Ovarian Cancer

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WHAT IS OVARIAN CANCER?

The ovary is the female reproductive organs that produce eggs and the female hormones oestrogen and progesterone. Ovarian cancer develops when cells in the ovaries begin to grow out of control.

Ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia, making up 5% of all female cancer cases, according to the Malaysian National Cancer Registry, 2007-2011.

Ovarian epithelial cancer – spread to the lining and organs of the pelvis and abdomen.
Germ cell tumors – Tumours may appear in the egg-producing cells of the ovaries.
Sex cord-stromal tumours – Develop from the stroma tissue cells that produce the female hormones estrogen and progesterone.
Ovarian sarcoma – Develop in the connective tissues of ovarian cells.
Krukenberg tumours– Spreads into the ovaries from other organs.
Ovarian cysts – Ovarian cysts are fluid-filled sacs that develop inside the ovary.

Like many cancers, ovarian cancer may not produce symptoms in the early stages. However, at an advanced stage, the common symptoms include:

Abdominal bloating or a feeling of pressure
Abdominal/pelvic pain
Frequent urination
A feeling of fullness even after a light meal
Unexplained weight gain/loss
Abnormal vaginal bleeding

Diagnosis

A Pelvic Examination

First steps in evaluating a patient with a known or suspected diagnosis of ovarian cancer.

Ultrasound

Uses sound waves to create an image of internal organs, including the ovaries, uterus and cervix.

Magnetic Resonance Imaging (MRI) scan

To detect tumors or recurrences in other areas of the body, such as the head.

Positron Emission Tomography (PET) scan

is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. This scan can sometimes detect disease before it shows up on other imaging tests.

Computerized Tomography (CT) scan

Used to help diagnose ovarian cancer, fallopian tube cancer, or peritoneal cancer.

Staging of Ovarian Cancer

Staging of ovarian cancer refers to the extent to which it has spread to other organs or tissues.

The stages of ovarian cancer inclusive of:

Stage I: The cancer is confined to the ovaries.

Stage II: The cancer is in one or both ovaries and has spread to the pelvic regions.

Stage III: The cancer is in one or both ovaries, and cancer has either spread beyond the pelvis to the lining of the abdomen or to the lymph nodes in the back of the abdomen.

Stage IV: In the most advanced stage of ovarian cancer, cancer has metastasized to distant sites, such as the inside of the spleen, liver, lungs or other organs outside the abdomen and pelvic region.

Treatment

Treatment for ovarian cancer depends on the type of ovarian cancer you have and how far it has spread. Most people have a combination of:

Surgery

To locate and remove visible signs of cancer in a process called debulking.

Targeted therapy

To block the enzyme poly ADP-ribose polymerase (PARP) from identifying damaged DNA inside cancer cells, PARP inhibitors may stop cancer cells from repairing themselves.