Overview of Ovarian Caner
According to data from Hong Kong Cancer Registry, Ovarian cancer was the sixth most common cancer in 2009 with 460 new cases registered. Fortunately the incidence and mortality rate of ovarian cancer have been steady in the past 2 decades.
The ovaries is part of the female reproductive organs, lie in the pelvis cavity of female’s lower abdomen, each ovary located each side of the uterus. The outer layer of cells is called the epithelium, and there are germ cells found inside of the ovary. The germ cells will develop into eggs (ova), once the female reach puberty, the eggs are released into the uterus through the fallopian tubes. If the egg was not fertilized, it will break apart from the uterus wall and be shed with inner lining, the process is called menstruation.
The other cells in the ovaries are Sex-cord Stromal Cell, which will produce female hormones oestrogen and progesterone. With ages, the level of female hormones from the ovaries will reduce, fewer eggs will be produce, and eventually they will stop producing eggs. Most women will hit menopause at age 45 to 55, they will no longer be fertile.
Types of Ovarian Cancer
- Epithelial Ovarian Cancer: The tumour started in the cells on the surface of the ovary. It is the most common type of ovarian cancer, accounts for 90% of cases. It tends to have a better prognosis since it response positively to treatment, though chance of the cancer coming back is relatively high.
- Germ Cell Ovarian Cancer: The tumour started in the cells that produce ova. It is commonly found in patients aged 30 and below. It is relatively rare, but it is curable.
- Sex-cord Stromal Cancer: The tumour started in the cells that produce female hormone. It can occur in patients of all ages. It is again, relatively rare, but it is curable.
- Borderline Tumour: This type of tumour barely spread or recur, commonly occur on patients who are younger, and have not reach menopause.
Causes of Ovarian Cancer
It is not yet completely understood the causes of ovarian cancer. But we know that there are some risk factors:
- Age over 45
- Child Bearing: Women who have no children have higher risk of developing ovarian cancer.
- Sexual Precocity
- Late Menopause
- Hereditary Syndromes:
- About 5% to 10% of cases have inherited faulty gene.
- Family history of Inherited breast cancer, ovarian cancer and hereditary nonpolyposis colorectal cancer will increase the risk of developing ovarian cancer.
Symptoms of Ovarian Cancer
Most cases do not show any symptoms in early stages, which make it difficult to detect. If there were any symptoms at all, it may include:
- Swelling in the abdomen
- Pressure, Discomfort, even pain in the abdomen
- Gastro-intestinal discomfort such as heartburn, nausea and bloating
- Changes in bowel habits such as constipation or diarrhea
- Frequent urination
- Fatigue
- Loss of appetite
- Unexplained weight loss or gain
- Irregular menstruation, or abnormal vaginal bleeding after menopause
- Pain during intercourse
Diagnosis of Ovarian Cancer
Physical Examination
Doctor will press your abdomen, to check for swelling and abnormal lumps. Doctor will also examine your vagina .
Blood Test
Cancer cells will release proteins into the bloodstream, we call that the cancer marker. The cancer marker of ovarian cancer is labeled as CA12. If there is an elevated level of CA125, it may represent the presence of ovarian cancer. But there are other gynecologic diseases that affect the level of CA125, such as the Endometriosis and Fibroids.
Screenings
- Abdominal Ultrasound
- Transvaginal Ultrasound
- Computer Tomography:A CT scan can show images of inner organs and structures, including images of the tumour. Doctor may ask you to stop eating prior to the screening, and to take a imaging medium dye in order to get a better picture.
- Magnetic Resonance Imaging:MRI uses magnetic energy to take cross sectional pictures of the body. It is a completely painless procedure.
Biopsy:
A laparoscopy will be carried out to locate the tumour, and to extract a sample of tissue for further examination.
Staging of Ovarian Cancer
Doctor will stage the tumour in order to determine treatment plans.
The common staging system is:
- Stage I:
Cancer cells are only found in one or two ovaries. Tumour can be found either on the surface, or in the inner lining of the ovaries, surrounded by fluids or washings from the abdomen.
- Stage II:
The tumour has grown pass the ovaries. Cancer cells have spread to the uterus, fallopian tubes, and other areas in the pelvis, such as the bladder, the sigmoid colon or the rectum.
- Stage III:
Cancer cells have spread to organs and lymph nodes in the pelvis, or to the inner lining of upper abdomen and lymph nodes.
- Stage IV:
Cancer cells have spread to distant tissues other than the abdomen, such as the liver, chest and other organs.
Treatment for Ovarian Cancer
Oncare's News Article about Ovarian Cancer: (to be updated)
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