Ovarian cancer in women has left so many women barren. Some might wonder how it is caused. Well, if you are among those who want to know what causes ovarian cancer, you should read through this guide keenly. We have researched and found out something that might interest you about ovarian cancer.
What are the ovaries?
Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus.
What is Ovarian Cancer?
Ovarian cancer is the growth of cells that forms in the ovaries. The cells multiply quickly and can invade and destroy healthy body tissue.
The female reproductive system contaitwo ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.
Each type of cell can develop into a different type of tumor:
- Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
- Germ cell tumors start from the cells that produce the eggs (ova).
- Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
Some of these tumors are benign (non-cancerous) and never spread beyond the ovary. Malignant (cancerous) or borderline (low malignant potential) ovarian tumors can spread (metastasize) to other parts of the body and can be fatal.
Ovarian cancer treatment usually involves surgery and chemotherapy.
Who gets ovarian cancer?
Ovarian cancer affects women and people assigned female at birth (AFAB). It’s slightly more common in Native American and white populatiothan in people who are Black, Hispanic, or Asian.
In addition, people of Ashkenazi Jewish descent are much more likely to have a BRCA gene mutation, placing them at a higher risk for breast and ovarian cancer.
Ovarian cancer accounts for 1% of all new cancer cases in the U.S. The lifetime risk of developing ovarian cancer is approximately 1 in 78.
What are the symptoms of ovarian cancer?
Ovarian cancer can develop and spread throughout your abdomen before it causes any symptoms. This can make early detection difficult. Ovarian cancer symptoms may include:
- Pelvic or abdominal pain, discomfort, or bloating.
- Changes in your eating habits, getting full early, and losing your appetite.
- Vaginal discharge or abnormal bleeding, especially if the bleeding occurs outside of your typical menstrual cycle or after you’ve gone through menopause.
- Bowel changes, such as diarrhea or constipation.
- An increase in the size of your abdomen.
- Peeing more often (frequent urination).
If you develop any of the symptoms listed above, schedule a visit with a healthcare provider.
Causes and risk factors
Ovarian cancer develops when cells in this area of the body divide and multiply in an uncontrolled way.
The cause of ovarian cancer is not clear, but experts have identified some risk factors that may contribute, including:
- having a family history of breast or ovarian cancer
- being an older adult
- having children later in life or never having children
- having a history of breast cancer
- undergoing hormone replacement therapy
- being overweight
Here is a closer look at each risk factor:
Family history
Having a close relative with a history of ovarian or breast cancer increases a person’s chance of developing ovarian cancer.
Undergoing genetic screening for mutatioin the BRCA gene may help determine if someone has a higher risk of both ovarian and breast cancer.
Age
Ovarian cancer is more common in older adults. In fact, around half of ovarian cancer cases occur after the age of 63 years.
Reproductive history
Having had one or more full-term pregnancies has an association with a lower risk of ovarian cancer. The more pregnancies a person has, the lower the risk seems to be. Breastfeeding or chest feeding may also lower the risk.
However, having children later in life (after age 35) or never having children have links with a higher risk. People who use some types of fertility treatment may have a higher chance of developing borderline cells, but not all studies confirm this.
Females who use birth control pills or an injectable contraceptive hormone also appear to have a lower risk.
Breast cancer
People with a history of breast cancer seem to have a higher chance of ovarian cancer. This may be due to changes in the BRCA gene.
For this reason, some people with breast cancer who test positive for this gene mutation may opt to have an oophorectomy, or surgery to remove the ovaries, as preventive therapy.
Hormone therapy
Undergoing hormone replacement therapy (HRT) after menopause appears to increase the risk of ovarian cancer, particularly if the therapy uses synthetic progestins.
Obesity and overweight
Ovarian cancer is more common in people with a body mass index (BMI) of over 30.
Additionally, a person is 1.1 times more likely to develop ovarian cancer with each 5-unit increase in BMI.
Gynecologic surgery
Having surgery to remove the uterus — a hysterectomy — may reduce the risk of ovarian cancer by one-third.
How is ovarian cancer diagnosed?
Despite years of research, experts haven’t yet developed a successful ovarian cancer screening test. For this reason, the condition is often difficult to diagnose in the early stages. If your healthcare provider suspects ovarian cancer, they’ll ask about your symptoms and perform a pelvic exam. During the exam, they’ll check for any abnormal growths or enlarged organs.
They may recommend additional tests, including:
Imaging tests
Providers may use several imaging tests, including:
- Pelvic ultrasound.
- MRI (magnetic resonance imaging).
- CT scan (computed tomography).
- PET scan (positron emission tomography).
Blood tests
Blood tests look for a substance called CA-125. High levels of CA-125 in your blood can be a sign of cancer. However, CA-125 levels can be normal, even when cancer is present, and higher in many conditiothat aren’t cancer. Because of this, providers use blood tests in combination with other tests to diagnose ovarian cancer.
