Ovarian Cancer Symptoms, Facts, Types, Treatment And Prognosis

Ovarian cancer is a form of cancer that starts in one or both of the ovaries. Because of the location of the ovaries and the infrequency with which they receive medical attention this is a form of cancer that often goes undetected until it begins to spread. The later the stage of the cancer the more difficult it is for a successful ovarian cancer treatment.

The better informed you are about the symptoms of ovarian cancer, the more proactive you can be about diagnosis and treatment.

Symptoms

One of the reasons ovarian cancer can be so difficult to diagnose is because the symptoms of the disease are not specific to ovarian cancer. In fact many of the ovarian cancer symptoms are indicators of other problems that include bladder or digestive health problems. If you notice that any of these symptoms persist for a long period of time or worsen, you may have ovarian cancer and you need to see a doctor immediately:

  • Bloated abdomen
  • Nausea
  • Extreme fatigue
  • Diarrhea
  • Shortness of breath
  • Constant need to urinate
  • Heavier than normal bleeding during your period
  • Indigestion or constipation
  • Pain or discomfort in the pelvic area
  • Loss of appetite
  • Lower back pain
  • Feeling full quickly after consuming small amounts of food
  • Menstrual bleeding after menopause has begun

If you notice any of these symptoms, particularly if they are worse than usual or worsen over time, you may be experiencing symptoms of ovarian cancer. See your doctor right away.

Facts

The American Cancer Society estimates that more than 20,000 new ovarian cancer diagnosis will occur each year. The Centers for Disease Control and Prevention found that approximately 14,000 women in the United States will die from ovarian cancer. With early diagnosis and treatment this number could be greatly reduced.

Some facts you should know about ovarian cancer:

  • There are several different forms of ovarian cancer
  • Most ovarian abnormalities in women under the age of 30 are non-cancerous
  • Currently no routine ovarian cancer screenings exist
  • There are several risk factors that affect certain members of the female population
  • Ovarian cancer prognosis depend on the stage of the illness, the age and overall health of patient
  • Symptoms of ovarian cancer are difficult to identify, making diagnosis difficult

What Are The Ovaries?

The reason ovarian cancer affects only women is because the ovaries are a vital component of the female reproductive system. Located on each side of the uterus, the ovaries are quite small about the size of a nut. The main function of the ovaries is to produce eggs for reproduction, however they also produce the hormones testosterone, estrogen and progesterone.

Although all women have ovaries, when menopause begins the ovaries no longer release eggs to the fallopian tube. During menopause the ovaries also produce much lower hormone levels, which is why many menopausal women undergo hormone therapy.

The photo below should give you a better idea where the ovaries are located, so you can better understand your symptoms.

Ovarian Cancer

Ovarian Cancer

Types

Two types of tumors and cysts may grow from these extra cells:

  • Benign or non-cancerous tumors
  • Malignant tumors can be cancerous

Risk Factors

There is no guaranteed way for any woman to know if she will get ovarian cancer because many of the women who do get it fall outside the known risk factors, according to the Centers for Disease Control and Prevention. Despite this fact, there are some factors that increase your risk of getting ovarian cancer.

Some ovarian cancer risk factors you should be aware of include:

  • Personal history of cancer. If you have had colon, rectum, uterus or breast cancer in the past then your risk is increased.
  • Family history of breast, colon or uterus cancer.
  • If you have never given birth or have had trouble conceiving in the past.
  • Women of Jewish or Eastern European ancestry.
  • Over 55 years of age, although women of any age may get ovarian cancer.
  • Inherited gene mutations known as BRCA1 and BRCA2, both are breast cancer genes but increase ovarian cancer risk.
  • Undergoing hormone therapy for symptoms of menopause.

It is important to know that belonging to any of the high risk categories is not guarantee that you will get ovarian cancer. Many of the women who do get ovarian cancer fall outside of all risk factor categories other than age. However if you do believe you are at risk you should talk to your doctor and check out your treatment options.

Diagnosis

If you present with any of the symptoms of ovarian cancer for a prolonged time and those symptoms begin to worsen you will have to undergo at least one ovarian cancer test. On many occasions more than one test is needed to confirm an ovarian cancer diagnosis. You will need to sit down and speak with your doctor to find out which test or tests are best for your symptoms.

Physical exam: A physical exam will first check for overall signs of good health, but specifically your physician will apply pressure to your abdomen looking for tumors or fluid build-up. Your doctor will also look closely at any ovarian cancer symptoms you have exhibited in the past to verify a cancer diagnosis.

Pelvic exam: This is not the same pap smear exam that women traditionally undergo yearly, but rather this is an exam specifically to test the ovaries and other adjacent organs for lumps, masses and other abnormalities. This exam requires digital insertion while the doctor simultaneously applies pressure to your abdomen to feel if your ovaries are swollen or bloated. This may take place on the same visit as your yearly pap exam.

Blood tests: Your doctor may order a blood test to check for some substances like CA-125 that are commonly found on the outside of ovarian cancer cells. Although CA-125 is not unique to ovarian cancer alone, it is a big indicator that ovarian cancer cells are present.

