Overview – What is it?
Ovarian cancer is a type of cancer that occurs in the ovaries which are organs found in the female reproductive system. These organs produce ova (eggs) and the hormones; oestrogen and progesterone, which are the female reproductive hormones. Some of the risk factors for this cancer are family history, undergoing oestrogen hormone replacement therapy and starting menstruation at an early age.
Its symptoms include weight loss, abdominal swelling and changes in bowel habits.
The diagnosis of ovarian cancer can be reached through a pelvic exam, imaging tests and biopsy, among other tests.
It can be treated through surgery, chemotherapy and radiation, among other treatment options.
The risk of this cancer can be reduced by limiting alcohol intake, maintaining a healthy body weight and not smoking, among other preventive measures.
Causes – What causes it?
Ovarian cancer occurs when cells in the ovaries begin to multiply rapidly and uncontrollably causing formation of tumour(s). The type of ovarian cancer one has depends on the type of cell where the cancer begins. The different types of ovarian cancers are:
- Epithelial tumours: This is the most common type of ovarian cancer; accounting for about 90% of all ovarian cancer cases. It begins in the thin layer of tissue that covers the outside of the ovaries.
- Stromal tumours: This begins in the ovarian tissue that contains cells which produce hormones, and in most cases, it is diagnosed earlier than the other types of ovarian cancer.
- Germ cell tumours: This is a rare type of ovarian cancer which begins in cells that produce the eggs in the ovaries.
The exact cause of ovarian cancer is not known, however, there are some risk factors that can lead to this type of cancer, including:
- Family history of ovarian cancer: If you have a close family member who has had ovarian cancer before, then your risk of getting the same cancer is increased.
- Age: Women who are 50 to 60 years of age and above, are at an increased risk of getting this cancer.
- Age of start and end of menstruation: Women who start menstruation at an early age; before 12 years, and have it stopping at an older age are also at an increased risk of ovarian cancer.
- Oestrogen hormone replacement therapy: If you go through this therapy for a long period, your risk of getting ovarian cancer is increased.
- Inherited gene mutations: A person can inherit genes that increase the risk of ovarian cancer. These genes are the breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2).
Symptoms – What do you feel?
In the early stages of ovarian cancer, a woman may not experience any symptoms. However, as the disease progresses, the following symptoms may start to manifest:
- Abdominal pain
- Abdominal swelling and bloating
- Unintentional weight loss
- Changes in bowel habits
- Frequent urination
- Feeling full faster when eating
- Swelling of the legs
- Shortness of breath
Diagnosis – How do you diagnose it?
The diagnosis of ovarian cancer, like most conditions, begins with an initial consultation during which the doctor gets to know your symptoms and understand yours, and your family’s, medical history which can help in further diagnosis.
- Pelvic exam: This is carried out during the physical exam to check for any abnormalities in the abdomen such as swelling of the abdomen.
Other tests for ovarian cancer include;
- Imaging tests: These can be done using an MRI or CT scan to give detailed images of the inside of the abdomen, including the ovaries, which can show any abnormalities such as ovarian tumours. A transvaginal ultrasound can also be done to give images of the ovaries.
- Blood tests: These are done to determine the overall health of a person by checking organ function. They can also be done to measure cancer antigen levels.
- Biopsy: This test is done by taking a sample of tissue from the tumour in the ovary and examining it under a microscope to determine whether there is presence of cancer cells.
Treatment – How do you treat it?
The different treatment options for ovarian cancer are:
- Surgery: This is done to remove tumours or the affected ovary and other organs where the cancer has spread to. The types of surgeries done for this cancer are:
- Hysterectomy: This is surgery done to remove the affected ovary when the cancer is in its early stage. The fallopian tube connected to the affected ovary can also be removed. However, fertility can be preserved by leaving one ovary and its fallopian tube intact.
- Surgery to remove both ovaries and fallopian tubes, leaving the uterus intact to enable a woman to get pregnant by freezing her eggs or by using a donor’s eggs.
- Total hysterectomy: Through this surgery both ovaries, both fallopian tubes and the uterus are removed, making a woman unable to fall pregnant. Nearby lymph nodes are also removed.
- In cases where the cancer is wide-spread, chemotherapy is recommended, after which the removal of as much cancerous tissue as possible, is done.
Surgery is often followed by other treatments including:
- Chemotherapy: The use of anti-cancer drugs to kill cancer cells in the body.
- Radiotherapy: The use of high-energy beams to destroy the cancer cells in the body.
- Targeted therapy: The use of drugs to target the specific cancer cells and destroy them without causing damage to normal body cells.
- Supportive (Palliative) care: This is the treatment offered to patients suffering from wide-spread ovarian cancer to relieve the symptoms of the cancer and can be carried out while other treatments such as surgery and chemotherapy are being offered.
Prevention – How do you prevent it?
There is no specific way to prevent ovarian cancer, however, the risk of this cancer can be reduced by:
- Taking birth control pills,
- Getting to know your risk by discussing your risk factors for the condition with your doctor,
- Having surgical procedures such as tubal ligation and hysterectomy if you are at a high risk of developing this cancer,
- Getting regular screening if you are at high risk of getting ovarian cancer,
- Getting pregnant can also reduce your ovarian cancer risk,
- Eating a healthy diet high in fruits and vegetables,
- Maintaining a healthy body weight, and
- Remaining physically active by doing regular exercises.