What are the Ovaries?
The ovaries are a pair of small, almond-shaped organs located in the female reproductive system, one on each side of the uterus. They are part of the female reproductive system and are responsible for producing and releasing eggs for fertilization.
In addition to producing eggs, the ovaries also secrete hormones, including estrogen and progesterone, which are important for regulating the menstrual cycle, supporting pregnancy, and maintaining overall reproductive health. These hormones also have other important functions in the body, such as regulating bone growth and maintaining cardiovascular health.
What is Ovarian Cancer?
Ovarian cancer is a type of cancer that starts in the cells of the ovaries. It can occur in one or both ovaries and can spread to other parts of the body if left untreated. While breast cancer is known as the most common cancer, ovarian cancer is the deadliest cancer. When the term “ovarian cancer” is used, it includes both fallopian tube and peritoneal cancers because it may be unclear where cancer started. An ovarian cyst is an abnormal growth of tissue that forms on the surface of the ovary. It can occur during a normal menstrual cycle and usually goes away without treatment. Simple ovarian cysts are not cancerous. Ovarian cancer is a serious condition that requires prompt medical attention and treatment.
Types of Ovarian Cancer
There are several types of ovarian cancer, each with different characteristics, treatment options, and prognosis. The four main types of ovarian cancer are:
Epithelial ovarian cancer:
This is the most common type of ovarian cancer, accounting for about 90% of cases. It develops in the cells that cover the surface of the ovary and can spread to other organs in the abdominal cavity.
Germ cell ovarian cancer:
This type of ovarian cancer develops in the cells that produce the eggs. It is rare, accounting for less than 5% of cases, and is most commonly diagnosed in young women.
Sex cord-stromal ovarian cancer:
This type of ovarian cancer develops in the connective tissue that holds the ovary together and produces hormones. It is also rare, accounting for less than 5% of cases.
Small cell carcinoma of the ovary:
This is a very rare and aggressive type of ovarian cancer that typically occurs in young women.
Other less common types of ovarian cancer include borderline tumours (also known as low malignant potential tumours) and primary peritoneal carcinoma, which develops in the lining of the abdomen.
Risk Factors of Ovarian Cancer
The exact cause of ovarian cancer is not fully understood, but there are several known risk factors that can increase the likelihood of developing the disease. These risk factors include:
Genetics
Women who have a family history of ovarian cancer, breast cancer, or certain inherited genetic mutations (such as BRCA1 or BRCA2) are at an increased risk of developing ovarian cancer.
Age
The risk of ovarian cancer increases as a woman gets older, with most cases occurring in women over 50.
Obesity
Women who are obese or overweight may be at a higher risk of developing ovarian cancer.
Personal history of cancer
Women who have had breast, colon, or endometrial cancer are at a higher risk of developing ovarian cancer.
Reproductive history
Women who have never been pregnant, who had their first pregnancy after age 35, or who have a history of infertility or irregular menstrual cycles are at a higher risk of ovarian cancer.
Hormone replacement therapy
Long-term use of estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) after menopause may increase the risk of ovarian cancer.
Endometriosis
Women with endometriosis, a condition in which tissue similar to the lining of the uterus grows outside of the uterus, may have a higher risk of developing ovarian cancer.
It is important to note that having one or more of these risk factors does not necessarily mean that a person will develop ovarian cancer, and many people with ovarian cancer have no known risk factors. Regular screening and early detection can help improve outcomes, so it’s important to discuss any concerns with a healthcare provider.
Symptoms of Ovarian Cancer
Ovarian cancer can be difficult to detect in its early stages because the symptoms can be vague and non-specific, and may be mistaken for other conditions. However, some common symptoms of ovarian cancer include:
- Abdominal bloating or swelling
- Pelvic pain or pressure
- Difficulty in eating or feeling full quickly
- Urinary urgency or frequency
- Unexplained weight loss
These symptoms can also be caused by other conditions, and having one or more of these symptoms does not necessarily mean that a person has ovarian cancer. However, if these symptoms persist or worsen over time, it’s important to see a healthcare provider for an evaluation.
