What is ovarian cancer?
Ovarian cancer is a type of cancer that
starts in the ovaries, the female reproductive organs that produce eggs and
hormones. Ovarian cancer can affect one or both ovaries, and it can spread to
other parts of the body, such as the abdomen, pelvis, lungs, or liver.
There are different types of ovarian
cancer, depending on the type of cell where the cancer begins. The most common
type is epithelial ovarian cancer, which starts in the cells that cover the
surface of the ovary. Other types include stromal tumors, which start in the
cells that produce hormones, and germ cell tumors, which start in the cells
that produce eggs.
The exact cause of ovarian cancer is not
known, but some factors can increase the risk of developing it, such as older
age, inherited gene changes, family history, hormone therapy, reproductive
history, endometriosis, obesity, smoking, and exposure to asbestos or talcum
powder.
History of scientific and medical advances
A historical preview can help you realize
how ovarian cancer has been understood and treated over time, and how
scientific and medical advances have improved the outcomes and quality of life
for patients.
The discovery and development of CA-125: A
blood test that measures the level of a protein that is often elevated in
ovarian cancer. CA-125 was first identified in 1981 by a team of researchers
led by Robert Bast J., who later became the vice president of
translational research at MD Anderson Cancer Center. CA-125 is now widely used
as a biomarker for ovarian cancer diagnosis, monitoring, and prognosis.
The invention and evolution of laparoscopy: A
minimally invasive surgical technique that allows doctors to examine and
operate on the ovaries and other pelvic organs through small incisions in the
abdomen. Laparoscopy was first performed in 1901 by Dmitry Ott, a
Russian gynecologist, who used a cystoscope to inspect the pelvic cavity of a
woman with ovarian cysts. Laparoscopy has since become a standard procedure for
ovarian cancer staging, debulking, and biopsy.
The introduction and improvement of
chemotherapy: A treatment that uses drugs to kill or stop
the growth of cancer cells. Chemotherapy was first used for ovarian cancer in
1956 by Roy Hertz and Minnie Randall, who treated a patient with
metastatic ovarian cancer with a drug called methotrexate. Chemotherapy
has since become a mainstay of ovarian cancer treatment, with various drugs and
combinations being developed and tested over the years.
Recent discoveries in ovarian cancer
You can find some recent discoveries in
ovarian cancer drugs as below:
New drug combinations:
Researchers have found that combining different types of drugs, such as
chemotherapy, targeted therapy, and immunotherapy, can improve the outcomes for
patients with ovarian cancer. For example, a recent clinical trial showed that
adding the immunotherapy drug pembrolizumab to the chemotherapy drug paclitaxel
improved the survival of patients with recurrent ovarian cancer. Another trial
showed that adding the targeted therapy drug bevacizumab to the
chemotherapy drug carboplatin improved the survival of patients with
newly diagnosed ovarian cancer.
New biomarkers and genetic factors:
Researchers have identified new biomarkers and genetic factors that can help
diagnose and predict ovarian cancer, as well as guide the choice of treatment.
For example, researchers have discovered that the levels of a protein called
UCHL1 in the blood can indicate the presence and aggressiveness of ovarian
cancer. Another example is the discovery of a gene mutation called STK11 that
can predict the response of ovarian cancer to immunotherapy.
New insights into the origin and
development of ovarian cancer: Researchers have gained new insights into
how ovarian cancer starts and progresses from different types of cells and
tissues. For example, researchers have found that some ovarian cancers may
originate from endometrial cells that migrate to the ovaries during
menstruation. Another example is the finding that some ovarian cancers may
develop from fallopian tube cells that have acquired mutations in genes such as
TP53 and BRCA1/2.
