Ovarian cancer is created by the abnormal and uncontrolled growth of cells. The cancer can sometimes spread more widely in the abdomen (tummy) through the bloodstream or the lymph system. It may grow here and form secondary tumors. More rarely it can spread to other organs. The spread of cancer is called metastasis.
The ovaries are two small organs that are part of the female reproductive system where eggs mature. Each month, in women of childbearing age, one ovary releases an egg into the Fallopian tube, where it may be fertilized with sperm. If it’s not fertilized, the egg passes into the womb and is lost when this sheds its lining as a monthly period.
The ovaries also produce the female hormones estrogen and progesterone. After the menopause, the ovaries produce less of these hormones and no longer release an egg each month.
Ovarian cancer types
There are two main types of ovarian cancer. The most common is epithelial type of cancer that affects the lining of the ovaries. Nine out of 10 ovarian cancers are epithelial. There are several different types of epithelial cancer including the two most common – serous and endometrioid.
Non-epithelial ovarian cancer is much less common. These include germ cell cancers that form from the cells in the ovary that make the eggs. These usually affect younger women.
Ovarian cancer symptoms
Lack of symptoms or vague symptoms in the early stages of cancer of ovaries is why the illness is known as the ‘silent killer’. If there are symptoms, they can include stomach pain or a bloated feeling that can be confused with irritable bowel syndrome (IBS). Ovarian cysts and non-cancerous growths also cause the same symptoms as ovarian cancer.
Other symptoms include:
- loss of appetite
- unexplained weight gain
- swelling of your abdomen (tummy)
- pain during sex
- changes in bowel or bladder habits – constipation, excess wind, diarrhea or needing to pass urine more often
- rarely, abnormal vaginal bleeding
Ovarian cancer causes
Doctors don’t know exactly what causes cancer in ovaries, but there are some things that seem to make it more likely. It’s more common in women who live in developed countries and for those who have gone through the menopause.
It’s known that faulty inherited genes called BRCA1 and BRCA2 increase the risk of ovarian cancer as well as breast cancer. However, having a close relative – mother, sister or daughter – with ovarian cancer doesn’t necessarily mean that there is a faulty inherited gene in your family. The cancers could have happened by chance.
Other factors that are thought to make ovarian cancer more likely include:
- hormone replacement therapy (HRT) – especially taking HRT for longer than five years
- being overweight or obese (in premenopausal women)
- starting your periods early and having the menopause late
Fertility treatment is no longer considered a risk factor after recent research ruled out the link. A possible link with using talcum powder has been suggested but this needs to be confirmed by more research.
Ovarian cancer may be less common in women who have:
- used the contraceptive pill
- had children – the more children, the lower the risk
- breastfed their children
- had a hysterectomy
Ovarian cancer diagnosis
Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history, including whether anyone else in your family has had breast or ovarian cancer.
You may have a blood test for a protein called CA125 that can be high in ovarian cancer. The GP may also carry out an internal examination to check your womb and ovaries.
You may be referred to a gynecologist. You may need to have further tests such as an ultrasound, CT scan or MRI scan to view the inside of your pelvis.
If the results of your scans show any abnormalities, you may also have a laparoscopy. This involves inserting a thin, fibre-optic tube (laparoscopy) into your stomach via a small cut just below your bellybutton. This allows the surgeon to look at your ovaries and surrounding organs. The procedure is carried out under a general anesthetic. The surgeon may take a biopsy – this is a small sample of tissue that will be sent to a laboratory for testing.
If fluid has built up in your stomach, it can be drawn out through a needle and examined to see whether cancer cells are present. This is known as abdominal fluid aspiration.
Ovarian cancer prevention and treatment see on next page.
(information from “Bupa” – http://www.bupa.co.uk/individuals/health-information/directory/o/ovarian-cancer)
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