Ovarian Cancer: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Ovarian cancer is a type of cancer that begins in the ovaries or in the fallopian tubes. Female reproductive organs include the ovaries, which produce eggs and hormones, as well as the fallopian tubes, which connect the ovaries to the uterus. In addition to spreading, ovarian cancer can cause serious health problems.
Causes of Ovarian Cancer
The exact cause of ovarian cancer is not known, but some factors may increase the risk of developing it. These include:
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Older age. The risk of ovarian cancer increases as you get older. Most cases are diagnosed in women over 60 years old.
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Family history. Having a close relative who had ovarian cancer, breast cancer, or colorectal cancer may increase your risk of ovarian cancer. This may be due to inherited gene changes that affect how cells grow and divide.
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Hormone therapy. Using estrogen-only hormone replacement therapy or fertility treatment may increase your risk of ovarian cancer.
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Obesity. Being overweight or obese may increase your risk of ovarian cancer.
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Endometriosis. Having endometriosis, a condition where the tissue that normally lines the uterus grows outside the uterus, may increase your risk of ovarian cancer.
Symptoms of Ovarian Cancer
Symptoms of ovarian cancer usually don't appear until the cancer has spread to other organs. When symptoms appear, they may be vague and similar to other conditions.
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Abdominal bloating or swelling
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Feeling full quickly after eating
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Weight loss
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Pelvic pain or pressure
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Changes in bowel habits, such as constipation or diarrhea
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Frequent urination
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Fatigue
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Back pain
If you have any of these symptoms that persist or worsen, you should see your doctor as soon as possible.
Diagnosis of Ovarian Cancer
You will be asked about your medical history, family history, and symptoms in order to determine if you have ovarian cancer. Your doctor will also perform a physical exam, including a pelvic exam, to check for abnormalities in your ovaries and abdomen. Several tests and procedures may also be ordered by your doctor to confirm the diagnosis and determine the extent of the cancer. These include:
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Blood tests. These can check for tumor markers, such as CA 125, that are often elevated in women with ovarian cancer. They can also check for your general health and organ function.
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Imaging tests. These can show the size, shape, and location of your ovaries and any tumors or metastases. They may include ultrasound, CT scan, MRI scan, PET scan, or X-ray.
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Surgery. This is usually done to remove one or both ovaries and have them tested for cancer cells. It can also help stage the cancer and plan further treatment. Depending on the situation, your surgeon may also remove other organs or tissues that are affected by the cancer, such as the fallopian tubes, uterus, lymph nodes, omentum, or peritoneum.
Treatment of Ovarian Cancer
The treatment of ovarian cancer depends on many factors, such as the type, stage, grade, and location of the cancer; your age and overall health; your preferences and goals; and the potential benefits and side effects of each option. There are a number of ways in which ovarian cancer can be treated:
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Surgery. This is often the first step in treating ovarian cancer. It involves removal of as much cancer as possible in order to prevent it from spreading or recurring. The extent of surgery depends on how far the cancer has spread and how much fertility you want to preserve. One or both ovaries are removed during surgery (oophorectomy), both ovaries and fallopian tubes are removed during surgery (salpingo-oophorectomy), the uterus is removed (hysterectomy), nearby lymph nodes are removed (lymphadenectomy), the abdominal organs are covered with fat (omentectomy), or the abdominal lining is removed (peritonectomy).
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As a treatment, chemotherapy kills or stops cancer cells from growing and dividing. It is possible to use chemotherapy before surgery (neoadjuvant chemotherapy) to shrink the tumor and make it easier to remove, after surgery (adjuvant chemotherapy) to kill cancer cells and prevent recurrence, or as a primary treatment when surgery cannot be performed. The drugs used for chemotherapy may vary depending on the type and stage of ovarian cancer. Chemotherapy can be given either intravenously (into a vein) or intraperitoneally (into the abdomen).
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Using targeted therapy, drugs are targeted at cancer cells or their environments that make them different from normal cells. Cancer cells can be stopped from growing, spreading, or surviving with targeted therapy without harming normal cells. It can be used alone or in conjunction with chemotherapy or surgery. In targeted therapy, PARP inhibitors, angiogenesis inhibitors, or immunotherapy agents may be used.
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A hormone therapy treatment is a form of treatment that blocks the production or action of hormones that may stimulate ovarian cancer growth. The drugs used in hormone therapy may include aromatase inhibitors, tamoxifen, or progestins, and can be used alone or in combination with other treatments.
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In radiation therapy, high-energy rays or particles are used to destroy cancer cells or damage their DNA. It can either be administered externally (from a machine outside the body) or internally (from a radioactive source within the body). Palliative treatment for ovarian cancer symptoms such as pain, bleeding, and obstruction can be achieved with radiation therapy.
Prevention of Ovarian Cancer
There is no sure way to prevent ovarian cancer, but some steps may help reduce your risk or detect it early. These include:
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Having regular pelvic exams and discussing any symptoms or concerns with your doctor
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Knowing your family history and considering genetic testing if you have a high risk of inherited ovarian cancer
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Taking birth control pills for several years, which may lower your risk of ovarian cancer
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Breastfeeding, which may lower your risk of ovarian cancer
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Having a tubal ligation (having your tubes tied) or a hysterectomy (having your uterus removed), which may lower your risk of ovarian cancer
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Avoiding hormone therapy after menopause, especially estrogen-only therapy
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Maintaining a healthy weight and eating a balanced diet
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Quitting smoking and limiting alcohol intake.