Personal experiences of survivors of
ovarian cancer
Personal experiences of survivors of
ovarian cancer can be very inspiring and informative for others who are facing
the disease. They can also raise awareness and encourage early detection and
treatment. Here are some examples of personal experiences of survivors, based
on the web search results from Bing:
Adora Rodriguez
was only 16 years old when she developed a feeling of heaviness in her lower
abdomen, along with severe bloating. She was diagnosed with a form of germ-cell
ovarian cancer, known as dysgerminoma, and had surgery to remove the mass,
along with her right ovary and fallopian tube. She is now 20 years old and
studying to become a pediatric oncology nurse. She says, "I just feel
incredibly lucky. If I hadn’t mentioned the bleeding and my doctor hadn’t acted
as quickly and definitively as she had, the outcome would have been much
different."
Mariangela DiPietri,
a 73-year-old mother of three and grandmother of 10, had excruciating pain in
her abdomen that was initially misdiagnosed as constipation. She later learned
that she had masses on both ovaries, which turned out to be stage 1 ovarian
cancer. She had surgery to remove the masses, along with her ovaries, uterus,
and lymph nodes. She says, "I want people to know that there is
hope—healing is available—there is life after cancer."
Sharolyn Jackson,
a 58-year-old mother of two and grandmother of four, was diagnosed with stage 3
ovarian cancer in 1992, when she was 27 years old. She had surgery to remove
the tumor, along with her ovaries, uterus, and part of her colon. She also had
chemotherapy and radiation therapy. She has been living with no evidence of
disease for 31 years. She says, "Almost no one thought I would survive the
initial cancer for six months, but here I am 31 years later."
Challenges of early detection
Early detection of ovarian cancer is
challenging for several reasons, such as:
The rarity of the disease, which makes it
difficult to design and implement effective screening programs for the general
population.
The non-specific and vague symptoms of
ovarian cancer, which can be easily mistaken for other conditions or ignored by
women and doctors.
The lack of a reliable and accessible
screening test for ovarian cancer, as the current methods of diagnosis, such as
CA125 blood test and transvaginal ultrasound, have limitations in accuracy,
sensitivity, specificity, and cost.
The limited knowledge of the natural
history and origin of ovarian cancer, which hinders the identification of risk
factors, biomarkers, and early signs of the disease.
These challenges contribute to the high
mortality and low survival rates of ovarian cancer, as most cases are diagnosed
at a late stage, when the cancer has already spread to other organs and is
harder to treat. Therefore, more research and innovation are needed to improve
the early detection and prevention of ovarian cancer.
Risk factors of ovarian cancer
A risk factor is something that increases
your chance of getting a disease, such as ovarian cancer. However, having a
risk factor does not mean that you will definitely get the disease, and not
having a risk factor does not mean that you are completely protected from it.
Some risk factors for ovarian cancer are:
1.
Older age.
The risk of ovarian cancer increases as you age. It's most often diagnosed in
older adults.
2.
Inherited gene changes.
A small percentage of ovarian cancer cases are caused by gene changes that you
inherit from your parents. These include BRCA1 or BRCA2, or one associated with Lynch syndrome.
3.
Family history.
Having close family members (such as your mother, sister, aunt, or grandmother)
on either your mother’s or your father’s side, who have had ovarian cancer,
breast cancer, or colon cancer, may increase your risk of ovarian cancer.
4.
Hormone therapy.
Taking estrogen by itself (without progesterone) for 10 or more years may increase
your risk of ovarian cancer.
5.
Reproductive history.
Having your first period before age 12, having menopause after age 50, never
giving birth or having trouble getting pregnant, or using fertility drugs may
increase your risk of ovarian cancer.
6.
Endometriosis.
This is a condition where tissue from the lining of the uterus grows elsewhere
in the body. It may increase your risk of ovarian cancer.
7.
Obesity.
Being overweight or obese may increase your risk of ovarian cancer.
8.
Smoking.
Smoking tobacco may increase your risk of a certain type of ovarian cancer called mucinous ovarian cancer.
9.
Exposure to asbestos or
talcum powder. Some studies suggest that exposure to
asbestos or using talcum powder on the genital area may increase your risk of
ovarian cancer, but the evidence is not conclusive.
