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Ovarian Cancer: Questions and Answers

By on March 3, 2012 in Diseases, Prevention with 0 Comments
  1. What is ovarian cancer?Ovarian cancer is cancer that originates in the ovaries, the pair of female reproductive organs located in the pelvis. The ovaries have two functions: to produce eggs and female hormones (chemicals that control the way certain cells or organs function). Ovarian cancer occurs when cells in the ovary become abnormal and divide without control or order. Cancer cells can invade and destroy surrounding tissue. Can also be separated from the tumor and spread to form new tumors in other parts of the body.
  2. Who is at risk?It is estimated that in the United States, more than 25,000 women were diagnosed with ovarian cancer in 1999 and over 14,000 died from the disease. The exact causes of ovarian cancer are unknown. However, studies show that the following factors may increase the likelihood of developing this cancer:
    • Family history. The first-degree relatives (mother, daughter, sister) of a woman who has had ovarian cancer are at increased risk of developing this cancer. The risk is especially high if two or more first degree relatives of a woman have had the disease. A family history of breast cancer or colon cancer is also associated with increased risk of developing ovarian cancer.
    • Age. The probability of developing ovarian cancer increases as women age. Most ovarian cancers occur in women over 50 years of age with increased risk for women over 60 years of age.
    • Motherhood. Women who have never had children are more likely to develop ovarian cancer than women who have  had children. In fact, the more children she has had, the less the chance of developing ovarian cancer.
    • Personal history. Women who have had breast cancer or colon cancer, are more likely to develop ovarian cancer than women who have not had these diseases.
    • Fertility drugs. Fertility treatment with certain drugs that trigger ovulation is associated with a probability greater than average of developing ovarian cancer.
    • Talc. Some studies suggest that women who have used talc in the genital area for many years may have an increased risk of developing ovarian cancer. However, more research is needed to understand this possible risk factor.
  3. Is there a test to detect early ovarian cancer?The sooner it is detected, the better the chance for recovery. However, ovarian cancer is difficult to detect early. Many times, women with ovarian cancer have no symptoms or have very mild symptoms until the disease reaches an advance stage. Scientists are studying ways to detect ovarian cancer before symptoms develop.The study of early detection of cancer of the Prostate, Lung, Colorectal, and Ovarian, or PLCO trial, seeks to determine whether certain evidence will reduce the number of deaths from such cancers. The PLCO trial is currently evaluating the utility of certain methods to detect ovarian cancer. One method is the blood test that measures the level CA-125, a substance called tumor marker, found in the blood often in quantities greater than normal in women with ovarian cancer. This study is also evaluating the effectiveness of a physical examination of the ovaries and a test called a transvaginal ultrasound to detect early disease. Transvaginal ultrasound, also known as DVT, is a procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, the sound waves vibrate the organs inside the pelvic area. These sound waves produce echoes, which uses the computer to create a picture called a sonogram.
  4. Does it cause any symptoms ovarian cancer?Ovarian cancer usually shows no obvious signs or symptoms until it is late in its development. Signs and symptoms of ovarian cancer may include:
    • General abdominal discomfort or pain (gas, indigestion, pressure, swelling, bloating, cramps).
    • Nausea, diarrhea, constipation or frequent urination.
    • Loss of appetite.
    • Feeling of fullness even after a light meal.
    • Gain or weight loss without just cause.
    • Abnormal vaginal bleeding.

    These symptoms may be caused by ovarian cancer or other less serious disorders. It is important to consult your doctor about any of these symptoms.

  5. How is the ovarian cancer diagnosed?To find the cause of symptoms, the doctor evaluates the woman’s medical history, perform a physical examination and orders diagnostic tests. Some of the examinations and tests that may be useful are described below:
    • Pelvic exam. This includes feeling the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size. It is usually done along with examination of Pap test (common test used to detect cervical cancer). Sometimes this test can detect ovarian cancer, but is not a reliable way to detect or diagnose ovarian cancer.
    • Ultrasound. Use high-frequency sound waves. These waves can not be heard by humans, they point to the ovaries. The pattern of the echoes they produce creates a picture called a sonogram.Healthy tissues, fluid-filled cysts and tumors look different on the table.
    • Analysis of CA-125. consists of a blood test to measure levels of CA-125, a tumor marker in the blood is usually in quantities greater than normal in women with ovarian cancer.
    • Radiography of the lower abdomen or barium enema. consists of a series of x-rays of the colon and rectum. The photographs were taken after the patient is given an enema with a white, chalky solution containing barium. The barium outlines the colon and rectum on the x-ray, making it easier to see the tumor or other abnormal areas.
    • Computed tomography (CT scan). consists of a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine.
    • Biopsy. involves taking a sample of tissue for examination under a microscope. A pathologist views the tissue for diagnosis. To obtain the tissue, the surgeon performs a laparotomy (opening the abdomen). If cancer is suspected, the surgeon performs an oophorectomy (removal of the entire ovary). This is important because if cancer is present, cutting the outer layer of the ovary to simply remove a tissue sample, may cancer cells to escape and spread the disease.

    If the diagnosis is ovarian cancer, the doctor will want to learn the stage (or extent) of disease in order to find out whether the cancer has spread and, if so, to what parts of the body. The staging of the disease may involve surgery, x-rays and other procedures making detailed images, and laboratory tests. Knowing the stage of the disease helps the doctor plan treatment.

  6. How is ovarian cancer treated?Doctors use sing different combinations of treatments and therapies to treat ovarian cancer. The treatment plan for a particular patient depends on several factors, including cancer stage, age and general health.
    • Surgery is the treatment for most women diagnosed with ovarian cancer. In general, ovaries, cervix, uterus, and fallopian tubes are removed in an operation called a hysterectomy with bilateral salpingo-oophorectomy (surgical removal of both fallopian tubes and ovaries).During surgery, determines the stage of the disease and usually involves the removal of lymph nodes (small organs located along the ducts of the lymphatic system) tissue samples from the diaphragm, the omentum (thin tissue covering the stomach and intestine) and other organs in the abdomen, and fluid in the abdomen. If the cancer has spread, the surgeon usually removes as much cancer as possible to reduce the amount of cancer that must then be treated with chemotherapy or radiation therapy.
    • Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat ovarian cancer are given by injection into a vein (intravenously or IV). There may also be chemotherapy drugs directly into the abdomen (intraperitoneal or IP) via a catheter, a thin tube that is placed on the duration of treatment.After chemotherapy is completed, you can perform a second look surgery to examine the abdomen directly. The surgeon may remove fluid and a tissue sample to see if the anti-cancer drugs have successfully removed the cancer.
    • Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells. Radiation therapy affects the cancer cells only in the treated area. Radiation may come from a machine (external radiation) or from a radioactive liquid placed directly into the abdomen through a catheter (intraperitoneal radiation).

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