Ovarian Cancer Awareness Month
Ovarian cancer is a malignant cancerous growth originating from the ovaries in females. Among all gynecologic cancers (uterus, cervix and ovaries), ovarian cancer account for the most of cancer-related deaths in women.
If diagnosed sufficiently early, there are chances that the disease can be cured and the patient has a ~94% chance of living for 5 years (technically, the chances of living for 5 years is a way by which we express the curability of cancer).
Ovaries are the female reproductive organs that hold, matures and releases the ‘ovum’ or ‘eggs’ for reproduction. In addition, ovaries also produce female sex hormones. There are 2 ovaries situated on either side of the uterus in the lowermost part of the abdomen or the 'pelvis', within the bony cage of the hip.
Risk factors: Major risk factors include
1. Family history- women whose close relatives who had breast or ovarian cancers are at higher risk of getting ovarian cancer themselves.
2. Older age- Most of the ovarian cancers occur after menopause.
3. Reproductive history- the more pregnancies a woman has lessens the risk. Breastfeeding may also decrease the risk.
5. Carriers of certain genetic mutations- like BRCA 1, BRCA 2 gene mutations, Lynch Syndrome etc.
Types of Ovarian Cancers:
Broadly, there are two types of ovarian cancers:
Epithelial ovarian cancers- which in simple terms, arise from the outer most covering layer of the ovary (called ‘epithelium’) - the commonest of the types.
Germ cell cancers- which arise from the reproductive cells within the ovary-forms a lesser variant, but not uncommon.
Ovarian cancers in the very early stages carry no or minimal symptoms. Sometimes the symptoms may resemble other more common conditions like the pre-menstrual syndrome, bowel disorders or a urinary problem. This may make a clinical suspicion very difficult. However, the main difference between ovarian cancer and other common problems may be persistence or gradual worsening of the symptoms over a few weeks or months in case of cancer.
Few of such persistent symptoms may be: Pain in the pelvis, back pain, indigestion, feeling of rapid fullness of abdomen when eating (early satiety), more frequent urination, urgency to pass urine as soon as you feel so, a newer change in bowel habits like constipation, or sometimes pain during sexual intercourse. As the disease grows, there may be feeling of vomiting (nausea) or vomiting, weight loss, breathlessness, swelling of abdomen and heaviness in abdomen, increasing tiredness, loss of appetite and worsening general health.
Summarizing all, if any individual experience pain in abdomen and/or back, swelling of the abdomen, bloating with or without tiredness/ weight loss or worsening of general health for more than a few weeks, they should seek a medical attention.
Screening and Early detection:
Many of the scientific guidelines warn against routine screening for ovarian cancers in individuals who are not at high risk for getting the disease. Tests that may be useful for women at ‘high risk’ of ovarian cancer include a blood test of the CA 125 tumour marker, ultrasonography, or a combination of the two. However, screening tests may be planned only after detailed discussion with your doctor (Oncologist/ Gynecologist/ Geneticist) since harms of screening may outweigh benefits sometimes.
You can now book an appointment online to meet our Department of Gynaecology and Obstetrics specialists by visiting http://bit.ly/OB-GYN.
A final diagnosis of ovarian cancer is made after a thorough clinical examination and detailed investigations like:
1. Blood tests- checking for elevated levels of certain blood-borne markers of ovarian cancer.
2. Imaging studies- ultrasound, CT scans or MRI scans
3. A diagnostic Laparoscopy (or keyhole surgery) to look inside the abdomen and to obtain a biopsy.
4. Aspiration and testing of fluid collected inside the abdomen.
5. Biopsy of the growth guided by scans or through a ‘key-hole’ surgery.
Surgery- involves removing the diseased ovaries, uterus, lymph nodes and any other growth that may appear as the cancerous disease spread out from the ovaries within the abdomen. Surgery may be done at first or after shrinking the tumour after a few cycles of chemotherapy in the beginning.
Chemotherapy- refers to medications give and 'drips'/ injections or sometimes as tablets. Chemotherapy may be given before or after the surgery, as decided by the treating oncologist/s based on the disease status to bring out the best results.
Targeted therapy- is a relatively newer form of treatment for various malignancies. These medicines ‘target’ molecular markers present specifically on the cancer cells, making them more 'cancer-specific' and less toxic compared to conventional chemotherapy medicines. Treatment using targeted therapy drugs are again decided and discussed with the patient by the treating oncologist/s based on the disease status and expected benefits of treatment.
Radiation therapy- the role of radiation therapy in Ovarian cancers is limited and is used in situations to 'palliate’ some of the symptoms that may cause pain or other significant difficulties.
You can now book an appointment online to meet our Department of Oncology specialists by visiting http://bit.ly/Muthootoncology.
To schedule an appointment to meet our specialists you can book an appointment online at http://bit.ly/muthootappointments or send us a message on WhatsApp at 7012223846