If you have one or more of these risk
factors, you should talk to your doctor about your risk of ovarian cancer and
how to reduce it. You should also be aware of the symptoms of ovarian cancer
and report any changes in your body to your doctor. Early detection and
treatment can improve your chances of survival.
Symptoms of ovarian cancer
Symptoms of ovarian cancer are signs that
something is wrong with your ovaries or other parts of your reproductive
system. However, many of these symptoms are also common in other conditions, so
they may not always indicate ovarian cancer. Some of the symptoms of ovarian
cancer are:
1.
Abdominal bloating or
swelling
2.
Quickly feeling full when
eating
3.
Weight loss
4.
Discomfort or pain in the
pelvic area
5.
Fatigue
6.
Back pain
7.
Changes in bowel or
bladder habits, such as constipation or frequent urination
8.
Abnormal bleeding from
the vagina
9.
Changes in your menstrual
cycle
10.
Pain during sex
These symptoms may vary depending on the
type and stage of ovarian cancer, as well as your individual factors. If you
have any of these symptoms and they last for more than two weeks, you should
see your doctor for a checkup. Early detection and treatment can improve your
chances of survival.
Diagnosis of ovarian cancer
Diagnosis of ovarian cancer is the process
of finding out if you have ovarian cancer and how advanced it is. Diagnosis
usually involves a combination of tests and procedures, such as:
Pelvic exam: Your doctor will examine your
vagina, cervix, uterus, ovaries, and other pelvic organs by inserting gloved
fingers into your vagina and pressing on your abdomen. This can help detect any
abnormal growths or masses in your ovaries.
Imaging tests:
Your doctor may use ultrasound, CT scan, MRI, or PET scan to create pictures of
your ovaries and other organs. This can help determine the size, shape, and location of any tumors or cancerous cells.
Blood tests:
Your doctor may check your blood for tumor markers, which are substances that
are often higher in people with ovarian cancer. The most common tumor marker
for ovarian cancer is CA-125, a protein that is found on the surface of ovarian
cancer cells. However, CA-125 can also be elevated by other conditions, such as
endometriosis, fibroids, or infection, so it is not a definitive test for
ovarian cancer.
Biopsy: The only way to confirm
that you have ovarian cancer is to take a sample of tissue from your ovary and
examine it under a microscope. This is called a biopsy. A biopsy can also help
determine the type and grade of ovarian cancer, which are important factors for
choosing the best treatment. A biopsy can be done during surgery or by using a
thin needle guided by imaging tests.
Genetic testing:
If you have a family history of ovarian cancer or other cancers, such as breast
or colon cancer, your doctor may recommend testing your DNA for gene changes
that increase your risk of ovarian cancer. These include BRCA1, BRCA2, and
Lynch syndrome genes. Knowing your genetic status can help you and your doctor make decisions about your treatment and prevention options.
After the diagnosis, your doctor will
assign a stage to your ovarian cancer, which indicates how far the cancer has
spread in your body. The stages range from 1 to 4, with 1 being the earliest
and 4 being the most advanced. The stage of your ovarian cancer affects your
prognosis and treatment plan.
If you have any questions or concerns about
the diagnosis of ovarian cancer, please talk to your doctor or health care
team. They can provide you with more information and support.
Treatment of ovarian cancer
Treatment of ovarian cancer usually
involves a combination of surgery and chemotherapy. Other treatments may be
used in certain situations, depending on the type, stage, and characteristics
of the cancer, as well as your personal preferences and overall health.
Surgery is the main treatment
for ovarian cancer. It aims to remove as much of the cancer as possible, along
with the ovaries, fallopian tubes, uterus, and nearby lymph nodes. Sometimes,
other organs or tissues may also be removed, such as the omentum (a layer of
fatty tissue that covers the abdominal organs) or parts of the bowel or
bladder. Surgery can also help determine the stage and grade of the cancer,
which are important factors for choosing the best treatment plan.
