Ovarian Cancer

Human ovaries can be described as the small, almond moulded tissues that are situated on both sides of the female uterus. Ovarian cancer comes about when abnormal cells in the ovary start to multiply out of control where they end up forming a tumour (Gajjar et al., 2012). This tumour when left untreated can spread to the other body parts and this is what is commonly known as metastatic ovarian cancer.  Ovarian cancer is the fifth most frequently detected malignance amongst women all over the globe (Gajjar et al., 2012). This type of cancer causes more deaths per year than any other malignancy of the female reproductive structure, with a projected count of 22,000 new cases every year in America. The life risk of a woman developing this type of cancer is 1 in 75 and her chances of dying of the illness are 1 in 100 (Gajjar et al., 2012). The syndrome stereotypically presents at the late phases when the five year comparative subsistence rate is only 29%. There are rare cases, about 15%, that are normally diagnosed with localized tumour when the five year comparative subsistence rate is only 92% (Lanceley et al., 2011). This strikes the general 5 year virtual survival rate to commonly range amid 30%-40% across the sphere (Lanceley et al., 2011).

The cancer of the ovaries can come about in numerous altered fragments of the ovary; it can begin in the ovary’s germ, epithelial cells or even the stromal.  There are three common types of ovarian cancer

• Epithelial tumours that form in the coating of matter on the outer side of the ovaries and roughly 90% of ovarian tumours are normally epithelial tumours.
• Stromal tumours, they develop in the hormone making cells and they description for around 70% of all the ovarian malignancies.
• The germ cell malignant tumours, they progress in the egg generating cells and they are very infrequent (Gajjar et al., 2012).

The precise source of ovarian cancer is not really known, though there are some risk factors that are associated with the epithelial ovarian cancer. As one gets older, there is higher risk of developing ovarian cancer. The cancer is infrequent among women that are younger than forty years and most of the ovarian malignancies are normally developed after menopause. It is estimated that half of all ovarian malignancies are prevalent among women who are 63 years of age and older (Gajjar et al., 2012). The women that get their first pregnancy after the age of 35 years and those that have never had a full term pregnancy have higher risks of developing ovarian cancer. Child bearing women are projected to have a 30 – 60% lower threat for ovarian malignancy and increasing births have a tendency to to reduce the risks even further (Gajjar et al., 2012). Breastfeeding is also a factor that affects risks of developing the cancer, breastfeeding supresses the emission of pituitary gonadotropins, hence causing anovulation. An increasing period of breastfeeding declines the threat of developing ovarian malignancy (Gajjar et al., 2012).

Obesity is highly associated to advanced risks of developing many malignancies. Obese women tend to have a higher threat of acquiring ovarian malignancy, though not necessarily the destructive categories. Obesity also greatly affects the overall survival of the women that has developed ovarian cancer (Gajjar et al., 2012).

Smoking of cigarette also upsurges the threat of mucinous and borderline ovarian malignancies and the longer one has smoked the greater the risks (Gajjar et al., 2012). Exposure to talcum powder is also associated with ovarian cancer, talc contains a substance that is known to cause cancers around the lungs and when it is inhaled (Gajjar et al., 2012). Women that use talcum powder in their genital areas have increased risks of developing ovarian cancer (Lanceley et al., 2011). The more years the talcum powder is used, the higher the risks.

History of the family is one of the most noteworthy risk factor of ovarian malignancy, the mutation of the genes that are involved in DNA reparation increases risks of cancer in some individuals. Ovarian malignancy can route in families and the threat increases if a parent, sibling or offspring has had ovarian malignance. The threats get higher with the number of relations that have the malignancy within the family (Gajjar et al., 2012). The history of other types of cancers such as breast cancer within the family can also be linked to an increased risk of ovarian cancer. This is because they can be instigated by a congenital transmutation in certain genes that source a family malignancy syndrome that upsurges the menace of the ovarian malignancy.

