Understanding Ovarian Cancer

Ovarian cancer accounts for around 3% of all cancers among women in the United States, placing fifth as the leading cause of cancer-related mortality in women in the country. The incidence rate has gone down since the 1990s.

Today, the annual incidence of ovarian cancer in the US is 25,580, according to the American Cancer Society, accounting for the highest mortality of all gynecological cancers.

What is ovarian cancer?

Ovarian cancer happens when cancerous cells develop in an ovary (or both ovaries). The cancer grows in the egg cells (causing a germ cell tumor) or in the lining of the ovary (causing epithelial ovarian cancer). Ovarian cancer can invade or spread to other organs near the ovaries like the uterus and fallopian tubes. Cancer cells can also break off from the main ovarian tumor.

What are the causes of ovarian cancer?

What causes ovarian cancer remains unknown in most cases. However, what we know is that some women are at higher risk than others to have ovarian cancer.

Many studies have revealed that those who have family history of cancer, aged over 55, and women who have never been pregnant have high risk of ovarian cancer. So are women who are past menopause or who have had breast cancer as well as colon, uterus, or rectum cancer.

What are its symptoms?

Ovarian cancer, like many other cancers, can be called a "silent killer’ since it usually does not cause symptoms at the outset, contributing to diagnostic delay and poor prognosis. But symptoms begin to manifest as the cancer grows.

Most common symptoms include: a bloated or swollen abdomen, always feeling very tired, nausea, constipation, indigestion, gas, diarrhea, and pain or pressure in the abdomen, back, pelvis, or legs.

Other symptoms include: frequent urination, abnormal vaginal bleeding (bleeding after menopause or heavy periods), and shortness of breath.

 How is it diagnosed?

Ovarian cancer at the early stage is hard to diagnose until it progresses to later stages. This is because most of the symptoms are non-specific. One way to know whether a woman has ovarian cancer is to take biopsies during surgery. Here, the doctor removes a small sample of any tumors found and tests them whether they contain cancer.

Another way to detect ovarian cancer is through a blood test known as cancer antigen 125 (CA-125). So far, studies cannot provide enough evidence to support the effectiveness of CA-125 in the early detection of ovarian cancer.

How is it treated?

Ovarian cancer can be treated by surgery, where the doctor removes any tumors. This may mean taking out one or both ovaries. It also usually means taking out the uterus and fallopian tubes.

Most patients undergo several months of chemotherapy after surgery. In many cases, ovarian cancer develops again after treatment. This means that cancer survivors need to have regular check-ups for the rest of their lives.