Diagnoses of Ovarian Cancer
The following tests may be used to diagnose ovarian/fallopian tube cancer:
Abdominal-pelvic examination:
Usually, the first exam is the abdominal-pelvic examination. The doctor feels the uterus, vagina, ovaries, bladder, and rectum to check for any unusual changes, such as a mass. Some cancers are very small before they spread and cannot be reliably felt and detected by pelvic examination. A Pap test, usually done with a pelvic examination, is not likely to find or diagnose these cancers because that test is used to find cervical cancer.
Blood tests/CA-125 assay:
There is a blood test that measures a substance called CA-125, which is a tumour marker. This marker is found at higher levels in people with ovarian/fallopian tube cancer. People younger than 50 with conditions such as endometriosis, pelvic inflammatory disease, and uterine fibroids may also have an increased CA-125 level. This test is more accurate in people who have experienced menopause.
Biopsy:
Biopsies for ovarian/fallopian tube cancer are often done as part of the first surgery. During the surgery, doctors may remove as much of the tumour as possible. A tumour sample will be analyzed by a pathologist after the surgery is over. A biopsy alone is sometimes used if the diagnosis is uncertain or if there is too much tumour to remove initially with surgery.
Computed tomography (CT) scan:
A CT scan takes pictures of the inside of the body using x-rays taken from different angles. An x-ray is a way to create a picture of the structures inside the body using a small amount of radiation. A computer combines these pictures into a 3-dimensional image that shows any abnormalities or tumours. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow. A CT scan can be used to measure the tumour’s size and find out how much cancer has spread.
Preventions and Treatments for Ovarian Cancer
Preventions to be considered are as follows
There is no sure way to prevent ovarian cancer, but there are some steps that may reduce the risk of developing the disease:
- Birth control pills: The use of birth control pills for 5 years or more may reduce the risk of ovarian cancer.
- Pregnancy and breastfeeding: Women who have had one or more full-term pregnancies and have breastfed may have a reduced risk of ovarian cancer.
- Removal of ovaries and fallopian tubes: Women who are at high risk of ovarian cancer due to inherited genetic mutations or other factors may choose to have their ovaries and fallopian tubes removed as a preventive measure.
- Healthy lifestyle habits: Maintaining a healthy weight, exercising, and eating a healthy diet rich in fruits and vegetables may help reduce the risk of developing ovarian cancer.
- Regular check-ups: Regular gynaecological check-ups and pelvic exams may help with the early detection and treatment of ovarian cancer.
Treatments required for Ovarian Cancer
The treatment for ovarian cancer depends on several factors, including the type and stage of cancer, the patient’s overall health, and individual preferences. Treatment options for ovarian cancer may include one or more of the following:
Surgery is usually the first step in treating ovarian cancer. The surgeon will remove as much of cancer as possible, which may include the ovaries, fallopian tubes, uterus, and nearby lymph nodes. The extent of the surgery will depend on the stage of cancer and whether it has spread to other parts of the body.
There are numerous surgical options for ovarian or fallopian tube cancer. The recommendation for the surgery depends on the stage of the tumour. Sometimes doctors perform two or more procedures during the same surgery. Some of these procedures are as follows –
- Salpingo-oophorectomy: This surgery involves the removal of the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy. If the patient wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only 1 ovary and 1 fallopian tube if the cancer is located in only 1 ovary. That surgery is called a unilateral salpingo-oophorectomy.
- Hysterectomy: This surgery focuses on the removal of the uterus and, if necessary, surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when both the uterus and cervix are removed.
- Lymphadenectomy/lymph node dissection: During this procedure, the surgeon may remove lymph nodes in the pelvis and para-aortic areas.
