Ovarian cancer (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview
Ovaries are reproductive glands only in women. Its functions are to produce ova for reproduction and maintain the female hormones estrogen and progesterone. Ovarian cancer doesn't have any early symptoms. With the development of the cancer, frequent symptoms include heavy feeling in pelvis, pain in lower abdomen, bleeding from the vagina, weight loss and abnormal periods. Treatments include surgery, radiation therapy, chemotherapy or a combination of them.

What are the symptoms of Ovarian cancer?
Early ovarian cancer does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:


 * Heavy feeling in pelvis
 * Pain in lower abdomen
 * Bleeding from the vagina
 * Weight loss, loss of appetite
 * Abnormal periods

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?
Clinical data has suggested that the development of ovarian cancer is related to several factors.


 * Some drugs or treatment protocols: Recent studies show that fertility drugs, androgens and estrogen replacement therapy may increase the risk of ovarian cancer.
 * Reproductive history: Clinical survey suggests that women who have had children have a lower risk of ovarian cancer than women who have no children. The risk gets even lower with each pregnancy.
 * Personal history of breast cancer: Studies show the person who has the history of breast cancer has higher risk of developing ovarian cancer. The reason may be inherited a mutated BRCA1 or BRCA2 gene.
 * Family history of ovarian cancer, breast cancer, or colorectal cancer: Clinical data show the person who has the family history of ovarian cancer, breast cancer, or colorectal cancer has higher risk of developing ovarian cancer. These may also be inherited mutated of some gene.
 * Talcum powder: Some surveys show that talcum powder applied directly to the genital area or on sanitary napkins may increase the chance of getting ovaries cancer.
 * Life-style: A rich-fat diet and obesity may increase the risk of getting ovarian cancer.
 * Age: Clinical data suggest most ovarian cancers develop after menopause.

When to seek urgent medical care?
Call your health care provider if symptoms of ovarian cancer develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:


 * A large amount of bleeding from the vagina

Diagnosis

 * Ultrasonography: This is an painless test which uses sound waves to create a picture of the internal organs. Because tumors generate different echoes of sound waves than normal tissue, the doctor can locate a mass inside the body.
 * Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose ovarian cancer. It can confirm the location of the cancer and show the organs near the ovaries, as well as lymph nodes and distant organs where the cancer might have spread. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.
 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.
 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread
 * Chest X-ray: This plain x-ray of your chest may be done to see if the cancer has spread to your lungs.
 * Whole Bone Scan: The goal of a whole body bone scan is to show if a cancer has metastasized to your bones.

Treatment options
Patients with ovarian cancer have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effect may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery treatment: If your cancer does not spread and your general health is good, surgery treatment may be the first-selective treatment protocol.
 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.
 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.

Diseases with similar symptoms

 * Ovarian cysts
 * Endometriosis
 * Ovarian tuberculosis

Where to find medical care for Ovarian cancer?
Directions to Hospitals Treating Ovarian cancer

What to expect (Outlook/Prognosis)?
The prognosis of ovarian cancer depends on the following:


 * Whether or not the tumor can be removed by surgery.
 * The stage of the cancer: the size of the tumor, whether the cancer has spread outside the ovaries
 * Whether the cancer has just been diagnosed or has recurred
 * The patient’s general health

Possible complications

 * Spread of the cancer to other organs
 * Loss of organ function
 * Fluid in the abdomen (ascites)
 * Blockage of the intestines

Prevention
Although the reasons for the development of ovarian cancer are not clear, epidemic data shows the following intervention may help to reduce your risk of ovarian cancer:


 * Oral contraceptives
 * Gynecologic surgery
 * Genetic counseling, genetic testing may be prevention strategies for women with a family history of ovarian cancer.