating
• Pelvic or abdominal pain
• Difficulty eating or feeling full quickly
• Urinary issues like bladder pressure or frequent urination
These symptoms can also be linked to non-cancerous conditions. If they persist or intensify, especially if experienced more than 12 times a month, consult a doctor.
Additional symptoms may include:
• Extreme fatigue
• Constipation
• Upset stomach
• Abdominal swelling with weight loss
• Back pain
• Pain during intercourse
• Changes in menstrual cycles, such as heavy or irregular bleeding
Ovarian cancer may result from inherited gene mutations, notably in the BRCA1 and BRCA2 genes. It may also originate from cells in the fallopian tubes rather than the ovaries. Another theory suggests that male hormones (androgens) might contribute to ovarian cancer.
Ovarian tumors can develop in three main cell types:
1. Epithelial Cells: Cover the ovary’s surface. Most ovarian cancers start here and are often found in postmenopausal women. Epithelial tumors can be benign (e.g., serous adenomas, mucinous adenomas) or malignant (e.g., serous carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma). Borderline epithelial tumors have a lower malignancy risk.
2. Germ Cells: Produce eggs and are more common in younger women. Types include:
o Teratoma: Can be benign or malignant.
o Dysgerminoma: Common in teenagers and young adults.
o Endodermal Sinus Tumor: More common in very young children.
o Choriocarcinoma: Rare and aggressive.
3. Stromal Cells: Support the ovary’s structure. Types include Granulosa-theca tumors and Sertoli-Leydig cell tumors, both rare.
• Age: Risk increases with age, especially post-menopause.
• Overweight or Obesity: Linked to a higher risk, though not always severe types.
• Pregnancy: Late childbirth or not having children can raise risk.
• Fertility Treatment: Some studies suggest a link between IVF and borderline ovarian tumors.
• Hormone Therapy: Prolonged use, especially estrogen-only, can increase risk.
• Family History: Increased risk if there’s a family history of ovarian, breast, or colorectal cancers.
• Previous Breast Cancer: Inherited mutations can elevate the risk for both breast and ovarian cancers.
• Smoking: Associated with a rare form of epithelial ovarian cancer.
• Infection: Treatment may reduce white blood cells, increasing infection risk.
• Bleeding and Bruising: Treatment can damage platelets, leading to prolonged bleeding and bruising.
• Loss of Fertility and Menopause: Removing ovaries or reproductive organs can lead to infertility and menopause.
• Neuropathy: Some chemotherapy drugs cause nerve damage, leading to numbness and pain.
• Hearing Loss: Certain chemotherapy drugs can affect hearing.
• Pelvic Ultrasound: Uses sound waves to image the ovaries. Can be done externally or internally (transvaginal).
• Imaging Tests: MRI, CT scan, PET scan, and chest X-ray help in diagnosis.
• Blood Tests: Measure CA-125 levels; high levels can indicate cancer but are not definitive alone.
• Surgical Evaluation: Diagnosis and treatment often involve surgery.
• Laparoscopy: A minimally invasive surgery using a camera to examine and sometimes remove tumors.
• Stage 1: Cancer is confined to the ovaries.
o Stage 1A: Cancer in one ovary only.
o Stage 1B: Cancer in both ovaries.
o Stage 1C: Cancer in both ovaries with additional complications like leakage or rupture.
• Stage 2: Cancer has spread to nearby organs.
o Stage 2A: Spread to uterus or fallopian tubes.
o Stage 2B: Spread to pelvic organs.
• Stage 3: Cancer has spread to nearby organs and lymph nodes or the stomach lining.
o Stage 3A: Cancer in lymph nodes or stomach lining.
o Stage 3B: Cancer deposits are less than 2 cm.
o Stage 3C: Cancer deposits are larger than 2 cm.
• Stage 4: Cancer has spread to distant organs.
o Stage 4A: Cancer cells in fluid around the lungs.
o Stage 4B: Cancer in distant organs like skin, lungs, or brain.
• Stage 1: Surgery to remove the tumor, possibly including nearby structures.
• Stage 2: Surgery (hysterectomy, bilateral salpingo-oophorectomy) followed by chemotherapy.
• Stage 3: Combination of surgery and chemotherapy.
• Stage 4: Combination of chemotherapy and surgery.
While prevention is not guaranteed, risk can be lowered by:
• Using birth control pills for five or more years.
• Undergoing tubal ligation, ovaries removal, or hysterectomy.
• Giving birth.
• Breastfeeding for over a year.
Most ovarian tumors found during pregnancy are benign. Early-stage cancers may allow for fertility preservation. If cancer is diagnosed early, it is possible to manage fertility with surgical options like unilateral salpingo-oophorectomy.
The 5-year survival rate for ovarian cancer is 45%. Survival rates are higher for those diagnosed before age 65 and for early-stage diagnoses, with a 92% 5-year survival rate for stage 1.
Treatment costs vary widely, from $20,000 for surgery to over $200,000 for comprehensive treatment including surgery and chemotherapy. Insurance coverage varies, and some treatments may not be fully covered.
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