Chemotherapy uses drugs to kill cancer cells throughout the body. It may be used before surgery to shrink the tumour, or after surgery to kill any remaining cancer cells. Neoadjuvant chemotherapy is a medical term used to define chemotherapy that is given before surgery. It is done to reduce the size of a tumour before surgery. It is usually started after a biopsy, so the doctors can determine where the tumour began. Adjuvant chemotherapy is a medical term to describe chemotherapy that is given after surgery to eliminate any remaining cancer. For these types of cancer, the specific drugs typically are carboplatin given with or other drugs intravenously (IV).
Targeted therapy uses drugs to specifically target and kill cancer cells. These drugs may be used in combination with chemotherapy or on their own. For ovarian/fallopian tube cancer, some targeted therapy drugs are aimed at certain genes that might be found with abnormalities in certain types of epithelial ovarian/fallopian tube cancer. Standard chemotherapy has been effective in treating most ovarian/fallopian tube cancer.
Immunotherapy uses the body’s natural defences to fight cancer by improving your immune system’s ability to attack cancer cells.
Denvax Immunotherapy:
Denvax is a treatment known as cancer immunotherapy. It boosts the immune system to fight against cancer, mostly solid tumours. Denvax is targeted therapy and comes under the 4th modality of cancer treatment called cancer Immunotherapy.
Dendritic cells are cells of the immune system that help in the fight against cancer. Denvax treatment is customized dendritic cell-based cancer immunotherapy.
Pembrolizumab (Keytruda) and dostarlimab (Jemperli) are a type of immunotherapy called immune checkpoint inhibitors. They work by preventing the ability of cancer cells to stop the immune system from activating, which helps the immune system destroy cancer cells. The specific treatment plan will depend on several factors, including the stage of cancer, the patient’s overall health, and individual preferences. It’s important to discuss all available treatment options with a healthcare provider, who can provide more information and guidance based on the specific situation.
The choice of treatment depends on the stage of cancer and the woman’s overall health. Early-stage cervical cancer is often treated with surgery, while more advanced cancers may require a combination of surgery, radiation therapy, and chemotherapy. In some cases, women may receive palliative care to help manage symptoms and improve their quality of life. It’s important to talk to your doctor about the best treatment options for your individual situation.
References:
What are the Ovaries?
The ovaries are a pair of small, almond-shaped organs located in the female reproductive system, one on each side of the uterus. They are part of the female reproductive system and are responsible for producing and releasing eggs for fertilization.
In addition to producing eggs, the ovaries also secrete hormones, including estrogen and progesterone, which are important for regulating the menstrual cycle, supporting pregnancy, and maintaining overall reproductive health. These hormones also have other important functions in the body, such as regulating bone growth and maintaining cardiovascular health.
What is Ovarian Cancer?
Ovarian cancer is a type of cancer that starts in the cells of the ovaries. It can occur in one or both ovaries and can spread to other parts of the body if left untreated. While breast cancer is known as the most common cancer, ovarian cancer is the deadliest cancer. When the term “ovarian cancer” is used, it includes both fallopian tube and peritoneal cancers because it may be unclear where cancer started. An ovarian cyst is an abnormal growth of tissue that forms on the surface of the ovary. It can occur during a normal menstrual cycle and usually goes away without treatment. Simple ovarian cysts are not cancerous. Ovarian cancer is a serious condition that requires prompt medical attention and treatment.
Types of Ovarian Cancer
There are several types of ovarian cancer, each with different characteristics, treatment options, and prognosis. The four main types of ovarian cancer are:
Epithelial ovarian cancer:
This is the most common type of ovarian cancer, accounting for about 90% of cases. It develops in the cells that cover the surface of the ovary and can spread to other organs in the abdominal cavity.
Germ cell ovarian cancer:
This type of ovarian cancer develops in the cells that produce the eggs. It is rare, accounting for less than 5% of cases, and is most commonly diagnosed in young women.
Sex cord-stromal ovarian cancer:
This type of ovarian cancer develops in the connective tissue that holds the ovary together and produces hormones. It is also rare, accounting for less than 5% of cases.
Small cell carcinoma of the ovary:
This is a very rare and aggressive type of ovarian cancer that typically occurs in young women.
