Ovarian cancer is the second most common type of gynaecologic cancer. The ovaries are composed of three distinct cell types: epithelial cells, germ cells, and stromal cells. Each of these cell types can give rise to different kinds of tumours. Ovarian cancer refers to any cancerous growth that occurs in the ovary. The majority of ovarian cancers arise from the epithelium (outer lining) of the ovary. 9 out of 10 ovarian tumours originate in the epithelial cells.
In many cases, early stages of ovarian cancer do not present any symptoms.
- Family history- Women with close relatives who have had ovarian cancer or Breast cancer, have a higher risk of developing ovarian cancer
- Age-The majority of ovarian cancers occur in women over 65
- Higher number of total lifetime ovulations
- Infertility or fertility treatment
- Breast cancer– Women who have been diagnosed with Breast cancer have a higher risk of developing ovarian cancer
- HRT (Hormone replacement therapy) – HRT slightly increases a women’s risk of developing ovarian cancer. Experts say that the risk increases the longer the HRT continues, and returns to normal as soon as treatment stops
- Obesity/overweight- Being obese or overweight increases the risk of developing many cancers
- Endometriosis- Women who develop endometriosis have a higher risk of developing ovarian cancer compared with other women
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary issues
- Ultrasound- Pelvic examination and transvaginal ultrasound
- Surgical biopsy of the tissue is used to confirm the diagnosis
- Additional imaging tests may be performed to determine if the disease has spread
The primary treatments for epithelial ovarian cancer are surgery, chemotherapy, and radiation therapy, delivered alone or in combination with another therapy.
The standard treatment for ovarian cancer is surgery — for diagnosis, staging (determining the extent of cancer), and tumour debulking, or
cytoreduction — followed by chemotherapy.
For cancers that appear to be confined to the ovary, the use of less invasive techniques to remove the tumour is adopted. These laparoscopic procedures, performed through small incisions made into the abdomen, can be used for biopsy and staging, and also to determine the extent of a cancer.
Depending on the size and location of the tumour, laparoscopy also can be used to remove cancerous tissue, meaning that a more extensive open surgery can be avoided. Such surgical approaches result in shorter hospital stays, a quicker recovery, and lower costs, and are as effective as conventional surgery. For selected younger patients, fertility preservation (retaining a normal ovary and the uterus) can be considered.
To destroy any tumour cells that remain after surgery, chemotherapy is recommended for the majority of women with ovarian cancer. This usually includes a combination of systemic and regional chemotherapy.
Radiation therapy may be given over a period of several weeks. It is rarely used as a primary treatment for ovarian cancer, but is sometimes considered after the removal of a recurrent tumour or in the treatment of a recurrence.