Ovarian malignancy comes about when there are faults in the standard cell development in the ovaries. This normally happens when the cells get old or broken and they die and fresh cells are developed to take their habitation. The malignancy starts to develop when these new cells form and they are not needed and the old cells fail to die as they are supposed to (Lanceley et al., 2011). These whole processes cause an accumulation of additional cells which form mass of soft tissue that become known as a tumour. The anomalous malignance cells often have inherent anomalies that cause them to grow excessively and this cause the cancer to be aggressive (Lanceley et al., 2011).

The diagnosis of ovarian malignance normally begins with a corporeal inspection which includes;

• A pelvic check,
• A blood exam or
• A transvaginal ultrasound

 A biopsy can be done to determine the presence of cancer, where by a small tissue sample is acquired from the ovaries to look for malignance cells. Imaging tests are also done to help detect any alterations in the ovaries and the other structures that may be instigated by the tumour (Koldjeski et al., 2005). The imaging includes CT scan, M.R.I and PET scan.

The early stages of the ovarian malignance may not have any defined signs and they may be difficult to detect but they include;

• Bloating
• Trouble eating
• Recurrent impulse to urinate
• Agony and distress in the pelvis
• Pain during sex
• Changes in menstrual periods for instance heavier bleeding

The cancer has four stages, the lower the number the lower the spread of the cancer. The highest number four means that the cancer has widely spread and hence requires intensive treatment (Lanceley et al., 2011). Three factors are used to stage the cancer including the size of the tumour, the spread to the adjacent lymph nodules and the spread to the distant spots. Stage I cancer is normally confined to one ovary, stage II cancer is normally restricted to the pelvis, stage III is the tumour that has spread into the stomach and the stage IV cancer is the one that spread outside of the stomach and also to other tissues (Lanceley et al., 2011).

The management of the ovarian malignance is dependent on the category, the phase, and whether one wants to have offspring in the future. Surgical procedure is normally conducted to help sanction whether one truly has cancer, the stage it is at, and to hypothetically eradicate the cancer (Koldjeski et al., 2005). During the surgical procedure, the surgeon attempt’s to eliminate all the tissue that comprises the cancer and they might also take a biopsy to perceive if the malignance has spread. The degree of this surgery is normally dependent on whether one wants to be pregnant in the future, where an individual that wants to get children in the future and has stage 1 cancer will have the affected ovary removed and a biopsy is done on the other ovary. The surgery may also include the removal of fatty tissues that are connected to some of the intestinal organs or even the elimination of intestinal and pelvic lymph nodes (Koldjeski et al., 2005).

Surgery for people that do not want to have children in the future can be more extensive. And more surgery may be required for the individuals that have stage 2, 3, and 4 cancer. This surgical procedure may comprise the elimination of the uterus, the elimination of both ovaries and fallopian ducts, and basically the elimination of as much tissue that has tumour cells as possible (Koldjeski et al., 2005).

Chemotherapy is what follows after the surgery. The medications in this case are given intravenously or through the abdomen and this is what is commonly known as intraperitoneal treatment (Koldjeski et al., 2005). Other oral medications may be given to help reduce the side effects of the chemo, most of which include painkillers and antibiotics.

 

 

 

 

 

 

 

 

References

Lanceley, A., Fitzgerald, D., Jones, V., Miles, T., Elliott, E., Darragh, L., & Peck, L. (2011).

Ovarian cancer: symptoms, treatment and long-term patient management. Primary Health Care, 21(7), 31–38. https://doi.org/10.7748/phc2011.09.21.7.31.c8689

Gajjar, K., Ogden, G., Mujahid, M. I., & Razvi, K. (2012). Symptoms and Risk Factors of

Ovarian Cancer: A Survey in Primary Care. ISRN Obstetrics & Gynecology, 1–6.

Koldjeski, D., Kirkpatrick, M. K., Swanson, M., Everett, L., & Brown, S. (2005). An Ovarian

Cancer Diagnosis-Seeking Process: Unraveling the Diagnostic Delay Problem. Oncology Nursing Forum, 32(5), 1036–1042. https://doi.org/10.1188/05.ONF.1036-1042