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Ovarian cancer refers to a type of cancer that occurs in the ovaries. Ovaries are reproductive organs that are found in females, and are responsible in the production of ova (eggs that travel through the fallopian tubes to the uterus for fertilization and implantation), and the production of progesterone and estrogen hormones. Women have two ovaries and each is located on each side of the uterus in the pelvis. Each ovary is composed of three types of cells, and each cell develops into a different kind of tumor. These include; epithelial tumors that arise from the epithelial cells (the outermost surface of the ovary), germ tumors that develop from the germ cells (cells that produce the ova), and stromal tumors that arise from the structural tissue cells (those that releases female hormones and holds the ovary together). Studies reveal that though ovarian cancers are less common (fifth most common cancer among women), they contribute to the occurrence of more deaths compared to the other female reproductive cancers such as cancer of the womb and cervical cancer (The American Cancer Society 2015).
History of the disease
Ovarian cancer was first identified during the industrial revolution. During this time, the occurrence of this disease was linked to exposure to environmental agents such as asbestos, since its incidence was high in the industrialized countries. Since then, numerous studies have been conducted in order to establish the cause of the disease (U.S National Library of Medicine 2015). Currently, the occurrence of this disease is linked to numerous factors such as age, ovulation and fertility, family history, among others.
Causes and risk factors
The exact cause of ovarian cancer is unknown, but researchers have revealed numerous factors that increase the chances of developing this disease. For example, women aged above fifty years are at high risk of developing ovarian cancer. Approximately more than 8 out of ten cases of ovarian cancer arise after menopause. In addition, women whose close relatives had earlier been diagnosed with either ovarian or breast cancer have high risks of developing this disease. Moreover, ovulation and fertility increases the risk of ovarian cancer development. Researchers stipulate that when an ovum is released from the ovary, the surface of the ovary is damaged, and this calls for its repair, and this increases the likelihood of the growth of abnormal cells. Consecutively, the occurrence of this disease is also contributed by practices such as human replacement therapy (HRT).
Stages of Ovarian Cancer
Ovarian cancer is grouped into four main stages, which are established based on the extent at which the disease has grown or spread. However, any stage of this disease is determined by the health physician through tests, scans or even surgery. Moreover, the determination of ovarian cancer stage helps the specialist to decide on the appropriate treatment to administer to the patient, and the probable course and outcome (prognosis) of the disease.
Stage 1(early disease)
This stage means that the spread of the cancer is only in the ovary or ovaries. This stage is further divided into three stages, which includes; Stage 1A, 1B, and 1C. In stage 1A, the growth of cancer is only present in one ovary, and the tumor is confined inside of the ovary. This means that there is no cancer on the external surface of the ovary, no ascites containing malignant cells are present, and the capsule is intact. In stage 1B, the growth of cancer is in both ovaries, no any tumor on the external surfaces of the ovaries, intact capsule, and no ascites that have malignant cells. For stage 1C, the tumor is categorized as either stage 1A or 1B, together with any of the following features that can be present: ruptured capsule; presence of tumor on the external surface of one or both ovaries; presence of ascites with positive peritoneal washings or malignant cells (National Ovarian Cancer Coalition 2015).
In this stage, the growth of cancer cells can be seen on the external surface of the ovary or ovaries and extends to the pelvic and the abdomen. This stage is also divided further into three stages; stage 2A, 2B, and 2C. In stage 2A, the growth of cancer extends to the fallopian tubes or the uterus, or both. In stage 2B, the growth of cancer extends to other pelvic organs such as the rectum or bladder (National Ovarian Cancer Coalition 2015). In stage 2c, cancer growth does not only extend to other pelvis tissues, but also starts to extend to the abdomen.
In this stage, the growth of cancer extends from the tissues in the pelvis to the abdominal cavity, lymph nodes, groin, or behind the womb. This stage is also divided into three sub-stages; 3A, 3B, and 3C. In stage 3A, the health practitioner can see (by use of a microscope) some cancer cells in the lining of the abdomen. In stage 3B, growing tumors that are less than or equal to 2 cm becomes visible on the lining of the abdomen. In stage 3C, the tumors become more visible (larger than 2cm) along the lining of the abdomen, lymph nodes, groin, or behind the womb (National Ovarian Cancer Coalition 2015).
