Ovarian Cancer, Causes, Symptoms, Diagnosis and Treatments

Ovarian cancer affects your ovaries, small organs present in a female’s reproductive system, specialized for egg production. Two glands of oval shape are located on both sides of your uterus. These are the specialized structures found in your body that carry out the function of producing eggs or ova. Ovaries are also responsible for excreting special hormones that control your pregnancy and menstrual cycle. The ovulation period is the duration of the formation of eggs and your ovaries release eggs after completion of the ovulation period. If fertilization without sperm is done you can become pregnant. Each menstrual cycle enables your ovary to release an egg until you reach the menopause stage. Menopause is a stoppage of egg production. Sometimes, more than one egg is produced in your ovaries which leads to multiple pregnancies. 

Now, it’s time to discuss ovarian cancer, its causes, symptoms, diagnosis and treatment options. So, let’s start! 

Abnormal and uncontrolled growth or production of ovarian cells form tumors inside or on the surface of your ovaries. According to an estimate, more than 34000 women have been diagnosed with ovarian cancer in the country in recent years.

What is Ovarian Cancer?

Your two ovaries are located on the opposite sides of your uterus. Different types of cells combine to form an ovary. Some prominent types of cells used to form an ovary include germ cells, sex-cord stromal cells, and epithelial cells. Eggs are formed in the ovaries and released every month during ovulation. Estrogen and progesterone are two important hormones secreted by your ovaries. Uncontrolled development of ovary cells leads to ovarian cancer that also forms tumors. These tumors are of two types i.e. Benign and Malignant. 

Here are the three phases when ovarian tumors form inside the ovary:

Epithelial Cells: When the tumor grows from cells on the surface of one or both ovaries this comes into existence through abnormal growth in epithelial cells. This type of ovarian cancer tumors are most common in females. Nearly 90% of ovary cancer originate from epithelial tumors. It contains clear cell carcinomas, endometrioid, mucinous, high-grade, and low-grade serous. Moreover, evidence has found that some types of ovarian cancers originate from abnormal growth in fallopian tube cells.

Germline Cells: Developing cancer tumors inside the ovary where eggs are stored are known as germ-line cell cancer tumors. These tumors include teratoma, choriocarcinoma, embryonal carcinoma, and dysgerminomas. 

Stromal Cells: When the tumors originate from the abnormal production in the cells of the ovaries that produce hormones, these are stromal cell tumors. These tumors are made of sertoli-Leyding tumors, fibromas, thecomas and granulosa cell tumors. 

Thus it is concluded that ovarian cancer is caused due to the production of abnormal cells in your fallopian tubes or ovaries. These Structures are harmful and grow abnormally.

Who Gets Ovarian Cancer?

Cancer in ovary occurs in females at different ages. This disease affects the native american and white population more than the black population and Asian. 

According to 2019 studies, ovarian cancer affects 10% more than other cancer cases in the country. Its lifetime risk of development is approximately 2 in 70.

Risk Factors for Ovarian Cancer

The exact causes of developing cancer in ovary are still under discussion. But some common factors are here that increase the risk of developing this disease:

Older Age: A progressive age is an invitation to different types of physical disease. A similar case is with ovarian cancer. In older age, menopause restricts the function of ovaries by ending the production of the ovum. Thus causing abnormal production and tumor formation in the ovaries.

Genetic Mutations: More than 20% of ovary related cancers are the results of genetic mutations that are often caused by Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations. However, these are not the only gene mutations that cause ovarian cancer other mutations like Lynch syndrome are associated with ovarian cancer. 

Family History: If you have a family history associated with such type of cancer the higher the risk of getting affected by the disease. For example, if your close relative, including your mother, sister, aunt, or grandmother was diagnosed with ovarian cancer in the past, you have a higher risk of ovarian cancer development.

Endometriosis: When tissues similar to the lining of your uterus grow outside the uterus, the condition is called endometriosis. You may feel severe pain which can delay your pregnancy. This condition may start at your first menstruation and can last until menopause starts.

Obesity: Obesity causes abnormal production of cells in your body. Similarly, abnormal growth occurs in your ovaries which leads to ovarian cancer.Never Being Pregnant: Females who never got a pregnancy have a higher risk of developing cancer in ovary because never getting a pregnancy disturbs their hormonal balance.

Early Menstruation and Late Menopause: Irregular menstrual periods are an alarming sign of developing a higher risk of ovarian cancer while delay in menopause also leads to ovarian cancer.

Limit the Risks of Ovarian Cancer

According to a 2020 study, you can do many things to lower the risk of ovarian cancer. You can:

• Consider taking pills for birth control. Talk to your doctor about whether you should use them or not.
• Discuss your family history and genetic test reports with your doctor.
• Remove your fallopian tubes to decrease the risks of ovarian cancer.

Causes and Symptoms 

What are the Causes of Ovarian Cancer? 

The exact reason for developing this cancer isn’t completely known. However, some factors are influential in this regard and increase the risk of getting affected. These include: 

• Older age such as being over the age of 55.
• Having children later in life. Delayed pregnancy.

How Does it Spread in Your Body?

Generally, ovarian cancer spreads from your pelvis to your lymph nodes, liver, stomach, chest,  abdomen, or intestines.

What are The Symptoms of Ovarian Cancer?

Before showing any symptoms, ovarian cancer usually develops and spreads throughout your abdomen. Thus early detection becomes difficult. Its common symptoms include:

• Frequent urination (peeing more often).
• Increase in the size of your abdomen.
• Abnormal bleeding or vaginal discharge, especially if it occurs after your typical menstrual cycle has completed. 
• Menopausal stage.
• Diarrhea, constipation, and some other bowel changes.
• Abdominal pain leads to pelvic pain along with feelings of discomfort or bloating.
• Changes in your appetite such as losing your appetite or feeling more hungry.

