Ovarian Cancer Treatment

Ovarian Cancer is cancer that occurs due to the growth of the cells that form in a woman’s ovaries. Ovaries are a part of the female reproductive system, one on either side of the uterus (womb). The ovaries are responsible for the production of eggs, as well as the progesterone and estrogen hormones (female sex hormones).

Types of Ovarian Cancer:
The different types of ovarian cancers are classified according to the type of cell that cancer begins in. The different types include:
1. Epithelial ovarian cancer: This is the most commonly occurring ovarian cancer, and includes cancers like serous carcinoma and mucinous carcinoma.
2. Germ cell tumors: These are rare types of ovarian cancers that occur at a young age.
3. Stromal tumors: These are rare types of tumors that are generally diagnosed at an earlier stage than the other ovarian cancers.

Causes of Ovarian Cancer:
Ovarian cancer does not have a known cause. It is thought to occur when the cells near or in the ovaries develop mutations (changes) in their DNA. This causes the growth and multiplication of these cells, leading to the formation of a mass or tumor The cancer cells may start invading the nearby tissues. The cancer cells may spread (metastasize) to the other parts of the body.

Risk factors of Ovarian Cancer:
Certain factors could increase the risk of developing ovarian cancer. These factors include:

• Old age
• Genetics
• Family history of ovarian cancer
• Obesity
• Endometriosis (a painful disorder in which the tissue that normally lines the inside of the uterus grows outside the uterus)
• Menstrual cycle beginning at an early age
• Menopause (stopping of the menstrual cycle at an older age)
• No history of pregnancy
• Postmenopausal hormone replacement therapy (treatment for controlling the symptoms of menopause)

Symptoms

No symptoms are generally seen in the early stages of ovarian cancer. The symptoms which may be seen later are:

• Stomach (abdominal) swelling or bloating

• Loss of weight

• Feeling full after eating a small quantity of food

• Fatigue

• Discomfort in the pelvic region (area below the abdomen)

• Back pain

• A frequent need of urinating

• Change in bowel habits

• Constipation

Diagnosis

1. Physical examination: The doctor examines the patient physically. The symptoms of the patient are noted, along with the medical history and family history of the patient.
2. Pelvic exam: The doctor inserts his/her lubricated, gloved fingers into the vagina while simultaneously pressing the other hand on the abdomen in order to feel the pelvic organs. The external genitalia, vagina, and cervix are also visually examined by the doctor.
3. Imaging tests: Certain imaging tests like x-rays, CT scans, MRI scans, or ultrasounds of the pelvis and abdomen region help in determining the shape, size, and structure of the ovaries, and to create images of the internal organs of the body.
4. Blood tests: The blood tests help in testing the blood for the presence of tumor markers, that may indicate ovarian cancer. For example, the cancer antigen (CA) 125 test can detect the presence of a protein that is often found on the surface of the cells causing ovarian cancer.
Blood tests may also include organ function tests to determine the overall health of the patient.
5. Genetic testing: The doctor may recommend testing a sample of the blood to check for genetic changes that increase the risk of developing ovarian cancer.
6. Surgery: The doctor can sometimes diagnose ovarian cancer only after the surgical removal of the ovary, and getting it tested for signs of cancer.
7. Biopsy: A small sample of the tissue from the ovary is removed and sent to the laboratory to check for the presence of cancer cells.
8. Laparoscopy: The doctor inserts a thin lighted tube with a camera on one end through a small hole made in the abdomen to see the ovaries and collect a tissue sample for the purpose of biopsy.

Treatment

A combination of surgery and chemotherapy is generally used for the treatment of ovarian cancer. However, other forms of treatment may also be used. The various forms of ovarian cancer treatments include:

1. Surgery: The various forms of surgeries that can be performed for the removal of ovarian cancer include:

• In early-stage cancer when cancer has not spread beyond one ovary, surgery may be performed to remove the affected ovary and its fallopian tube.
• In case of cancer involving both the ovaries, the surgeon may remove both the ovaries and both the fallopian tubes.
• If the cancer is more extensive, surgery may be done to remove both the ovaries, fallopian tubes, uterus, the nearby lymph nodes, and a fold of the fatty abdominal tissue called the omentum.
• In the case of advanced cases of cancer where cancer has spread to the other parts of the body, the doctor recommends surgical removal of as much cancer as possible. Sometimes, chemotherapy may be recommended before or after such a surgery.

2. Chemotherapy: It is a form of drug treatment done to kill cancer cells. Chemotherapy drugs may be given orally or intravenously (injected into the vein).

3. Targeted therapy: This is a type of drug treatment that focuses on specific weaknesses that are present within the cancer cells, causing the death of the cancer cells.

4. Hormone therapy: Certain drugs are used for blocking the effects of the estrogen hormone on the ovarian cancer cells, as estrogen may help the cancer cells to grow.

5. Immunotherapy: This therapy boosts the body’s immune (disease-fighting) system to fight the cancer cells.

Risks

The complications of ovarian cancer treatments include:

• Infection
• Bleeding
• Bruising
• Infertility
• Menopause
• Leukemia (blood cancer)
• Kidney damage
• Nerve damage 
• Loss of hearing
• Holes or perforations in the colon (large intestine)
• Fatigue
• Hair loss
• Nausea
• Vomiting
• Loss of appetite
• Mouth ulcers or sores
• Skin reactions
• Rashes on the feet and hands

After Procedure

• Hot flushes
• Sweats
• Dryness in the vaginal area
• Easily tired