HEALTH - OVARIAN CANCER (OVARIES) SYMPTOMS & TREATMENT
What is Ovarian Cancer?
Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs. They are part of a woman's reproductive system and every woman has two ovaries, one located on each side of the uterus. They are almond shaped and about one and a half inches long. Every month, during ovulation, an egg is released from an ovary and travels to the uterus through a structure called the fallopian tube.
Ovaries are the primary source of women's sex hormones, estrogen and progesterone. These hormones influence breast growth, body shape, and body hair, and regulate the menstrual cycle and pregnancy. During menopause, the ovaries stop releasing eggs and producing sex hormones.
Ovarian cancer begins when normal cells in an ovary begin to change, grow without control, and no longer die, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it could spread to other parts of the body). Removing the ovary or the part of the ovary where the tumor is located can treat a noncancerous ovarian tumor. An ovarian cyst, which forms on the surface of the ovary, is different than a noncancerous tumor and usually goes away without treatment. Ovarian cysts are not cancerous.
Early detection is important; still, only about 20 percent of ovarian cancers are found before tumor growth has spread beyond the ovaries. Your chance of surviving ovarian cancer is better if the cancer is found early. Until recently, ovarian cancer was known as a "silent killer" because it usually wasn't found until it had spread to other areas of your body. But new evidence shows that most women may have symptoms even in the early stages, and awareness of symptoms may hopefully lead to earlier detection.
Ovarian cancer is the seventh most common cancer in women in the U.S. with over 25,000 women newly diagnosed each year with this disease. It is the fifth leading cause of cancer deaths in women and frequently does not result in symptoms until the cancer has spread extensively. Less than one-third of ovarian cancers are detected before they have spread outside of the ovaries.
Health: Causes of Ovarian Cancer (Ovaries)
Women have two ovaries, one on either side of the uterus. The ovaries —
each about the size of an almond — produce eggs (ova) as well as the
female sex hormones estrogen and progesterone. An ovarian tumor is a
growth of abnormal cells that may be either noncancerous (benign) or
cancerous (malignant). Although benign tumors are made up of abnormal
cells, these cells don't spread to other body tissues (metastasize).
Ovarian cancer cells metastasize in one of two ways. Generally, they spread directly to adjacent tissue or organs in the pelvis and abdomen. They can also spread through your bloodstream or lymph channels to other parts of your body.
Three basic types of ovarian cancer exist, designated by where they form in the ovaries:
- Epithelial tumors. About 85 to 90 percent of ovarian cancers develop in the epithelium, the thin layer of tissue that covers the ovaries, according to the American Cancer Society.
- Germ cell tumors. This uncommon type of ovarian cancer develops in the egg-producing cells of the ovaries, and generally occur in younger women.
- Stromal tumors. This rare form of ovarian cancer develops in the connective tissue cells that hold the ovaries together and produce female hormones.
The exact cause of ovarian cancer remains unknown. Some researchers
believe it has to do with the tissue-repair process that follows the
monthly release of an egg through a tiny tear in an ovarian follicle
(ovulation) during a woman's reproductive years. The formation and
division of new cells at the rupture site may set up a situation in
which genetic errors occur. Others propose that the increased hormone
levels before and during ovulation may stimulate the growth of abnormal
cells.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Health: Risk Factors of Ovarian Cancer (Ovaries)
Certain factors may increase your health risk of ovarian cancer. Having one or more of these risk factors doesn't mean that you're sure to develop ovarian cancer, but your health risk may be higher than that of the average woman. These risk factors include:
Age. Risk of developing ovarian cancer increases with age. Women of all ages have a risk of ovarian cancer, but women over 50 are more likely to develop ovarian cancer (68% of women with ovarian cancer are older than 55 and 32% are younger than 55).
Family history. Ovarian cancer risk increases for women who have a first-degree relative (mother, daughter, sister) who has had ovarian cancer. The health risk increases when two or more first-degree relatives have had the disease.