Surgical evaluation
Providers can diagnose ovarian cancer during surgery. Typically, if they find abnormal growths, they’ll remove them during the same procedure.
Laparoscopy
During laparoscopic surgery, a surgeon places a thin camera (laparoscope) through a small cut (incision) made in your abdomen. Using the scope as a guide, along with additional ports to hold instruments, the surgeon can assess cancer, perform staging biopsies and, in some circumstances, remove ovarian tumors.
What are the stages of ovarian cancer?
There are four stages of ovarian cancer. In this cancer staging system, the least severe is the lowest number. The more serious the condition, the higher the number.
- Stage I: This stage is divided into three sub-stages (Stage IA, Stage IB, and Stage IC). In the first sub-stage, cancer is only in one ovary or one fallopian tube. Stage IB has cancer in both ovaries or fallopian tubes. In Stage IC, cancer is in both ovaries or fallopian tubes and is found outside of your ovary (on the outside of the organ itself or in the space around the ovary, called the peritoneal cavity).
- Stage II: Stage II is also divided into a few additional stages. In Stage IIA, the cancer is no longer only in your ovary but has also spread to your uterus. In Stage IIB, cancer has spread to other nearby structures in your pelvis.
- Stage III: This stage includes three sub-stages. In Stage IIIA, cancer has spread beyond your pelvis to your abdomen (microscopically) or within lymph nodes. In the second sub-stage (Stage IIIB), the tumor is up to 2 centimeters in size and has spread beyond your pelvis or within your lymph nodes. In Stage IIIC, cancer has moved outside of your pelvis area and is larger in size (more than 2 centimeters) or maybe within your lymph nodes. At this point, it could impact other organs, like your liver and spleen.
- Stage IV: Stage IV cancer is the most severe. In this stage, cancer has spread to the inside of orgasuch as your liver or spleen. In Stage IVA, it’s found near your lungs, and in Stage IVB, cancer has spread to the lymph nodes of your groin or into your chest.
Staging is important because it helps your healthcare provider design a tailored treatment plan for you. Your healthcare provider will talk with you about your treatment options.
How ovarian cancer is treated
The treatment depends on how far cancer has spread. A team of doctors will determine a treatment plan depending on your situation. It will most likely include two or more of the following:
- chemotherapy
- surgery to stage cancer and remove the tumor
- targeted therapy
- hormone therapy
Surgery
Surgery is the main treatment for ovarian cancer.
The goal of surgery is to remove the tumor, but a hysterectomy, or complete removal of the uterus, is often necessary.
Your doctor may also recommend removing both ovaries and fallopian tubes, nearby lymph nodes, and other pelvic tissue.
Identifying all tumor locatiois difficult.
In one study, researchers investigated ways to enhance the surgical process so that it’s easier to remove all of the cancerous tissue.
Targeted therapy
Targeted therapies, such as chemotherapy, attack the cancer cells while doing little damage to normal cells in the body.
Newer targeted therapies to treat advanced epithelial ovarian cancer include PARP inhibitors. These drugs block an enzyme used by cells to repair damage to their DNA.
The first PARP inhibitor was approved in 2014 for use in advanced ovarian cancer that had been treated previously with three lines of chemotherapy (meaning at least two recurrences). However, for those with advanced ovarian cancers, PARP inhibitors may be offered alongside chemotherapy.
The three PARP inhibitors currently available include:
- olaparib (Lynparza)
- niraparib (Zejula)
- rucaparib (Rubraca)
The addition of another drug, bevacizumab (Avastin), has also been used with chemotherapy following surgery.
Individuals who have the BRCA1 or BRCA2 genes may have slightly different targeted therapy options, due to the fact that BRCA genes are involved in DNA repair and may be more sensitive to anticancer agents that work by damaging DNA.
Fertility preservation
Cancer treatments — including chemotherapy, radiation, and surgery — can damage your reproductive organs, making it difficult to become pregnant.
If you want to become pregnant in the future, talk to your doctor before starting treatment. They can discuss your optiofor possibly preserving your fertility.
Possible fertility preservation optioinclude:
- Embryo freezing. This involves freezing a fertilized egg.
- Oocyte freezing. This procedure involves freezing an unfertilized egg.
- Surgery to preserve fertility. In some cases, a surgery that only removes one ovary and keeps the healthy ovary can be done. This is usually only possible in early-stage ovarian cancer.
- Ovarian tissue preservation. This involves removing and freezing ovarian tissue for future use.
- Ovarian suppression. This involves taking hormones to suppress ovarian function temporarily.
Ovarian cancer treatment primarily focuses on surgery to remove the ovaries and uterus, plus chemotherapy. As a result, some women will experience menopause symptoms.
Conclusion
To conclude, A cancer diagnosis is scary, no matter the type. Although if you or a loved one has ovarian cancer, you should not feel sad, frustrated, or hopeless. Your doctor can help you during this trying time.