Ovarian Cancer – Questions and Answers
What is ovarian cancer?
Ovarian cancer is cancer that starts in the ovaries, the pair of female reproductive organs located in the pelvis. The ovaries have two functions: to produce eggs and female hormones (chemicals that control the way certain cells or organs function). Ovarian cancer occurs when cells in the ovary become abnormal and divide without control or order. Cancer cells can invade and destroy the tissue around them. They can also extend away from the tumor and to form new tumors in other body parts.
Who is at risk?
It is estimated that in the United States, more than 25,000 women will be diagnosed with ovarian cancer in 1999 and more than 14,000 die from the disease. The exact causes of ovarian cancer are unknown. However, studies show that the following factors may increase the likelihood of developing this disease:
Family history. The first-degree relatives (mother, daughter, sister) of a woman who has had ovarian cancer are at increased risk of developing this cancer. The risk is especially high if two or more first-degree relatives of a woman had the disease. A family history of breast cancer or colon is also associated with an increased risk of developing ovarian cancer.
Age. The probability of developing ovarian cancer increases as a woman ages. Most ovarian cancers occur in women over age 50, with more risk for women over 60 years old.
Motherhood. Women who have never had children are more likely to develop ovarian cancer than women who have had them. In fact, the more children they had, the lower the chances of developing ovarian cancer.
Personal History. Women who have had breast cancer or colon, are more likely to develop ovarian cancer than women who have not had these diseases.
Fertility treatment. The fertility treatment with certain drugs that trigger ovulation is associated with a probability higher than average of developing ovarian cancer.
Talc. Some studies suggest that women who have used talc in the genital area for many years may have an increased risk of developing ovarian cancer. However, more research is needed to understand this potential risk factor.
Is there a test to detect ovarian cancer early?
The sooner it is detected and ovarian cancer, the better the chance for recovery. But ovarian cancer is hard to detect early. Many times, women with ovarian cancer have no symptoms or have very mild symptoms until the disease is at an advanced stage. Scientists are studying ways to detect ovarian cancer before symptoms develop.
A large-scale study, known as the study of early detection of cancer of the Prostate, Lung, Colorectal, and Ovarian or PLCO study seeks to determine whether certain evidence will reduce the number of deaths from these cancers. The PLCO trial is currently evaluating the utility of three methods for detecting ovarian cancer.
One is a blood test that measures the level of CA-125, a substance called tumor marker found in the blood often in quantities greater than normal in women with ovarian cancer. This study is also evaluating the effectiveness of a physical examination of the ovaries and a test called a transvaginal ultrasound to detect the disease early.
Transvaginal ultrasound, also known as DVT, is a procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, and sound waves vibrate the organs inside the pelvic area. These sound waves produce echoes, which uses the computer to create a picture called a sonogram.
Does it cause any symptoms ovarian cancer?
Ovarian cancer usually shows no obvious signs or symptoms until it is advanced development. Signs and symptoms of ovarian cancer may include:
- General abdominal discomfort or pain (gas, indigestion, pressure, swelling, bloating, cramps).
- Nausea, diarrhea, constipation, or frequent urination.
- Loss of appetite.
- Feeling of fullness even after a light meal.
- Weight gain or loss without just cause.
- Abnormal vaginal bleeding.
These symptoms may be caused by ovarian cancer or by other, less serious conditions. It is important to consult your doctor about any of these symptoms.
How is ovarian cancer diagnosed?
To find the cause of symptoms, the doctor evaluates a woman’s medical history, perform a physical examination and order diagnostic tests. Some of the examinations and tests that may be useful are described below:
Pelvic exam. This includes touching the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size. It is usually done along with the pelvic exam Pap test (common test used to detect cervical cancer). Sometimes this test may detect ovarian cancer, but it is not a reliable way to detect or diagnose ovarian cancer.
Ultrasound. It uses high-frequency sound waves. These waves can not be heard by humans, they point to the ovaries. The pattern of the echoes they produce waves creates a picture called a sonogram. Healthy tissues, fluid-filled cysts and tumors look different on the table.
Analysis of CA-125. It consists of a blood test to measure levels of CA-125, a tumor marker in the blood is usually in amounts above normal in women with ovarian cancer.
Lower abdominal radiograph or barium enema. It is a series of x-rays of the colon and rectum. The photographs are taken after the patient is given an enema with a white, chalky solution containing barium. The barium outlines the colon and rectum on the x-ray, making it easier to see the tumor or other abnormal areas.
Computed tomography (CT scan). It is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine.
Biopsy. Involves the removal of a tissue sample to be examined under the microscope. A pathologist examines the tissue to make a diagnosis. For tissue, the surgeon performs a laparotomy (incision to open the abdomen).
If cancer is suspected, the surgeon performs an oophorectomy (total excision of the ovary). This is important because, if cancer is present, to cut the outer layer of the ovary to simply remove a tissue sample, maybe cancer cells to escape and spread the disease.
If ovarian cancer is diagnosed, the doctor will want to learn the stage (or extent) of the disease in order to find out whether the cancer has spread and, if so, to what parts of the body. Determining the stage of the disease may involve surgery, x-rays and other methods of making detailed images, and laboratory testing. Knowing the stage of the disease helps the doctor plan treatment.
How is ovarian cancer?
Using different treatments and combinations of treatments to treat ovarian cancer. The plan of treatment for a particular patient depends on several factors, including the stage of the cancer, your age and general health.
Surgery is the treatment for most women diagnosed with ovarian cancer. Generally, ovaries, cervix, uterus, and fallopian tubes are removed by an operation called a hysterectomy with bilateral salpingo-oophorectomy (surgical removal of both fallopian tubes and ovaries).
During surgery determining the stage of the disease and usually involves removing lymph nodes (small organs located along the lymph system ducts) Diaphragm tissue samples, omentum (thin tissue that covers the stomach and intestine) and other organs in the abdomen and abdominal fluid. If the cancer has spread, the surgeon usually removes much of the cancer as possible to reduce the amount of cancer that must then be treated with chemotherapy or radiation therapy.
Chemotherapy is the use of anticancer drugs to kill cancer cells in the body. Most drugs used to treat ovarian cancer are given by injection into a vein (intravenous or IV). There may also be chemotherapy drugs directly into the abdomen (intraperitoneal or IP) via a catheter, a thin tube is placed through the duration of the tratamiento.
Después of chemotherapy is completed, you can make a second look with surgery to examine the abdomen directly. The surgeon may remove fluid and a sample of tissue to see whether anticancer drugs have successfully removed the cancer.
Radiation therapy, also called radiotherapy, involves the use of high energy rays to kill cancer cells. Radiation therapy affects the cancer cells only in the treated area. Radiation may come from a machine (external radiation) or from radioactive liquid placed directly into the abdomen through a catheter (intraperitoneal radiation).
Are clinical trials (research studies) for patients with ovarian cancer?
Yes, clinical trials (research studies) to evaluate new ways to treat cancer are an important treatment option for many women with ovarian cancer. In some studies, all patients receive the new treatment. In others, doctors compare different therapies by giving a group of patients a promising new treatment and other standard therapy group (standard).