Chemotherapy
is the use of drugs to kill or stop the growth of cancer cells. It can be given
before or after surgery, or sometimes both. Chemotherapy can be given
intravenously (into a vein) or intraperitoneally (into the abdomen).
Chemotherapy can help shrink the tumor, prevent or delay recurrence, and
improve survival. However, chemotherapy can also cause side effects, such as nausea, vomiting, hair loss, fatigue, and increased risk of infection.
Other treatments that may be used for
ovarian cancer include:
Hormone therapy: This
is the use of drugs that block or lower the levels of hormones, such as
estrogen, that may stimulate the growth of some types of ovarian cancer.
Hormone therapy can be used as a palliative treatment, which means it can help
relieve symptoms and improve quality of life, but it cannot cure the cancer.
Targeted therapy:
This is the use of drugs that target specific features of cancer cells, such as
gene mutations or proteins, that make them different from normal cells. Targeted
therapy can help stop or slow down the growth of cancer cells, while sparing
normal cells. Targeted therapy can be used alone or in combination with
chemotherapy.
Immunotherapy:
This is the use of drugs that stimulate the body's immune system to recognize
and destroy cancer cells. Immunotherapy can help shrink the tumor, prevent or
delay recurrence, and improve survival. However, immunotherapy can also cause
side effects, such as rash, fever, diarrhea, and inflammation of organs.
Radiation therapy:
This is the use of high-energy rays or particles to kill cancer cells or shrink
tumors. Radiation therapy is not commonly used for ovarian cancer, but it maybe used in certain situations, such as to treat cancer that has spread to the bones or brain, or to relieve pain or bleeding.
The choice of treatment for ovarian cancer
depends on many factors, such as the type, stage, and characteristics of the
cancer, your age, your general health, your fertility goals, and your personal
preferences. You should discuss all of your treatment options, including their
benefits and risks, with your doctor or health care team. They can help you
make the best decision for your situation.
Prevention of ovarian cancer
Prevention of ovarian cancer is the process
of reducing your risk of developing the disease. There is no sure way to
prevent ovarian cancer, but some factors may lower your risk, such as:
a.
Using oral contraceptives:
Birth control pills for five or more years. This can reduce your risk by about50%, but it may also have some side effects, such as increasing your risk of breast cancer.
b.
Having a surgery:
(getting your tubes tied), a hysterectomy (removing your uterus), or an
oophorectomy (removing your ovaries). These surgeries can lower your risk, but they should only be done for valid medical reasons, not just for prevention.
c.
Having children and
breastfeeding: These can lower your risk by affecting
your hormone levels and reducing the number of ovulations you have in your
lifetime.
d.
Maintaining a healthy
weight and diet: Being overweight or obese may increase
your risk of ovarian cancer, as well as eating a diet high in fat or eggs.
e.
Avoiding hormone therapy
after menopause: Taking estrogen alone for 10 or more years
may increase your risk of ovarian cancer. If you need hormone therapy, talk to
your doctor about the benefits and risks.
f.
Avoiding smoking and
exposure to asbestos or talcum powder: These may increase your risk of a certain
type of ovarian cancer called mucinous ovarian cancer, but the evidence is not
conclusive.
g.
Gettting genetic testing
and counseling: if you have a family history of ovarian
cancer or other cancers, such as breast or colon cancer. You may have inherited
gene changes that increase your risk of ovarian cancer, such as BRCA1, BRCA2,
or Lynch syndrome genes. Knowing your genetic status can help you and your doctor make decisions about your prevention and treatment options.
These are some of the ways you can prevent
ovarian cancer, or at least lower your risk. However, none of these methods are
guaranteed to prevent ovarian cancer, and some of them may have drawbacks or
limitations. You should also be aware of the symptoms of ovarian cancer and
report any changes in your body to your doctor. Early detection and treatment
can improve your chances of survival.
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