Genetics. A mutation in the BRCA1 or BRCA2 gene is associated with increased risk of ovarian cancer; there is also an increased health risk of fallopian tube cancer and primary peritoneal (the membrane lining the abdomen) cancer, which are similar to ovarian cancer.
Ethnicity. Women of North American, Northern European, or Ashkenazi Jewish heritage have an increased health risk of ovarian cancer.
Reproductive history. Women who have never had children, have unexplained infertility (the inability to bear children), have not taken birth control pills, or had their first child after the age of 30 have an increased risk of ovarian cancer. Also, women who started menstruation before age 12 and/or go through menopause later in life have an increased risk of ovarian cancer.
Hormones. Women who have taken estrogen-only hormone replacement therapy (HRT) after menopause have a higher health risk of ovarian cancer. Fertility treatment drugs may also be associated with a higher health risk of developing ovarian cancer.
Obesity. Recent studies have shown that women who were obese in early adulthood are 50% more likely to develop ovarian cancer. Women who are obese are also more likely to die from the disease.
Behavioral and social factors. Homosexual or bisexual women may have a higher health risk of ovarian cancer than heterosexual women. This may be because lesbian women may be less likely to give birth, take oral contraceptives, or receive preventive screenings for fear of discrimination or insensitivity. Female-to-male transgendered and transsexual people may have a higher risk of ovarian cancer because of receiving hormones.
A history of breast cancer. If you've been diagnosed with breast cancer, your risk of ovarian cancer also is elevated.
Health: Symptoms of Ovarian Cancer (Ovaries)
Ovarian
cancer was thought to cause no symptoms. However, recent studies have
shown that woman with ovarian cancer are more likely to have the
following symptoms, even if the cancer is in an early stage. Sometimes,
women with ovarian cancer do not show any of these symptoms.
Symptoms of ovarian cancer are nonspecific and mimic those of many other more common conditions, including digestive and bladder disorders. A woman with ovarian cancer may be diagnosed with another health condition before finally learning she has cancer. Common misdiagnoses include irritable bowel syndrome, stress and depression.
These symptoms may be caused by a health condition that is not cancer.
- Abdominal pressure or bloating
- Pelvic discomfort or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary symptoms (urgency or frequency)
The key seems to be persistent or worsening symptoms. With
most digestive disorders, symptoms tend to come and go, or they occur
in certain situations or after eating certain foods. With ovarian
cancer, there's typically little fluctuation — symptoms are constant
and gradually worsen. For many women with ovarian cancer, these symptoms occur often and
are different from what is normal for their bodies.
Women who have these symptoms almost daily for more than a few weeks should see a gynecologist (a doctor who specializes in treating diseases of the female reproductive organs). Early medical evaluation may help detect the cancer at the earliest possible stage of the disease, when it is easier to treat.
Women with ovarian cancer may also have the following symptoms:
- Fatigue, persistent lack of energy
- Persistent indigestion, gas or nausea
- Unexplained changes in bowel habits, such as constipation
- Changes in bladder habits, including a frequent need to urinate
- Loss of appetite or quickly feeling full
- Increased abdominal girth or clothes fitting tighter around your waist
- Pain during intercourse (dyspareunia)
- Lower back pain
- Menstrual irregularities
However, these symptoms are equally as likely to be caused by
another health condition. If you are concerned about any of these
symptoms, please talk with your doctor or health care provider. See your doctor if you have swelling, bloating, pressure or pain in
your abdomen or pelvis that lasts for more than a few weeks.
If you've already seen a doctor and received a diagnosis other than ovarian cancer, but you're not getting relief from the treatment, schedule a follow-up visit with your doctor or get a second opinion. Make sure that a pelvic exam is a part of your evaluation.
If you have a history of ovarian cancer or a strong history of breast
cancer in your family, strongly consider seeing a doctor trained to
detect and care for ovarian cancer patients so that you can talk about
screening, genetic testing and treatment options while you are
disease-free.
