Ovarian cancer is a type of cancer which develops in the reproductive organs of females called ovaries. Ovaries produce ovum, which, when fertilized, gives rise to new life. This cancer doesn’t show any symptoms until it reaches later stages. Chemotherapy and surgery to remove tumours are two treatment options for ovarian cancer once it has been identified.
What is cancer, and what happens in ovarian cancer?
A person is said to have cancer when cells in the body start to proliferate uncontrollably anywhere in the body. Hence, one gets ovarian cancer when this abnormal development takes place in the ovaries. Each cell has a unique life cycle that includes growth, division, replacement and death. Even when they cease to function effectively or have outlived their usefulness, they go through “programmed cell death” – at this point, the cells pass away. However, in cancer cells may begin to grow quickly or stop dying when needed. This uncontrolled cell development can be problematic and frequently results in the formation of tumours, which are categorized into two types viz. Bening (Non-Cancerous) and Malignant (Cancerous).
Malignant tumours behave differently in the body than benign tumours. The body does not experience the spread of a benign tumour. Instead, it stays put and gradually expands over time. The doctor might advise observing it over time or surgically removing the tumour. Benign tumours often pose no immediate threat to one’s health. Malignant tumours are more aggressive as they spread throughout the body. They tend to grow quickly and enter new areas, creating further issues. Ovarian cancer refers to the developing malignant (cancerous) cells in the ovaries.
The ovaries are a pair of spherical organs at the upper corners of an upside-down triangle representing the female reproductive system. The fallopian tubes are two thin tubes that connect ovaries, each roughly the size of a walnut, to the uterus, the base of the triangle. Eggs generated in the ovaries move via the fallopian tubes and then are transferred to the uterus during a female’s reproductive years.
What causes ovarian cancer, and what are its types?
Although there are factors that can raise the risk of developing the disease, the cause of ovarian cancer remains unknown.
As far as medical professionals know, ovarian cancer starts when cells inside or close to the ovaries experience DNA alterations. The instructions on how the cell cycle should go on are encoded in its DNA. Any modification to this information causes the cells to quickly divide and expand, resulting in a mass (tumour) of cancer cells. When healthy cells would expire, the cancer cells live on. They can spread (metastasise) to different body areas by invading neighbouring tissues and separating from an initial tumour.
The ovarian cancer type and the best treatments for it will be determined by the type of cell in which cancer first appears. Types of ovarian cancer include:
– Ovarian epithelial cancer: This is the form of ovarian cancer which is the most prevalent. Serous carcinoma and mucinous carcinoma are two of their many subtypes.
– Stromal tumours: Compared to other ovarian malignancies, these uncommon tumours are typically discovered earlier.
– Germ cell cancers: These uncommon ovarian tumours typically develop in younger patients.
What are the symptoms of ovarian cancer?
Sadly, ovarian cancer can grow, expand significantly, and spread across the abdomen before symptoms appear, making early self-detection very hard. However, one may encounter any of the following symptoms:
– Having abdominal or pelvic pain, discomfort, or bloating.
– Changes in one’s eating patterns, such as eating less and feeling full sooner. Bloating, belching, and occasional stomach ache.
– Irregular vaginal bleeding or discharge is more frequently accompanied by digestive abnormalities like constipation and diarrhoea, especially if they occur outside of regular monthly cycles or after menopause.
– Discovering a rise in the size of the abdomen or feeling any strange bumps.
– Having frequent urges for urination.
Method of diagnosis and staging
The doctor can begin by taking a medical history and performing a pelvic exam. This examination is done to look for any unusual growths or enlarged pelvic organs. The first test could provide the doctor with more details and aid in determining whether one needs any follow-up exams.
Pelvic ultrasound: An ultrasound creates a picture of the internal organs using sound waves. This can be done with a wand inside or externally (usually on the abdomen). Transvaginal ultrasound is the name for an internal ultrasound. There is no need for one to prepare for these painless imaging exams. The doctor will examine the ovaries during the test to check for growths or enlargements. Not only malignant growths but all growths will be shown on the ultrasound. Several further tests are often conducted after this one to confirm the diagnosis.
Other imaging tests, including MRI scans, CT scans, PET scans, and chest X-rays, might also be prescribed.
Blood tests: Blood tests search for the CA-125 compounds, whose higher concentration can indicate cancer. However, CA-125 levels can be greater in numerous illnesses that are not cancer and can even be normal while cancer is present. As a result, blood tests are combined with other examinations to identify ovarian cancer.
Laparoscopy: A small cut (incision) is made in the abdomen during this surgery to insert a thin camera (laparoscope). The doctor can examine cancer, do staging biopsies, and, in certain cases, remove ovarian tumours using the scope as a guide and extra ports to hold equipment.
Stages of ovarian cancer
Ovarian cancer progresses through four phases. The lowest number is the least severe. The higher the stage, the more critical the condition becomes.
Stage I: There are three smaller phases within this stage (stage IA, stage IB, and stage IC). Cancer only affects one ovary or one fallopian tube in the early stages. Cancer in the fallopian tubes or ovaries is present in stage IB. Stage IC cancer is discovered outside the ovary, in either the fallopian tubes or both ovaries (outside the organ itself or in the space around the ovary, called the peritoneal cavity).
Stage II: Stage II is further broken down into a few stages. In stage IIA, cancer has gone to the uterus and is no longer just in the ovary. Instead, cancer has spread to further neighbouring abdominal organs at stage IIB (peritoneal cavity).
Stage III: There are three sub-stages in this stage. Stage IIIA signifies lymph node-mediated cancer spreading outside the peritoneum cavity (abdomen). The tumour is around 2 cm in size and has spread outside the abdominal cavity in the second stage (stage IIIB). Finally, stage IIIC refers to cancer that has spread outside the pelvic region and grown in size (more than 2 centimetres). At this time, it might affect other organs, such as the liver.
Stage IV: The most serious form of cancer is stage IV. Cancer has spread throughout the body at this point. Stage IVA cancer is discovered close to the lungs, while stage IVB cancer is discovered in the groin lymph nodes.
Methods of treatment
Cancer treatment aims to eliminate as much cancer as possible from the body, if not all of it. For example, if one has ovarian cancer, their reproductive organs and any other organs with cancer must typically be removed. This includes sections of the intestine and the fatty tissue that covers the intestines.
Ovarian cancer can be surgically removed through a laparoscopy (a minimally invasive procedure frequently used for cancer diagnostics) or during a laparotomy. With a laparotomy, a doctor can access the abdomen through a bigger incision and remove the ovaries. Other organs that cancer may have spread to may also be removed during this procedure.
Depending on several variables, such as the severity of cancer at the time of diagnosis, the healthcare professional may advise chemotherapy either before or after surgery. Drugs used in chemotherapy are intended to find and kill malignant cells.
Following treatment for ovarian cancer, the doctor will want to check in frequently for observation. To be sure cancer hasn’t come back over time, one might have regular checkups. The doctor may examine and review any potential symptoms during these visits. Be aware of any symptoms one might be experiencing and let the doctor know about them.