When cancer begins in the ovaries it is called ovarian cancer. The ovaries are a pair of organs that are a part of the female reproductive system. Each ovary is an oval-shaped organ, roughly two inches long. They are located in the pelvis on either side of the uterus. Their main functions include producing eggs or ova and the female sex hormones (estrogen and progesterone).
If a woman has ovarian cancer, they may or may not experience any significant symptoms. Ovarian cancer is rarely diagnosed in its early stages due to the lack of any typical signs and symptoms. When present, the symptoms may include
- Abnormal vaginal bleeding or discharge (vaginal bleeding in postmenopausal women should not be ignored)
- Abdominal pain or discomfort
- Reduced appetite
- Swollen or distended abdomen
- Heaviness or pain in the pelvic area
- A change in bowel habits, typically constipation
- A frequent urge to urinate
Who gets ovarian cancer?
Any female can get ovarian cancer. Recent studies suggest that ovarian cancer may begin in the part of the fallopian tubes near the ovaries (distal end). The definitive cause of ovarian cancer is not known. Certain conditions may increase the risk of getting ovarian cancer. Having any of the risk factors does not necessarily mean a woman will get ovarian cancer. Some women may not get ovarian cancer despite the risk factors whereas some may get the condition despite the absence of any risk factors. Some of the important risk factors for ovarian cancer include
- Being middle-aged or older.
- Having a family history of ovarian cancer, breast cancer or colorectal cancer (this means any of the first-degree relatives, such as mother, sister, or daughter have had any of these cancers).
- Inheriting certain abnormal genes, namely BRCA and BRCA2, or the gene associated with Lynch syndrome or Peutz-Jeghers syndrome.
- Having a positive personal history of cancer of the breast, uterus, colon or rectum.
- Being obese or overweight.
- Having a certain ethnic background (Eastern European or Ashkenazi Jewish).
- Having endometriosis (a condition in which the tissue lining the uterus grows elsewhere in the body).
- Using fertility treatment (such as in vitro fertilization or IVF) may increase the chances of noncancerous or cancerous tumors of the ovaries.
- Never having been pregnant or carrying a pregnancy to term.
- Smoking (it typically increases the risk for mucinous ovarian cancer).
- Applying talcum powder to the genital area or using talc on sanitary napkins, condoms or diaphragms.
- Taking the hormone, estrogen, without progesterone for 10 years or more.
How do doctors diagnose ovarian cancer?
Doctors may diagnose ovarian cancer by
- Taking a detailed medical history including the details about the symptoms, any underlying health conditions and any significant personal or family history of ovarian, breast or colorectal cancer.
- Performing a thorough physical examination, particularly a pelvic exam to look for a bulky ovary or signs of fluid in the abdomen (called ascites).
- Ordering imaging tests such as ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, positron emission tomography (PET) scan and barium enema X-ray, to see whether the cancer has spread to the large bowel. A chest X-ray may also be done to check whether the cancer has spread to the lungs.
- Getting a biopsy done that includes taking a small tissue sample from the tumor and examining it under a microscope. The biopsy sample may also help stage and grade the cancer and determine the presence of special proteins (such as hormone receptors) that help plan a proper treatment regimen.
- Performing a laparoscopy to examine the pelvic organs, including the ovaries, by using a thin, flexible tube with a light source and camera (laparoscope) inserted into the abdomen via a small cut (incision).
- Ordering certain blood tests, such as blood counts and clotting time tests, to check the levels of certain important substances, such as human chorionic gonadotropin (HCG), lactate dehydrogenase (LDH), alpha-fetoprotein (AFP) and cancer antigen 125 (CA-125), which are linked with ovarian cancer.
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