Health: Diagnosis for Ovarian Cancer (Ovaries) As with all cancers, early detection and
treatment is important. However, early detection of ovarian cancer is
difficult. Often, women don’t have any symptoms until the later stages
of the disease. In fact, 70% of ovarian cancers are not found until the
disease is in an advanced stage and has spread to other parts of the
body, most commonly the abdomen. Because no standardized screening test exists to reliably detect
ovarian cancer, doctors don't recommend screening for this type of
cancer for most women. If you have a high risk of ovarian cancer, you
need to have a careful discussion with your doctor about the risks and
benefits of undergoing screening tests. While you may wonder what harm
could come from a screening test, such tests can lead to unnecessary
operations or other procedures that have significant side effects.
Along with the potential complications of surgery, unnecessary
procedures can cause anxiety, loss of work and substantial financial
costs. In addition to a physical exam, the following tests may be used to diagnose ovarian cancer: Pelvic examination. The doctor feels the uterus, vagina,
ovaries, fallopian tubes, bladder, and rectum to check for any unusual
changes. A Pap test, usually done with a pelvic examination, cannot
find or diagnose ovarian cancer. Transvaginal ultrasound. An ultrasound wand is inserted in
the vagina and aimed at the ovaries. An ultrasound uses sound waves to
create a picture of the ovaries, including healthy tissues, cysts, and
tumors. Researchers are currently evaluating whether this test can help
with early detection of ovarian cancer. CA-125 assay. This blood test measures a substance called
CA-125, a tumor marker, which is found in higher levels in women with
ovarian cancer and other conditions, including endometriosis and pelvic
inflammatory disease. This test is more accurate in postmenopausal
women. Biopsy. A biopsy is the removal of a small amount of tissue
for examination under a microscope. A biopsy for ovarian cancer is
rarely done as a separate procedure. If the doctor suspects ovarian
cancer, the patient will most likely receive surgery to remove as much of the tumor as possible, and a tumor sample will be
analyzed afterwards. Other tests can suggest that cancer is present,
but only an analysis of the tumor can make a definite diagnosis. The
sample removed during surgery or biopsy is analyzed by a pathologist (a
doctor who specializes in interpreting laboratory tests and evaluating
cells, tissues, and organs to diagnose disease). The doctor may
recommend additional tests to see if the cancer has spread beyond the
ovaries. Lower gastrointestinal (GI) series. This is a series of
x-rays of the colon and rectum taken after the patient has a barium
enema. The barium highlights the colon and rectum on the x-ray, making
it easier to identify a tumor or abnormal area in those organs. Computed tomography (CT or CAT) scan. A CT scan creates a
three-dimensional picture of the inside of the body with an x-ray
machine. A computer then combines these images into a detailed,
cross-sectional view that shows any abnormalities or tumors. Sometimes,
a contrast medium (a special dye) is injected into a patient’s vein to
provide better detail. Positron emission tomography (PET) scan. A PET scan is a way
to create pictures of organs and tissues inside the body. A small
amount of a radioactive substance is injected into a patient’s body and
absorbed by the organs or tissues being studied. This substance gives
off energy that is detected by a scanner, which produces the images. X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can show if the cancer has spread to the lungs.
Health: Staging of Ovarian Cancer (Ovaries)
To plan the best treatment, your doctor needs to know the grade of the tumor and the extent (stage) of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body.
Usually, surgery is needed before staging can be complete. The surgeon takes many samples of tissue from the pelvis and abdomen to look for cancer.
These are the stages of ovarian cancer:
- Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.
- Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found on the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
- Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
- Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.
_______________________________________________________________________________________________________
Natural Alternative Treatment Option: NATURAL CANCER TREATMENT
_______________________________________________________________________________________________________
Health: Conventional Treatment for Ovarian Cancer (Ovaries)
Ovarian cancer is treated with one or a combination of treatments, including surgery, chemotherapy, and radiation therapy. Each treatment option is described below, followed by an outline of the treatments based on the stage of the disease.
