Understanding Ovarian Cancer: Symptoms, Causes, and Treatment

Ovarian cancer begins when cells in one or both ovaries become abnormal and grow uncontrollably, forming a tumor. It often spreads to the abdomen and pelvis, causing fluid buildup in some cases. Sometimes, a tumor may be classified as a “borderline tumor,” which is not cancerous but can still spread.

Types of Ovarian Cancer

Symptoms of Ovarian Cancer

Ovarian cancer symptoms are often subtle and can be confused with other conditions. As the cancer grows, symptoms may include:

Fatigue

Weight changes (loss or gain)

Irregular or heavy periods, or vaginal bleeding post-menopause

pain during sex

Appetite loss or feeling full quickly

Changes in bowel or urinary habits

Nausea and indigestion

Abdominal or pelvic pain or discomfort

Swelling or bloating

pain during sex

Causes and Risk Factors

The exact cause of ovarian cancer is unknown, but certain factors increase the risk:

Diagnosis of Ovarian Cancer

Currently, there is no effective screening test for ovarian cancer. Diagnosis typically involves:
1. Physical exams: The doctor may check for any lumps or masses in the abdomen and pelvic area.
2. Blood tests: These can include tumor markers like CA125, CEA, and CA19-9, which help assess the presence of cancer.
3. Imaging tests: Ultrasound, CT scans, MRI, and PET-CT scans are used to detect tumors and check if the cancer has spread.
4. Biopsy: The definitive diagnosis is usually confirmed through a biopsy, where tissue samples are examined for cancer cells.

Treatment Options

Treatment depends on the type and stage of cancer:
1. Epithelial cancer (Stage 1): Surgery alone, followed by chemotherapy if the risk of recurrence is high.
2. Epithelial cancer (Stages 2-4): Surgery combined with chemotherapy. Targeted therapies may be offered for those with BRCA gene mutations.
3. Stromal cell cancer: Surgery, followed by chemotherapy or targeted therapy, is often used.
4. Germ cell cancer: Treated with surgery, chemotherapy, or both, depending on the situation.
5. Borderline tumors: Treated with surgery alone.

Surgical Options

Surgery is often the first treatment for ovarian cancer. This can involve:
1. Laparoscopy (small cuts to explore and biopsy the tumor)
2. Laparotomy (larger incision for more extensive surgery)
3. Debulking surgery: Involves removing as much visible cancer as possible, often including ovaries, fallopian tubes, uterus, and sometimes other organs if the cancer has spread.
4. Omentectomy: Removal of the omentum (fatty tissue that hangs down in front of the intestines) if cancer has spread there.
5. Lymphadenectomy: Removal of lymph nodes to check for cancer spread.
6. Colectomy: Removal of parts of the bowel if the cancer has spread there.

Chemotherapy

Chemotherapy is a key treatment that uses anti-cancer drugs to destroy cancer cells. It can be used:

Radiation Therapy

Radiation therapy may be used to treat advanced ovarian cancer that has spread to the pelvis or other body areas. It can help shrink tumors and relieve symptoms.

Targeted Therapy

Targeted drugs are used for advanced or recurrent ovarian cancer, especially for those with genetic mutations like BRCA. Drugs like Olaparib and Niraparib target specific cancer cell features to stop growth.

Palliative Care

Palliative care focuses on improving quality of life by managing symptoms, rather than curing the disease. It’s available at any stage of advanced cancer and can be provided alongside active treatment.