Ovarian Cancer

Ovarian Cancer

Ovarian cancer occurs in approximately 570 women in South Africa per year and is thus the second most common form of abdominal cancer in South Africa ( cancer of the uterusis the most frequent). Approximately eight times more sheep breast cancer.

Ovarian cancer can occur from several different types of tissue in the ovary or oviduct. This means that there are several different types of ovarian cancer. In approximately 10% of cases due to ovarian cancer spread of cancer arising in other organs.

Both the mortality and the number of new cases of ovarian cancer has declined slightly in recent decades in Northern Europe. The disease mostly affects women of 70-80 years of age, but it can affect women of all ages.

The lifetime risk of getting ovarian cancer is 1-2%. If your sister or mother has had ovarian cancer, the risk is doubled and is 2-5%. The vast majority of cases of ovarian cancer are not inherited but approximately 10% are inherited, and each family has specific genes which are associated with increased risk of ovarian and breast (including BRCA 1 and BRCA2). In families where genetics play a role, the cancer will often show up in younger age than in those who develop cancer, without close family is affected.

How common is ovarian cancer?

Every year there are almost 600 new cases of ovarian cancer in South Africa. In the end of 2013 lived 4556 South African women diagnosed with ‘ovarian cancer’. Ovarian cancer represents 3.1% of all cancers and the risk of getting the disease before 75 years of age is 1.3%.

The number of new cases has fallen by around 1.5% per year for the last 10 years.

What causes ovarian cancer?

Cancer is uncontrolled cell growth. We are not certain what triggers ovarian cancer. Ovarian cancer is more frequent in women who have not had children compared with those who have given birth to more children. The pill is believed to reduce the risk of ovarian cancer. This may suggest that hormones or conditions around ovulation may have something to do with the risk of this cancer, but the link is unclear.

There are more and more indications that ovarian cancer occurs in the outer place of the fallopian tubes and from there spread to the ovaries and it turns out that women who have removed the fallopian tubes, have been sterilized or have had hysterectomies are less likely to develop ovarian cancer. The correlation is again not fully understood.

5-10% of those who develop ovarian cancer have a hereditary factor. In some cases, the identification of a gene having an alteration that results in an increased risk of ovarian cancer (and breast cancer (BRCA1 and BRCA2 genes).

If you are suffering from ovarian cancer at an early age, and there are several in your immediate family who also had abdominal or breast cancer, it may be appropriate to test for the hereditary form of the disease. If you find a hereditary component, both information and management of the disease organized more precisely. In one test, one should be aware that other family members may also be predisposed, and may not want that information.

Factors you think acting on the autonomic risk of ovarian cancer

Age – most developing ovarian cancer after age 50.

Number of ovulation – a low number of ovulations through life seems to reduce the risk of developing ovarian cancer. Both the use of the pill and childbirth reduces the number of ovulations.

Hormone therapy – after menopause affects probably not the risk of ovarian cancer.

Radiation – against the pelvis increases the risk of this cancer.

It is important to remember that these factors only affect the risk quite a bit.

What are the symptoms of ovarian cancer?

Ovarian cancer is difficult to detect, and routine testing or for “screening” to identify this type of cancer does not mean that several cases are discovered early. In the first phase of the disease, there are few or no symptoms.

As the tumor grows, there may come stomach discomfort, stomach can grow and feel distended. Many believe they have taken on and trying to lose weight. Do you think that the stomach grows despite unchanged diet may be due to a cyst in the ovary or fluid in the abdomen. Growth is slow and you feel it is not from one day to the other.

Some find they need to empty the bladder more often and some get constipated because of pressure from the growing tumor on surrounding organs.

Fatigue is a symptom associated with many benign and malignant diseases but may also be present for ovarian cancer.

In rare cases there may be bleeding disorders. Bleeding disturbances after menopause should always lead to an examination by the doctor.

Advanced disease can cause pain and difficulty breathing.