Developing any of the above mentioned symptoms tells you to schedule a visit with your healthcare provider on an urgent basis.

Diagnosis and Tests

How is Ovarian Cancer Diagnosed?

Years of research have been passed without devising or discovering a successful ovarian cancer screening test. That’s why the condition is still difficult to diagnose in the early stages. Your healthcare provider will diagnose the condition first by observing your symptoms and performing a pelvic exam. This examination will help them to check for abnormal growth or enlarged organs.

Additional tests including imaging tests such as pelvic ultrasound, magnetic resonance imaging (MRI), compound tomography (CT scan), and positron emission tomography (PET scan) also can be recommended by your healthcare provider.

Blood Tests 

When your healthcare provider tries to look for a substance called CA-125 to confirm the diagnosis of ovarian cancer, they will ask you to perform a blood test. Increased levels of CA-125 in your blood will confirm the presence of ovarian cancer symptoms. But in some conditions, CA-125 levels remain normal, even in the presence of cancerous tumors, and get higher in many conditions that don’t belong to cancer. Therefore, blood tests are performed in combination with other tests to diagnose ovarian cancer.

Surgical Evaluation

Finding abnormal growths during a surgical procedure helps doctors to observe ovarian cancer. They remove such enlarged organs during the same procedure. 

LaparoscopyIn this type of surgery, a surgeon places a laparoscope ( a thin camera) by making a small incision in your abdomen to diagnose ovarian cancer. This procedure assists the surgeon to spot the carneros tumors or abnormal growths. They perform biopsies and sometimes remove ovarian cancer tumors.

Stages of Ovarian Cancer

Cancer in ovary develops in has four stages. In the cancer staging system, the least severe cancer stage is with a lower number of patients and a more serious condition of cancer comes with a higher number of affected people. 

Let’s learn about the four stages of ovarian cancer!

Stage 1: This is the initial stage that is further divided into three sub-stages i.e. stage IA, stage IB, and stage IC. In the first substage is recognized by the presence of a cancerous tumor in only one ovary or one fallopian tube. In the second substage, the IB is characterized by the presence of cancerous tumors in both ovaries or fallopian tubes. While in substage IS the cancer has been spread to both ovaries, fallopian tubes, and outside the ovaries. This stage is the most severe and here the cancer reaches on the outside of the organ itself or in space around it. In the case of ovarian cancer, this is the peritoneal cavity.

Stage 2: There are a few additional sub-stages in the second stage. In stage IIA the cancer starts to spread to your uterus after extracting your ovaries. While in sub-stage IIB, the cancer has reached other nearby structures such as in your pelvis and organs around.

Stage 3: Three sub-stages are included in this stage. Sub-stage IIIA is characterized by the spreading of cancer beyond your pelvic area to your abdominal area and the lymph nodes. IB the second substage has a larger size of tumor approximately up to 2 centimeters in size and spreads to beyond your pelvic area. Then the next sub-stage IIIC comes with the spreading of cancer outside of the pelvic area and goes in size more than 3 centimeters. As it reaches you within your lymph nodes, it tends to impact your other organs including your spleen and liver.

Stage 4: The most severe stage is the last stage. Here the cancer has spread to the inside of other vital organs such as your liver, lungs, and stomach. And in its second sub-stage IVB the cancer affects the lymph nodes located in your chest and groin.

Staging of ovarian cancer helps design a tailored treatment program for you. Now your healthcare provider will be able to plan a proper and effective treatment option for you. He will discuss it with you.

Treatment and Management

How is Ovarian Cancer Treated? 

The true treatment of cancer means the removal of the condition from your body as much as you can if not all. Treatment options for ovarian cancer are:Surgery: This is a typical way of removing your reproductive organs or any other organ that has a cancerous tumor. Laparoscopy or laparotomy procedures are used to remove such organs. The second one is an open surgery that requires an abdominal incision.

Hormone Therapy: Sometimes hormones are used by doctors to slow or stop the growth of cancerous tumors. This type of therapy is also used to block the production of hormones that are responsible for causing ovarian cancer.

Targeted Therapy: In this treatment option, certain drugs are used to identify and attack the cancer cells in your ovary’s fallopian tubes or the nearby areas.

Radiation Therapy: This type of therapy has more side effects than useful impacts. Therefore, healthcare providers use this treatment option in rare cases where the other options fail.

Chemotherapy: This method of ovarian cancer treatment is as acceptable as surgery and in most cases the healthcare provider prefers this option to surgery. In this procedure, the specifically designed drugs are used to target and kill the cancer cells. The chemotherapy can be given orally i.e. in the form of pills or intravenously i.e. through veins in the form of injections.

After the completion of cancer treatment, your healthcare provider used to see you regularly for a keen observation of the after-effects of treatment. So schedule routine appointments to make sure that cancer will not return over time. If you see any symptoms during these appointments, your healthcare provider may do some examinations. You should be mindful of any symptoms you may have and tell your provider about them. 

Conclusion

Ovarian cancer diagnosis is scary and dreadful. Having ovarian cancer may make you feel frustrated, hopeless, and stressed but the timely diagnosis and effective treatment plans will ensure your recovery. Keep in touch with your healthcare provider and ask about all possible resources to recover soon. Making close bonds with other people who are going through this difficult phase of life can help you understand the reality and process the harsh emotions that come with this cancer diagnosis.