Surgery
Surgery is often the first treatment used for ovarian cancer. Usually, a bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes) and hysterectomy are performed. The surgeon may also remove the omentum, the thin tissue covering the stomach and large intestine.
To determine whether the cancer has spread, the surgeon will often also remove lymph nodes, tissue samples, and fluid from the abdomen.
If the woman wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only one ovary and fallopian tube if the cancer is located in only one ovary.
If, during the surgery, it is clear that the cancer has spread, the surgeon removes as much of the cancer as possible. This may reduce the amount of cancer that will require further treatment with chemotherapy or radiation therapy.
Surgery causes short-term pain and tenderness. If a patient is experiencing pain, the doctor will prescribe an appropriate medication. For several days after the operation, the patient may have difficulty emptying her bladder (urinating) and having bowel movements. Studies have shown that women who have their surgeries performed by gynecologic oncologists are more likely to be successfully treated with surgery and have fewer side effects.
If both ovaries are removed, a woman can no longer bear children. The loss of both ovaries also eliminates the body's source of sex hormones, resulting in premature menopause. Soon after surgery, the patient is likely to experience menopausal symptoms, including hot flashes and vaginal dryness. Women should talk with their doctors before and after surgery about ways to cope with these side effects.
Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The goal of chemotherapy can be to destroy cancer remaining after surgery, slow the tumor's growth, or reduce side effects.
Although chemotherapy can be given orally (by mouth), most drugs used to treat ovarian cancer are given intravenously (IV) or intraperitoneally (IP). IV chemotherapy is either injected directly into a vein or through a catheter, a thin tube temporarily put into a large vein to make injections easier. IP chemotherapy is when a catheter is placed in the abdomen to deliver chemotherapy directly into the pelvic area.
Several clinical trials have shown a significant benefit for combining IP and IV chemotherapy for patients with advanced ovarian cancer. The National Cancer Institute recommends that women with later-stage ovarian cancer be offered this option of treatment.
The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
Other potential side effects include both the inability to become pregnant and premature menopause. Rarely, certain drugs may cause some hearing loss. Others may cause kidney damage. Patients may be given extra fluid intravenously for kidney protection.
After chemotherapy is completed, a second surgery may be performed to examine the abdomen and remove fluid and tissue samples to determine if any cancer cells remain.
The medications used to treat cancer are continually being
evaluated. Talking with your doctor is often the best way to learn
about the medications prescribed for you, their purpose, and their
potential side effects or interactions with other medications.
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy is given either by delivering a small amount of radioactive material directly to the tumor or by injecting radioactive liquid directly into the abdomen through a catheter (called intraperitoneal radiation therapy).
Radiation treatment is not usually used to treat ovarian cancer, but it may be used to relieve side effects.
Side effects from radiation therapy depend on the dose and the area of the body being treated, but may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Side effects of internal radiation therapy may include abdominal pain and bowel obstruction. Most side effects usually go away soon after treatment is finished.
Sometimes, doctors advise their patients not to have sexual intercourse during radiation therapy. Women may resume normal sexual activity within a few weeks after treatment if they feel ready.
Treatment options by stage
Stage I
- Surgery
- Surgery and chemotherapy
Stage II
- Surgery
- Chemotherapy
Stage III & IV
- Surgery and chemotherapy (either IV or IP or both combined)
- Chemotherapy
Recurrent ovarian cancer
If ovarian cancer recurs, the symptoms are similar to those experienced when the disease was first diagnosed. The four of the most common symptoms are bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, urinary symptoms (urgency or frequency). However, other symptoms may include:
- Persistent indigestion, gas, nausea, diarrhea, or constipation
- Unexplained weight loss or gain, especially in the abdominal area
- Abnormal bleeding from the vagina
- Pain during intercourse
- Fatigue
- Lower back pain
Treatment for advanced cancer and recurrent disease
If standard treatment is not effective, the doctor may recommend options including "second-line" chemotherapy drugs and radiation therapy to help relieve side effects.
New therapies for ovarian cancer include experimental combinations of chemotherapy and new biologic agents, which are designed to boost the body’s natural defenses to fight the cancer. Since the benefits of these options remain unproven, their risks must be carefully weighed against possible improvements in symptoms and survival.
Health: Prevention of Ovarian Cancer (Ovaries)
Several factors appear to reduce the health risk of ovarian cancer, including:
- Oral contraception (birth control pills). Compared with women who've never used them, women who use oral contraceptives for five years or more reduce their risk of ovarian cancer by about 50 percent, according to the ACS.
- Pregnancy and breast-feeding. Having at least one child lowers your risk of developing ovarian cancer. Breast-feeding a child also may reduce your risk of ovarian cancer.
- Tubal ligation or hysterectomy. Having your tubes tied or having a hysterectomy may reduce your risk of ovarian cancer.
Women who are at very high health risk of developing ovarian cancer may elect to have their ovaries removed as a means of preventing the disease. This surgery, known as prophylactic oophorectomy, is recommended primarily for women who've tested positive for a BRCA gene mutation or women who have a strong family history of breast and ovarian cancers, even if no genetic mutation has been identified.
Studies indicate that prophylactic oophorectomy lowers ovarian cancer risk by up to 95 percent, and reduces the risk of breast cancer by up to 50 percent, if the ovaries are removed before menopause. Prophylactic oophorectomy reduces, but doesn't completely eliminate, ovarian cancer risk. Because ovarian cancer usually develops in the thin lining of the abdominal cavity that covers the ovaries, women who have had their ovaries removed can still get a similar but less common form of cancer called primary peritoneal cancer.
In addition, prophylactic oophorectomy induces early menopause, which in itself may have a negative impact on your health, including an increased risk of osteoporosis, heart disease and other health conditions. If you're considering having this procedure done, be sure to discuss the pros and cons with your doctor or health care provider.
Health: Lifestyle Changers with Ovarian Cancer (Ovaries)
Eating well, managing stress and exercising are ways to promote your overall health and may help you better take care of yourself if you have ovarian cancer.
Eating well
Good nutrition is especially important for people undergoing cancer
treatment. But eating well can be difficult for a time if your
treatment includes chemotherapy or radiation therapy. You may feel
nauseated or lose your appetite, and foods may taste bland or
unpleasant. You may find that the last thing you want to do is plan
meals.
Even so, eating well during cancer treatment can help you maintain your stamina and your ability to cope with the side effects of treatments. Good nutrition may also help you prevent infections and remain more active.
Remember these strategies for eating well when you don't feel well:
- Eat protein-rich foods. Foods high in protein can help build and repair body tissues. Choices include eggs, yogurt, cottage cheese, peanut butter, lean meat, poultry, fish, beans and lentils.
- Keep an open mind about the foods you might eat. Something that is unappealing today might taste better to you next week.
- When you do feel well, make the most of it. Eat as many healthy foods as you can. Prepare meals that you can easily freeze and reheat. Also look for low-fat frozen dinners and other prepared foods.
- Pack calories into the foods you eat. For example, spread butter, jam or honey on bread. Sprinkle foods with chopped nuts.
- Eat smaller amounts of food more frequently. If you can't face the thought of a large meal, try eating small amounts of food more often. Keep fruits and vegetables handy for snacking.
Staying active
Even if you don't feel well, try to stay physically active. A regular,
short walk or climbing the stairs can keep your muscles from
deteriorating due to lack of use. Exercise can also help prevent
fatigue and depression and reduce anxiety.
In addition, activities that require repetitive movement, such as swimming, can produce a mental state similar to that achieved with meditation. The same is true with stretching exercises.
_______________________________________________________________________________________________________
Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.
Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
<<Previous (Home Page) Next>>