Cysts in the ovary – both benign and malignant – For ovary to turn around. It provides sudden onset, severe pain.

How is it diagnosed?

There may be suspected of the disease if there is a lump or cyst on the ovaries in gynecological examination. The vast majority of nodules or ovarian cysts are benign.

An ultrasound examination through the vagina or abdomen can provide additional useful information and can point in one or other direction. A definite diagnosis is often only at the operation and analysis of tissue sample.

There is no blood, which helps to detect the condition at an early stage. A blood sample, CA-125, can be useful to follow the development of ovarian cancer, but the sample is not suitable for the diagnosis of safety and can not be used for screening.

Only if there is detected a cyst, one can by means of a measurement of CA-125 to assess whether there is high or low risk that there is a cancerous tumor. No matter what the measurement of CA-125 shows, there is in most cases a need for the removal of the knot.

Can we screen for ovarian cancer?

A screening means study of an entire population in order to confirm that they have a given disease. Examples are cervical cancer and breast cancer. The requirements for a screening is that it must be fairly cheap, must not overlook the many sick and not give suspected disease in many women are in fact healthy.

There are provided several studies that have attempted to screen for ovarian cancer with blood samples (Ca-125), and sonography. Yet there have been clear signs to the screening finds the disease in early stage. Conversely, many women with healthy ovaries had them removed due. Benign cysts which so suspicious and some have even died after surgery.

Against this background, it is currently not possible to screen the entire female population.

If a woman has a genetically increased risk of developing ovarian cancer, she offered screening once a year with ultrasound and blood tests (Ca-125).

What treatment is there?

Treatment depends on the spread of the disease and the subtype of ovarian cancer that is. If the disease is in an early stage and has not spread to other organs, it is hoped to achieve cure by surgery.

The operation takes place under general anesthesia and will in most cases include removal of both ovaries and fallopian tubes, uterus, intestinal fat apron (omentet) and the lymph nodes along the large blood vessels in the abdomen.

Ovarian cancer can also sit on the peritoneum and other organs inside the abdominal cavity. Therefore, it may be necessary to remove some of the small or large intestine, in some cases.

The aim of surgery is to remove all visible cancer tissue, but there is advanced disease is recommended to treat subsequent chemotherapy. This is called adjuvant chemotherapy.

Chemotherapy is usually given six times, once every three weeks.

In some cases it will be appropriate to give the cell poison before surgery to reduce the tumor size. It may be because women are generally affected by the disease to undergo a major surgery or disease located in areas where it is not possible to remove it. This treatment is called neo-adjuvant chemotherapy.

There will rarely be a need for radiation therapy.

How is long-term prospects?

Ovarian cancer is not easy to detect at an early stage, and therefore many have advanced disease when the condition is detected. As with any cancer, the prognosis is worse the more advanced the disease is. The fact that the detected late, therefore contributing to the prognosis for this cancer type overall is relatively poor.

After the diagnosis ‘ovarian cancer’ will 74% be alive one year after and 38% will be alive five years later. The prognosis is very dependent on the stage of the disease is.

The five year survival rate (the% of women are alive five years after diagnosis) for the disease are:

• Stadium In 75-87%
• Stage II 48-66%
• Stage III 23-39%
• Stage IV 18%

It is important to remember that statistics say nothing about the individual’s future!

How do I avoid or aggravate ovarian cancer?

If you have a suspicion that occurs ovarian and / or breast cancer in the family, should be referred for genetic counseling. If it turns out that you have family history of the disease can come in a test run and be recommended surgery with removal of the ovaries and fallopian tubes as well as any. uterus when one is about 40 years. This advice is individual and depends on many factors.

In addition to smoking, there are no special factors to avoid if you want to reduce her risk of developing ovarian cancer.

The main thing is to contact your doctor if you have any of the genes mentioned above. The doctor can assess the need for referral to a gynecologist and blood – or referral to another specialist.