Ovarian Cancer

Cancer of the ovary is a disease in which cancer cells are found in the ovary. Ovaries are small organs in the pelvis that makes female hormones and holds egg cells which, when fertilized, can develop into a baby.

Symptoms

Swelling of the abdomen and general discomfort in the lower abdomen.

Loss of appetite and feeling of fullness even after a light meal.

Indigestion, nausea and weight loss.

A large tumor may press on nearby organs, such as the bowel or bladder, causing diarrhea or constipation, or frequent urination.

Bleeding from the vagina.

Diagnosis

Medical history and physical examination

Pelvic examination - The doctor feels the vagina, rectum and lower abdomen for masses or growths.

Ultrasonography - The use of high frequency sound waves, which cannot be heard by humans and are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid filled cysts and tumors produce different echoes.

CT (or CAT) scan - A series of x-rays put together by a computer.

Lower GI series or barium enema - Series of x-rays of the colon and rectum, taken after the patient is given an enema with a white, chalky solution containing barium. The barium outlines the colon and rectum on the x-ray, which helps the doctor see tumors or other abnormal areas.

Intravenous urogram (IVU) - An x-ray of the kidneys and ureters, taken after the injection of a dye.

Often, the doctor orders a blood test to measure a substance in the blood called CA 125. This substance, called a tumor marker, can be produced by ovarian cancer cells. However, CA 125 is not always present in women with ovarian cancer, and it may be present in women who have benign ovarian conditions. Thus, this blood test cannot be used alone to diagnose cancer.

Sample of biopsy tissue under the microscope. To obtain the tissue, the surgeon does an operation called a laparotomy. If cancer is suspected, the surgeon removes the entire ovary (oophorectomy).

Staging in Ovarian cancer
Stage I - Cancer is found only in one or both of the ovaries.

Stage II - The cancer is more than 2 centimeters, but less than 4 centimeters (less than 2 inches), and has not spread to lymph nodes in the area.

Stage II - Cancer is found in one or both ovaries and/or has spread to the uterus, and/or the fallopian tubes (the pathway used by the egg to get from the ovary to the uterus), and/or other body parts within the pelvis.

Stage III - Cancer is found in one or both ovaries and has spread to lymph nodes or to other body parts inside the abdomen, such as the surface of the liver or intestine. (Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.)

Stage IV - Cancer is found in one or both ovaries and has spread outside the abdomen or has spread to the inside of the liver.

Recurrent or refractory - Recurrent disease means that the cancer has come back (recurred) after it has been treated. Refractory disease means the cancer is no longer responding to treatment.

Side Effects of the Treatment

Difficulty in normal bowel movements.

Pain and infection

In younger women, when the ovaries are removed, the body's natural source of estrogen is lost and menopause starts.

Hot flashes and vaginal dryness in menopausal women.

Skin rashes, loss of hair, diarrhea, vomiting, tingling and numbness in the fingers and toes and hearing loss along with extreme fatigue.

Radiation dermatitis - Skin covering the radiated area becomes red, dry, itchy, and may show signs of scaling off. This will slowly settle down after radiation ceases, but there may be a permanent 'bronzing' of the skin.

Radiation also may cause urinary discomfort and fall in the white blood cells.

Vaginal dryness and difficulty with intercourse.

Biological therapy may result in low grade fever.

Risk Factors:

History of occurrence of ovarian cancer among family members.

Women who have never been pregnant are more likely to develop ovarian cancer .

Most ovarian cancers occur in women over the age of 50; the risk is high for women over 60.

Women who have had breast cancer are twice as likely to develop ovarian cancer.