What is ovarian cancer?
Ovarian cancer is a disease where some of the cells in one or both ovaries start to grow abnormally and develop into a mass. The ovaries are responsible for the production of eggs and female hormones during a woman’s reproductive life. Ovarian cancer begins in the ovaries but can quickly spread throughout the body. There are three types of ovarian cancer:
- Epithelial tumor: It is the most common type that affects the surface layers of the ovary.
- Germ cell tumor: It begins in the cells that eventually develop into the eggs.
- Stromal cell and other rare types: They may include sex-cord stromal cell ovarian cancer, stromal tumors and sarcomas.
It is also possible to have borderline epithelial tumors that are sometimes called low malignant potential tumors.
Women older than 63 years of age are at high risk of ovarian cancer. Ovarian cancer is the leading cause of gynecological cancer-related deaths among women aged 35 to 74 years of age. Most forms of ovarian cancer develop after a woman reaches menopause. Other risk factors may include:
- Being overweight
- Addictions such as smoking and (less commonly) alcohol consumption
- Having children after 35 years of age or never having a full-term pregnancy
- Taking hormone therapy, particularly estrogen alone, after menopause
- Having a family history of ovarian, breast, or colorectal cancer
- Polycystic ovarian disease (PCOD)
- Diabetes mellitus
- Certain types of birth control pills
- Talc granulomas in the ovaries due to the use of talcum powder in the sanitary pads
Stages of ovarian cancer (FIGO system):
- Stage I: Cancer is in one or both the ovaries only.
- Stage II: Cancer is in one or both the ovaries and has spread to other organs in the pelvis (uterus, fallopian tubes, bladder, or bowel).
- Stage III: Cancer is in one or both the ovaries and has spread beyond the pelvis to the peritoneum (lining of the abdomen) or the nearby lymph nodes.
- Stage IV: Cancer has spread further to distant organs such as the lung or liver.
Ovarian cancer treatment depends upon the stage of cancer, size of the tumor, age and health of the woman. Most often, ovarian cancer is treated with a combination of surgery and chemotherapy.
Surgery is the most common treatment for ovarian cancer. Surgery options can include
- Salpingo-oophorectomy: It involves removal of one or both the ovaries and fallopian tubes.
- Debulking: It involves removal of as much of the tumor as possible.
- Hysterectomy: It involves removal of the uterus and sometimes the cervix.
- Omentectomy: It involves removal of the fatty tissue that covers the organs in the lower abdomen.
- External beam radiation treatments may be used for recurring ovarian cancer. During this treatment, a high-energy beam of radiation is directed to the tumor for a few minutes. This procedure is repeated five days a week for several weeks.
- Special drugs designed to kill the cancer cells can be given as a pill or an intravenous (IV) injection or can be injected into the abdominal cavity. Chemotherapy can be given in combination with surgery.
- Maintain a healthy weight
- Eat balanced diet with fruits and vegetables
- Be physically active, at least 30 minutes of exercise five times a week
- Abstain from tobacco; no form is safe
- Drink alcohol in moderation, for example, one drink/day for women
Awareness is the key. Women need to be counseled routinely on the signs and symptoms of ovarian cancer, hopefully leading to early detection and treatment. Because ovarian cancer is typically diagnosed in the later stages, only about 20 percent of patients remain disease-free after initial therapy. That means further treatment is required. Every year, more than 20,000 women are diagnosed with ovarian cancer according to the American Cancer Society (ACS). The five-year survival rate is extremely high for patients with localized ovarian cancer and for those whose ovarian cancer is diagnosed and treated early. These women often go on to live long, healthy lives. However, the rate for all stages combined is under 50 percent, and stage IV ovarian cancer has a very low long-term rate of survival.