This stage means that the growth of cancer has spread to other body organs such as lungs or the liver (National Ovarian Cancer Coalition 2015). Apparently, if the cancer cells are only identified on the surface of the liver and not inside the liver itself, the disease is still in stage three.
There are numerous factors that influence the survival rate of individuals who are diagnosed with ovarian cancer. Some of these factors include; the age of the patient, stage of the disease at the time of diagnosis, the kind of treatment administered, general health of the patient, and how the disease responds to the treatment administered. Numerous studies show that women who are diagnosed with ovarian cancer before the age of 65 years have a higher survival rate compared to those who are diagnosed being over this age. In addition, when this disease is diagnosed during the initial stages (stage 1A and 1B), the 5-year relative survival rate is approximately 92 percent. However, only few cases (15 percent) have been diagnosed with this disease at early stages. Moreover, the 5-year survival rate for all types of ovarian cancer is 45 percent (The American Cancer Society 2015).
Epithelial Ovarian cancer is an umbrella term that is used to describe numerous subtypes of cancer such as clear cell, borderline serous, high grade serous, low-grade serous, and endometrioid ovarian cancer. Nevertheless, these subtypes are essentially distinct conditions in terms of their spreading patterns, precursor lesions, genetic risk factors, epidemiology, and molecular events during prognosis, response to chemotherapy, and ontogenesis. However, recent molecular biology techniques have shown that some tumors that were initially thought to have arose from the ovaries actually begun in the fallopian tubes (The American Cancer Society 2015). The development of these techniques promises the development of more individualized and effective approaches of screening, diagnosing, and managing ovarian cancer.
Signs and Symptoms
Patients who are diagnosed with ovarian cancer during the early stages rarely do they present any symptom of the disease. In contrast, the advanced stages of ovarian cancer contribute to the appearance of few (though non-specific) symptoms that are frequently mistaken with more benign conditions. Some of these symptoms include; weight loss, constipation, frequent urge of urinating, abdominal bloating, discomfort in the pelvis region, and loss of appetite, among others. This disease alters the normal function of body organs such as liver, lungs, ovary, uterus, abdomen, among others (The American Cancer Society 2015).
Treatment and Medication
The treatment of ovarian cancer entails a combination of chemotherapy and surgery. For surgery, the affected body organs such as lymph nodes, omentum (a lining of fatty abdominal tissue), ovaries, uterus, and fallopian tubes among others. In case the disease is diagnosed during the early stages, surgery may involve the removal of one ovary and its linking fallopian tube. On the other hand, chemotherapy involves the killing of any remaining tumors (U.S National Library of Medicine 2015).
Some of the suggested medications for this disease include; cisplatin, Clafen, avastin, bevacizumab, Carboplatin, among others. However, the type of medication to be administered depends on the stage of the disease.
It is, therefore, evident that ovarian cancer is a vital reproductive condition that affects most women. The occurrence of this disease is influenced by numerous natural and environmental factors. In addition, this disease develops in stages, which influences the treatment and survival rate of patients. The initial stages are asymptomatic and this makes it difficult for early detection. Due to this reason, it is advisable for women to embrace ovarian cancer screening behaviors.
National Cancer Institute: Ovarian, Fallopian tube, and Primary Peritonea Cancer. Updated on 9th April, 2015. Retrieved from, http://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq#section/all
National Ovarian Cancer Coalition: Types and Stages of Ovarian Cancer. Published on February 2015. Retrieved from, http://www.ovarian.org/types_and_stages.php
The American Cancer Society: Ovarian Cancer. Published on 12th March 2015. Retrieved from, http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-what-is-ovarian-cancer
U.S National Library of Medicine: The Natural History and Treatment of Ovarian Cancer. Accessed on May 2015. Retrieved from, http://www.ncbi.nlm.nih.gov/pubmed/7013683