Ovarian cancer happens when normal cells in the ovary change into abnormal cells and grow out of control. The ovaries are organs that are part of a woman’s reproductive system where a woman’s eggs develop.
Ovarian cancer is one of the deadliest cancers in women, in part because it is mostly found at late stage, yet if detected early it can be treated. Ovarian cancer occurs most often in women ages 40 to 65, and sometimes runs in families.
During the early stages of ovarian cancer, symptoms are often vague and ill-defined and the patient can easily find them tolerable and ignore them for long until the cancer grows and the symptoms worsen and bothersome.
Early symptoms of ovarian cancer may include pelvic or abdominal discomfort, bloating, difficulty eating or feeling full, increased abdominal size, or rushing to urinate frequently. However, these symptoms can also be caused by many other conditions and hence early medical attention can help in early detection of life threatening causes of such symptoms, such as ovarian cancer.
Just like most cancers, ovarian cancer has no single known cause, although there are some known factors associated with ones increased risk of developing ovarian cancer and some of these include; older age, having one or more relatives who suffered from ovarian cancer or some forms of cancers of intestines, having some abnormalities in one’s genes. Never being pregnant in one’s life and overweight is also associated with increased risk of developing ovarian cancer
There are some factors that are associated with reduced risk of developing ovarian cancer such as; using hormonal methods of birth control (pills, patch, vaginal ring, and injection), being pregnant, and breastfeeding. Someone who had their tubes tied to prevent pregnancy, or had surgery to remove the uterus or ovaries are also at a reduced risk of developing cancer of the ovaries later in life
Screening for ovarian cancer is made by a clinician after taking the history of the patient’s complaints and assessing all the probable individual’s risks to ovarian cancer, doing a physical body examination and some clinical investigations can be carried out to screen for suspicion or confirmation of ovarian cancer.
Tests that may be useful for women at high risk of ovarian cancer include a blood test of some component that usually is found elevated in some conditions such as in most of women with ovarian cancer (test called CA 125 and is found elevated in more than 80% of women with ovarian cancer). This blood test doesn’t confirm presence of ovarian cancer since it can also be found higher than normal in other medical conditions and hence usually supplemented with an ultrasound scan of the pelvis which creates images of the organs in the pelvis, including the ovaries and any suspicious growth observed.
The final diagnosis of ovarian cancer is usually made when all the clinical information point to a cancerous ovarian tumor and surgery to remove the tumor done and results from the lab analysis of the removed ovary confirm cancer
Once the diagnosis of ovarian cancer has been made, the treatment will depend on the stage of the cancer and the patient’s clinical strength to handle the treatment plan designed. The main treatment for ovarian cancer is surgery and chemotherapy, and surgery alone can be curative for very early ovarian cancers, although both surgery and chemotherapy is usually administered for better outcome. There are other forms of treatments such as hormonal, targeted and radiation therapies which can be done, usually in combination with surgery.
For very late stage ovarian cancer, just like any other form of cancers, palliation to prevent pain and improve the patient’s quality of life will be offered.
Dr. Ian Shyaka is a General Practitioner at Rwanda Military Hospital.