Written by Dr. Sanjana V.B Bhms,dbrm,cdn.

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed medically by SIAHMSR

Ovarian cancers

  Ovarian cancer accounts for an estimated 239,000 new cases and 152,000 deaths worldwide annually. These cancers arise by the uncontrolled proliferation of cells of ovaries. A woman’s lifetime risk of developing ovarian cancer is 1 in 75, and her chance of dying of the disease is 1 in 100.

Cancerous epithelial tumours are the most common type of ovarian cancer. The following are the common subtypes of ovarian carcinoma:

·       Serous carcinoma

·       Endometrioid carcinoma

·       Clear cell carcinoma

·       Mucinous carcinomas

Ovarian serous carcinoma is the most common subtype of ovarian carcinoma. The  endometrioid carcinomas are postulated to be derived from endometriosis. Various other subtypes and rare types of ovarian cancers occur.

 Who are at risk for ovarian cancers?

Most ovarian cancers are caused by genetic mutations and that could be inherited to offsprings.

There are also certain genetic changes  including BRCA1 and BRCA2 gene mutations that increase the risk of ovarian and  breast cancers.

Besides genetics, your lifestyle and the environment can affect your risk of ovarian cancer.

Some women are more likely to develop ovarian cancer. They include :

·       Women having a family history of ovarian cancer

·       Inherited changes in the BRCA1 or BRCA2 genes

·       Other genetic conditions, such as Lynch syndrome

·       Women with endometriosis

        There is association between endometriosis and endometrioid and clear cell ovarian carcinomas

·       Women on hormone replacement therapy

·       Overweight & obese women

·       Post-menopausal women

Other probable risk factors include environmental and lifestyle factors such as asbestos and talc powder exposures, and cigarette smoking.

What are the Signs & symptoms of ovarian cancer?

Symptoms are often absent or vague and it may mimic various other diseases of the body such as gastrointestinal ailments and therefore diagnosis of ovarian cancer is often delayed.

Any of the following symptoms may occur, although most ovarian cancers do not show any symptoms in the initial stages.

·       Pelvic pain

·       Lower back or abdominal pain

·       Menstrual changes

·       Weight loss

·       Bloating

·       Feeling full quickly

·       Difficulty eating

·       Nausea

·       Pelvic pressure

·       Vaginal bleeding

·       Abnormal vaginal discharge

·       A change in bowel habits

·       Frequent or urgent urination

·       Frequent or urgent bowel movements

·       Constipation

Most symptoms listed above occur as the tumor compresses on the adjust structures or organs within the pelvis.

                      SIAHMSR                                     

How are ovarian cancers diagnosed?

 Cancer symptoms are often vague and therefore early detection is difficult. It is often discovered accidentally when ultrasonogram done for other purposes such as urinary problems, abdominal discomfort, back pain etc.

In suspected cases a thorough physical examination is done by the gynaecologist, including rectovaginal examination on an empty bladder to look for pelvic and abdominal masses before ordering the screening tests.

Those who are already diagnosed as BRCA gene positive should see a gynecologic oncologist to perform additional screenings for ovarian cancer.

 Women suspected with ovarian cancer symptoms can receive the following tests:

CA-125 blood marker:

 It evaluates your blood for a protein that is elevated in ovarian cancer. However, it is not confirmatory. This marker can be elevated in other conditions also e.g.: endometriosis or pregnancy.

Transvaginal ultrasound:

An ultrasound probe that is inserted into your vagina to examine your pelvic organs can visualize the tumor well.

How are ovarian cancers managed?

Surgery and chemotherapy are the usual method of treatment in ovarian cancers depending on the stage of the disease. Gynecologic oncologists are doctors who have been trained to treat cancers of a woman’s reproductive system. The team may include medical oncologists and surgeons also.

The standard mode of treatment includes surgery and platinum-based chemotherapy; however, anti-angiogenic bevacizumab and Poly(ADP-ribose) polymerase (PARP) inhibitors have been used effectively in the ovarian cancer treatment recently. However, recurrence is still a problem in the treatment of ovarian cancers.

What is the survival rate in women with ovarian cancers generally?

Ovarian cancers are not detected early due to vague symptoms. Most of the cancers which are diagnosed at late stage and in these when the 5-year relative survival rate is only 29%. Few cases (15%) are diagnosed with localized tumor (in stage 1) when the 5-year survival rate is 92%. The overall 5-year relative survival rate generally ranges between 30%–40% across the globe.

Do oral contraceptive pills protect against ovarian cancers?

It is found that oral contraceptive use helps in the prevention of approximately 30,000 ovarian cancer cases every year and has already prevented an estimated 200,000 OC cases and 100,000 deaths over the last 50 years.

 written by dr.sanjana vb. BHMS,DBRM,CDN [ copyright]

References

1.    https://www.cancerresearchuk.org/about-cancer/cervical-cancer
2.    https://www.cdc.gov/cancer/gynecologic/basic_info/index.htm
3.    https://www.kucancercenter.org/news-room/blog/2020/08/most-common-cancers-women-how-to-detect-them-early
4.    https://www.uicc.org/what-we-do/areas-focus/women-and-cancer
5.    https://www.who.int/initiatives/cervical-cancer-elimination-initiative/strategy
6.    https://www.who.int/initiatives/global-breast-cancer-initiative
7.     https://medlineplus.gov/ovariancancer.html
8       https://pubmed.ncbi.nlm.nih.gov/25467588/ 
9      Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review, 1975–2008, National Cancer Institute. Bethesa, MD, http://seer.cancer.gov/csr/1975_2008/, based on November 2010 SEER data submission, posted to the SEER web site, 2011. (请核对文献类型及格式) 

10   Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer, 2013[2016-09-09]. http://globocan.iarc.fr.

11  Mancari R, Cutillo G, Bruno V, Vincenzoni C, Mancini E, Baiocco E, Bruni S, Vocaturo G, Chiofalo B, Vizza E. Development of new medical treatment for epithelial ovarian cancer recurrence. Gland Surg. 2020 Aug;9(4):1149-1163 https://pubmed.ncbi.nlm.nih.gov/32953630/