Ultrasound: If your doctor has located a tumor or mass during a physical or pelvic exam, they may want to order an ultrasound to get a better picture. The ultrasound relies on sound waves to create a computer generated photo that provides a clearer image of the lump or mass, to determine if it is cancerous.

Biopsy: A biopsy may be used to diagnose ovarian cancer by removing a portion of the tissue in the ovaries or in this case, fluid as well. Depending on what your blood test and ultrasound reveal, a biopsy may be needed to confirm your diagnosis.

Laparotomy for diagnosis: A laparotomy is a type of surgery used to diagnose ovarian cancer. This is the most effective method for diagnosing ovarian cancer, although for many women the other ovarian cancer tests may be sufficient. During this surgery samples of tissue and fluid will be removed for testing. The surgeon will also have a chance to see for themselves if cancer is indeed present in your ovaries.

Stages Of Ovarian Cancer

Before you can begin effective ovarian cancer treatment your doctor will need to know the stage of your cancer. The stage is the extent or severity of the cancer, which will help your doctor determine the best course of treatment as well as your ovarian cancer prognosis.

The stage of your ovarian cancer will be based on whether or not the cancer has spread in addition to what other organs have been affected by the spreading. This process of the diagnosis may require several tests including surgery.

These are the four different stages of ovarian cancer.

  • Stage I is when cancer cells have been found in at least 1 ovary. In this stage the cells will be on the ovarian surface or in abdominal fluid.
  • Stage II is identified when cells have spread from the ovaries to other tissues in the pelvis including the uterus and fallopian tubes. Cancer cells may also be observed in abdominal fluid during this stage.
  • Stage III occurs when the cancer cells have spread to tissues outside the pelvis or to certain lymph nodes. You may also find cells on the outside of the liver during this stage.
  • Stage IV is observed when the cells have spread to tissue outside of the pelvis and abdomen. During Stage IV the cancer may spread to the lungs, liver or other nearby organs.

Treatment Methods

Effective treatment of ovarian cancer usually combines a two-fold approach that includes surgery as well as chemotherapy. Sometimes radiation therapy is included but you will need to consult with your physician to see if this method of treatment is right for you.

Once you have received your ovarian cancer diagnosis you will likely be referred to a gynecologic oncologist who is trained specifically to treat cancer of the female reproductive system. Together you will come up with a workable treatment for ovarian cancer.

Your treatment options for ovarian cancer are:

  • Surgery to remove the cancerous tissue in your ovaries. If however the cancer has spread you may need surgery to remove any or all of the following: uterus, ovaries, lymph nodes and uterus. The severity of the surgery will be determined by your stage of cancer.
  • Chemotherapy uses drugs to halt or reduce the growth rate of cancer cells in the ovaries and surrounding reproductive organs. You can receive chemotherapy in pill or intravenous form, however both forms cause severe side effects that you will need to talk to your doctor about for post-chemo relief.
  • Radiation therapy is used to directly target cancer cells in the ovaries and any other organs to which it may have spread. The radiation waves are aimed directly at the infected areas to kill the cancer cells and stop their progress.
  • Clinical trials may also be available, trying out a wide variety of ovarian cancer treatments. However there are very specific parameters for entering into a clinical trial so check with your physician to see if these trials will work for you.

Questions Before Treatment

Before you and your physician implement an ovarian cancer treatment plan you should get all of your questions answered in a manner that you understand. The more actively involved you are in your cancer treatment, the better your chances are of success.

Below are some of the questions you may want to ask your physician prior to the start of treatment:

  1. What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where?
  2.  What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why?
  3. Would a clinical trial be appropriate for me?
  4. Will I need more than one kind of treatment?
  5. What are the expected benefits of each kind of treatment?
  6. What are the risks and possible side effects of each treatment? What can we do to control side effects? Will they go away after treatment ends?
  7. What can I do to prepare for treatment?
  8. Will I need to stay in the hospital? If so, for how long?
  9. What is the treatment likely to cost? Will my insurance cover the cost?
  10. How will treatment affect my normal activities?
  11. Will treatment cause me to go through an early menopause?
  12. Will I be able to get pregnant and have children after treatment?
  13. How often should I have checkups after treatment?

Prognosis

Your ovarian cancer prognosis depends on a lot of factors, but in general the prognosis for this type of cancer is very poor due to the lack of custom screening and difficulty in early detection. However the prognosis for early detection is very good with nearly all women surviving at least 5 years from the date of diagnosis.

Typically the prognosis is low however because by the time ovarian cancer is diagnosed it is in the later stages, which severely decrease a woman’s chances for survival. Your best bet for a good prognosis is immediate detection, which can be helped by quickly identifying symptoms of ovarian cancer and getting tested immediately.

Written By Charles Howard

Charles Stanton Howard, MD, is a specialist in Molecular Pathology from the USA. Dr Howard’s educational background includes a BA with the Highest Distinction from the University of Texas, one of the most highly regarded cancer institutes in the world, as well as an MD gained at the University of Virginia.

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