Other less common types of ovarian cancer include borderline tumours (also known as low malignant potential tumours) and primary peritoneal carcinoma, which develops in the lining of the abdomen.
Risk Factors of Ovarian Cancer
The exact cause of ovarian cancer is not fully understood, but there are several known risk factors that can increase the likelihood of developing the disease. These risk factors include:
Genetics
Women who have a family history of ovarian cancer, breast cancer, or certain inherited genetic mutations (such as BRCA1 or BRCA2) are at an increased risk of developing ovarian cancer.
Age
The risk of ovarian cancer increases as a woman gets older, with most cases occurring in women over 50.
Obesity
Women who are obese or overweight may be at a higher risk of developing ovarian cancer.
Personal history of cancer
Women who have had breast, colon, or endometrial cancer are at a higher risk of developing ovarian cancer.
Reproductive history
Women who have never been pregnant, who had their first pregnancy after age 35, or who have a history of infertility or irregular menstrual cycles are at a higher risk of ovarian cancer.
Hormone replacement therapy
Long-term use of estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) after menopause may increase the risk of ovarian cancer.
Endometriosis
Women with endometriosis, a condition in which tissue similar to the lining of the uterus grows outside of the uterus, may have a higher risk of developing ovarian cancer.
It is important to note that having one or more of these risk factors does not necessarily mean that a person will develop ovarian cancer, and many people with ovarian cancer have no known risk factors. Regular screening and early detection can help improve outcomes, so it’s important to discuss any concerns with a healthcare provider.
Symptoms of Ovarian Cancer
Ovarian cancer can be difficult to detect in its early stages because the symptoms can be vague and non-specific, and may be mistaken for other conditions. However, some common symptoms of ovarian cancer include:
- Abdominal bloating or swelling
- Pelvic pain or pressure
- Difficulty in eating or feeling full quickly
- Urinary urgency or frequency
- Unexplained weight loss
These symptoms can also be caused by other conditions, and having one or more of these symptoms does not necessarily mean that a person has ovarian cancer. However, if these symptoms persist or worsen over time, it’s important to see a healthcare provider for an evaluation.
Diagnoses of Ovarian Cancer
The following tests may be used to diagnose ovarian/fallopian tube cancer:
Abdominal-pelvic examination:
Usually, the first exam is the abdominal-pelvic examination. The doctor feels the uterus, vagina, ovaries, bladder, and rectum to check for any unusual changes, such as a mass. Some cancers are very small before they spread and cannot be reliably felt and detected by pelvic examination. A Pap test, usually done with a pelvic examination, is not likely to find or diagnose these cancers because that test is used to find cervical cancer.
Blood tests/CA-125 assay:
There is a blood test that measures a substance called CA-125, which is a tumour marker. This marker is found at higher levels in people with ovarian/fallopian tube cancer. People younger than 50 with conditions such as endometriosis, pelvic inflammatory disease, and uterine fibroids may also have an increased CA-125 level. This test is more accurate in people who have experienced menopause.
Biopsy:
Biopsies for ovarian/fallopian tube cancer are often done as part of the first surgery. During the surgery, doctors may remove as much of the tumour as possible. A tumour sample will be analyzed by a pathologist after the surgery is over. A biopsy alone is sometimes used if the diagnosis is uncertain or if there is too much tumour to remove initially with surgery.
Computed tomography (CT) scan:
A CT scan takes pictures of the inside of the body using x-rays taken from different angles. An x-ray is a way to create a picture of the structures inside the body using a small amount of radiation. A computer combines these pictures into a 3-dimensional image that shows any abnormalities or tumours. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow. A CT scan can be used to measure the tumour’s size and find out how much cancer has spread.
Preventions and Treatments for Ovarian Cancer
Preventions to be considered are as follows
There is no sure way to prevent ovarian cancer, but there are some steps that may reduce the risk of developing the disease:
- Birth control pills: The use of birth control pills for 5 years or more may reduce the risk of ovarian cancer.
- Pregnancy and breastfeeding: Women who have had one or more full-term pregnancies and have breastfed may have a reduced risk of ovarian cancer.
