Ovarian Cancer

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

Causes of ovarian cancer

Although we know that ovarian cancer, like many other cancers, is caused by cells dividing and multiplying in an unregulated way, nobody completely understands why cancer of the ovary occurs.

  • Family history – Women with close relatives who have had ovarian cancer, or breast cancer, have a higher risk of developing ovarian cancer compared to other women.
  • Age– The majority of ovarian cancers occur in women over 65.
  • High number of total lifetime ovulations– There is a link between the total number of ovulations during a woman’s life and the risk of ovarian cancer. Four main factors influence the total:
    • The more times a woman has become pregnant, the lower her risk is
    • Women who have never been on the contraceptive pill have a higher risk
    • Women who started their periods at an early age have a higher risk
    • Women whose menopause started later than average have a higher risk
    • Infertility or fertility treatment
      Some studies have found a link between infertility treatment and a higher risk of ovarian cancer. Nobody knows whether the risk is because of the infertility treatment, infertility itself, or both.
  • Breast cancer – Women who have been diagnosed with breast cancer have a higher risk of developing ovarian cancer.
  • HRT (Hormone replacement therapy) – HRT slightly increases a women’s risk of developing ovarian cancer. Experts say that the risk increases the longer the HRT continues, and returns to normal as soon as treatment stops.
  • Obesity/overweight – Being obese or overweight increases the risk of developing many cancers.
  • Endometriosis – Women who develop endometriosis have an approximately 30 percent higher risk of developing ovarian cancer compared with other women.

What are the symptoms of ovarian cancer?

Can have no symptoms, but people may experience:
  • Pain areas: in the abdomen or pelvis
  • Gastrointestinal: bloating, change in bowel habits, fluid in the abdomen, indigestion, or nausea
  • Whole body: cancer-related fatigue or loss of appetite
  • Abdominal: abdominal fullness or lump in the abdomen
  • Also common: tumor or weight loss

How is ovarian cancer diagnosed?

  • Physical exam – Your doctor will first take your history and do a physical exam to look for signs of ovarian cancer.
  • Imaging tests, such as ultrasound or CT scans, of your abdomen and pelvis. These tests can help determine the size, shape and structure of your ovaries.
  • Blood test, which can detect a protein (CA 125) found on the surface of ovarian cancer cells.
  • Surgery to remove a tissue sample and abdominal fluid to confirm a diagnosis of ovarian cancer.

Treatments for ovarian cancer

Surgery is the main treatment for most ovarian cancers. What kind of ovarian cancer surgery performed depends on the type of tumor, the stage of the cancer, whether it has spread beyond the ovary and the patient’s general health. Minimally invasive surgery will be performed to stage the cancer to determine if it is confined to the ovary or has spread.

Surgeons will perform a hysterectomy to remove the uterus, as well as both ovaries and the fallopian tubes. Lymph nodes and tissue from the abdomen may be removed. The procedure can be performed laparoscopically. Ovarian cancers that have spread usually require open, abdominal surgery.

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DR Chitrathara K

HOD & Senior Consultant in Surgical & Gynaec Oncology. VPS Lakeshore Kochi
Specialized in gynecological, urological, and breast cancer surgeries.

  • Actively participated in the development of surgical oncology as a separate speciality in Kerala
  •  First lady Urologist of Kerala.
  • Started Kerala's first Gynaecological Cancer Surgery unit at Regional Cancer Centre, Thiruvananthapuram in 1993 & urological oncology in 2009.
  • Authored malayalam book “ Sthreekalile Arbudam-Ariyendathellam” published in 2014 by DC books
  • Editor of the following books - Ovarian Cancer (2008), Cervical cancer (2010) and Uterine Cancer (2015).

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