Ovarian Cancer Awareness Month

Ovarian cancer occurs when abnormal cells in the ovary begin to multiply out of control and form a tumor. Ovaries are reproductive glands found only in females and are located on each side of the uterus.¹The ovaries hold the eggs which are released each month during childbearing age and produce sex hormones that control periods.²

The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of cancer:¹
Epithelial cell cancer –Begins in the layer of tissue on the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
Germ cell cancer –Arise in the cells that produce the eggs.
Stromal cell cancer –starts in the cells that produce the female hormones estrogen and progesterone.

Ovarian cancer is the 7^thcause of death and morbidity in females worldwide.³

Ovarian Cancer Symptoms and Signs:¹

When ovarian cancer symptoms develop, they’re usually attributed to other more common conditions. Signs and symptoms of ovarian cancer may include:

• Abdominal bloating or swelling
• Abnormal fullness after eating
• A frequent urge to urinate
• Menstrual irregularities
• Discomfort in the pelvic area
• Fatigue
• Weight loss
• Back pain
• Changes in bowel habits (constipation)

Risk Factors for Ovarian Cancer:⁴

• Getting older: The risk of developing ovarian cancer gets higher with age. Most ovarian cancers develop after menopause.
• Overweight or obese: Obesity has been linked to a higher risk of developing cancer cells and may negatively affect the woman with ovarian cancer.
• Having children later/never having a full-term pregnancy: Women with their first full-term pregnancy after age 35 or who never carried a pregnancy to term have a higher risk of ovarian cancer.
• Taking hormone therapy after menopause: Women using estrogens alone or with progesterone after menopause has an increased risk of developing ovarian cancer.
• Family history: The risk gets higher with more relative shaving ovarian cancer. Increased risk for ovarian cancer can also come from the father’s side.
• Inherited gene changes: This is caused by inherited mutations in the genes BRCA1 and BRCA2, which increases the risk of ovarian as well as breast cancer.
• Using fertility treatment: In-vitro fertilization (IVF) seems to increase the risk of the type of ovarian tumors known as “borderline” or “low malignant potential”.
• Smoking: Smoking increased the risk for the mucinous type and leads to ovarian cancer.

Complications:⁵

Every person may respond to treatment differently, here are some of the most common complications:

• Infection: The risk for infection increases dramatically in case of a lower white blood cell count.
• Bleeding and Bruising: Ovarian cancer treatments may damage the platelets. Without enough platelets, may experience prolonged bleeding and develop larger and more frequent bruises.
• Loss of Fertility and Menopause: Some women will need to have portions of their reproductive system removed to treat cancer.
• Leukemia: Chemotherapy may damage the bone marrow which could eventually lead to myeloid leukemia.
• Kidney Damage: Various type of chemotherapy has been shown to cause permanent kidney damage.
• Hernias: The risk of developing a hernia after cancer surgery. A hernia occurs when a hole or weak point in the muscular wall develops.
• Perforations: Certain targeted ovarian cancer treatments may cause holes to form in the colon. These holes are called perforations. This can lead to severe infection.
• Other common complications include fatigue, nausea, vomiting, hair loss, rashes on the hands and feet, and bone thinning.

Prevention:⁶

Some risk factors for ovarian cancer, like getting older or having a family history, cannot be changed. But women might be able to lower their risk slightly by avoiding other risk factors.

Managing certain risk factors: staying at a healthy weight, or not taking hormone replacement therapy after menopause may decrease the risk of ovarian cancer.

Exercise and diet. Maintain a weekly exercise regimen and a healthy diet.

Healthy lifestyle. Avoid tobacco products and limit alcohol consumption.

Pregnancy and breastfeeding.  Studies suggest that women who breastfeed may have a reduced risk of ovarian cancer.

Oral contraceptives: Using oral contraceptives decrease the risk of developing ovarian cancer for average-risk women.

Gynecologic surgery: Both ligation and hysterectomy may reduce the chances of developing a certain type of ovarian cancer.

Treatment for Ovarian cancer:^{7, 8}

Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.

Surgery-It is the main treatment for ovarian cancer. Operations on ovarian cancer include removing one ovary, removing both ovaries, and removing both ovaries. The goal of surgery is to remove the tumor, but complete removal of the uterus (hysterectomy) is frequently needed.

Chemotherapy- It is a drug treatment that uses chemicals to kill fast-growing cancer cells in the body and in certain situations, chemotherapy drugs may be heated and infused into the abdomen during surgery.

Targeted therapy- This treatment focus on specific factors present within cancer cells that help them to grow or survive.

Hormone therapy-Some ovarian cancers require estrogen to grow. Hormonal treatment blocks the production or the effects of estrogen on ovarian cancer cells.

Immunotherapy- Uses the immune system to fight cancer.

Supportive (palliative) care- It is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness.

Ovarian Cancer Awareness Month is observed every year in September. Ovarian cancer often has no symptoms, making it difficult to diagnose. Understanding ovarian cancers early signs and symptoms can help extremely decrease deaths and save many lives. Therefore, raising awareness of early signs and symptoms and educating people is crucial.⁹

References:

1. https://www.healthline.com/health/cancer/ovarian-cancer-early-signs#what-is-it,
2. https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html,
3. Shabir S, Gill PK. The global scenario on ovarian cancer – Its dynamics, relative survival, treatment, and epidemiology. Adesh Univ J Med Sci Res 2020;2(1):17-25.
4. Ovarian Cancer Risk Factors. Available at: https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html. Assessed on 22^nd August 2022.
5. Advanced Ovarian Cancer: Treatment Complications. Available at: https://www.healthline.com/health/ovarian-cancer/advanced-ovarian-cancer-treatment-complications#. Assessed on 22^nd August 2022.
6. Can ovarian cancer be prevented? Available at: https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/prevention.html. Assessed on 22^nd August 2022.
7. Ovarian Cancer. Available at: https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/diagnosis-treatment/drc-20375946. Assessed on 3^rd September 2022.
8. Ovarian Cancer. Available at: https://www.nhs.uk/conditions/ovarian-cancer/treatment/, Assessed on 3rd September 2022.
9. Ovarian Cancer Awareness Month – September 2022. Available at: https://nationaltoday.com/ovarian-cancer-awareness-month/. Assessed on 22^nd August 2022.