- Removal of ovaries and fallopian tubes: Women who are at high risk of ovarian cancer due to inherited genetic mutations or other factors may choose to have their ovaries and fallopian tubes removed as a preventive measure.
- Healthy lifestyle habits: Maintaining a healthy weight, exercising, and eating a healthy diet rich in fruits and vegetables may help reduce the risk of developing ovarian cancer.
- Regular check-ups: Regular gynaecological check-ups and pelvic exams may help with the early detection and treatment of ovarian cancer.
Treatments required for Ovarian Cancer
The treatment for ovarian cancer depends on several factors, including the type and stage of cancer, the patient’s overall health, and individual preferences. Treatment options for ovarian cancer may include one or more of the following:
Surgery is usually the first step in treating ovarian cancer. The surgeon will remove as much of cancer as possible, which may include the ovaries, fallopian tubes, uterus, and nearby lymph nodes. The extent of the surgery will depend on the stage of cancer and whether it has spread to other parts of the body.
There are numerous surgical options for ovarian or fallopian tube cancer. The recommendation for the surgery depends on the stage of the tumour. Sometimes doctors perform two or more procedures during the same surgery. Some of these procedures are as follows –
- Salpingo-oophorectomy: This surgery involves the removal of the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy. If the patient wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only 1 ovary and 1 fallopian tube if the cancer is located in only 1 ovary. That surgery is called a unilateral salpingo-oophorectomy.
- Hysterectomy: This surgery focuses on the removal of the uterus and, if necessary, surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when both the uterus and cervix are removed.
- Lymphadenectomy/lymph node dissection: During this procedure, the surgeon may remove lymph nodes in the pelvis and para-aortic areas.
Chemotherapy uses drugs to kill cancer cells throughout the body. It may be used before surgery to shrink the tumour, or after surgery to kill any remaining cancer cells. Neoadjuvant chemotherapy is a medical term used to define chemotherapy that is given before surgery. It is done to reduce the size of a tumour before surgery. It is usually started after a biopsy, so the doctors can determine where the tumour began. Adjuvant chemotherapy is a medical term to describe chemotherapy that is given after surgery to eliminate any remaining cancer. For these types of cancer, the specific drugs typically are carboplatin given with paclitaxel or other drugs intravenously (IV).
Targeted therapy uses drugs to specifically target and kill cancer cells. These drugs may be used in combination with chemotherapy or on their own. For ovarian/fallopian tube cancer, some targeted therapy drugs are aimed at certain genes that might be found with abnormalities in certain types of epithelial ovarian/fallopian tube cancer. Standard chemotherapy has been effective in treating most ovarian/fallopian tube cancer.
Immunotherapy uses the body’s natural defences to fight cancer by improving your immune system’s ability to attack cancer cells.
Denvax Immunotherapy:
Denvax is a treatment known as cancer immunotherapy. It boosts the immune system to fight against cancer, mostly solid tumours. Denvax is targeted therapy and comes under the 4th modality of cancer treatment called cancer Immunotherapy.
Dendritic cells are cells of the immune system that help in the fight against cancer. Denvax treatment is customized dendritic cell-based cancer immunotherapy.
Pembrolizumab (Keytruda) and dostarlimab (Jemperli) are a type of immunotherapy called immune checkpoint inhibitors. They work by preventing the ability of cancer cells to stop the immune system from activating, which helps the immune system destroy cancer cells. The specific treatment plan will depend on several factors, including the stage of cancer, the patient’s overall health, and individual preferences. It’s important to discuss all available treatment options with a healthcare provider, who can provide more information and guidance based on the specific situation.
The choice of treatment depends on the stage of cancer and the woman’s overall health. Early-stage cervical cancer is often treated with surgery, while more advanced cancers may require a combination of surgery, radiation therapy, and chemotherapy. In some cases, women may receive palliative care to help manage symptoms and improve their quality of life. It’s important to talk to your doctor about the best treatment options for your individual situation.
References:
