Ovarian Cancer: Management and Prevention

Diagnosis

For effective treatment of ovarian cancer, it is required for women get diagnosed in its early stages. In diagnosing ovarian cancer, it is important for medical doctors to note the medical history of the patient involved; this is because there are presently no effective screening test until a physical test has been done if there are suspicions of ovarian cancer in the body.

However, due to the fact that the ovaries are situated deep within the abdominal cavity, the presence of tumor being noticed is quite slim, that is why it is important for an individual to report any unusual or persistent pain or symptoms to a medical doctor. Thereafter, the doctor can recommend various screening test (most important the pelvic examination) if he/she suspects ovarian cancer. These tests will help to show if there are any form of abnormalities present in the ovary, and they could be followed up with a biopsy.

Pelvic Examination

This is the checking for any form of lumps by feeling the abdomen. Here, the doctor will place two fingers inside the vagina while he/she presses the abdomen with the other hand. Vaginal and rectal examination can also be done by the doctor so as to feel the tissues surrounding the uterus to check if the cancer has not grown there.

Blood Tests (CA 125 Tests)

Getting the blood tested helps to determine the overall health condition of a person, that is why some medical doctors prescribes that some patient get it done. For ovarian cancer, the blood is usually tested for tumor makers that outline the presence of ovarian cancer; and this blood test is known as the CA-125 test. The CA-125 test help to check for proteins produced by cancer cells, and it tends to be higher in some women with ovarian cancer. However, it can rise due to other reasons other than cancer, including ovulation, menstruation, liver or kidney disease etc.

The CA-125 test can’t be used in women that do not show signs of ovarian cancer, and they help to give clues to medical doctors on the diagnosis and prognosis of ovarian cancer.

Imaging Test

So as to enable medical doctors or oncologist determine the extent or stage of the ovarian cancer, there can be recommendation for imaging tests to be carried out. X-rays can also be used to check the lungs for cancer that might have spread there. Imaging tests such as pelvic ultrasound, CT scan, PET scan are the commonly used ones.

• Pelvic Ultrasound: This is the use of echoes from sound waves to create a picture of the ovaries and uterus on the computer system. And they can be done in two ways: abdominal ultrasound and transvaginal ultrasound. The Abdominal ultrasound is done with a transducer (a small handheld device) that is moved across the abdominal area. But in Transvaginal ultrasound, the transducer is inserted into the vagina so as to have a clearer picture of the ovaries and uterus.
• Computerized Tomography (CT) Scan: This is an x-ray test that gives a detailed picture of the inside of the body. It is usually used to check if the cancer might have spread to other organs. It can’t be used to detect all ovarian cancer or small tumors, but can see larger tumors, showing it growth.
• Positron Emission Tomography (PET) Scan: This is used to show the various abnormal tissues in the body, being more accurate than the CT scan. Here, radioactive glucose (sugar) are given to the patient so as to aid the look for cancer presence. A special camera is used to create the pictures of areas of radioactivity in the body, and results gotten are often used to help in recommending the best treatment option available along with its progress.

Biopsy

This is the best method for diagnosing and determining the presence and growth of cancer. It is medical procedure where a small tissue sample is taken from the ovaries so as to check for cancer cells. Biopsy is usually done with the guidance of an ultrasound or CT scan. The sample gotten is analyzed under a microscope.

Treatment

Treatment for ovarian cancer depends on so many variables: the type of cancer a patient have, the stage of the cancer, general health conditions and fitness, future desire to have children and the doctor’s recommendation. This would help to know which treatment plan is best suited.

Treatment Options

These are the various treatment options available for ovarian cancer:

Surgery

This is the main option required for ovarian cancer. It is the total removal of the tumour; and its operations include:

• Surgery to Remove One Ovary: For ovarian cancer at its early stages that hasn’t spread beyond one ovary, surgery may involve removing the affected ovary and its fallopian tube. This would help to preserve future ability to have children.
• Surgery to Remove Both Ovaries: The moment ovarian cancer has spread to both ovaries; it is advisable to remove both ovaries and fallopian tubes. This procedure keeps the uterus intact so that there can be a possibility of getting pregnant.
• Surgery to Remove Both Ovaries and Uterus: When the cancer becomes more aggressive and the ability to have children is threatened; the ovaries, fallopian tubes, uterus, nearby lymph nodes and some abdominal tissue (omentum) are removed.
• Surgery for Advanced Cancer: Once ovarian cancer is advanced, the doctor may recommend chemotherapy followed by surgery to remove as much of the cancer as possible.

Chemotherapy

This is the drug treatment of ovarian cancer using chemicals known as anti – cancer (cytotoxic) to kill fast – growing cancer cells in the body. It is used to destroy cancer cells without causing damages to other normal and healthy cells. It can be used before or after surgery.

Targeted Therapy

This is using medications to target certain abnormalities present within the ovary. It is usually reserved for treating ovarian cancer that returns after an initial treatment has been resisted (especially after chemotherapy). The targeted therapy drugs get inside the cancer cells and block some particular proteins (enzymes) that help the cancer to grow.

Radiation Therapy

This is also known as radiotherapy; it uses x-rays to damage cancer cells. The radiation is targeted at cancer sites in your body, with the aim of reducing the cancer's growth and improving symptoms. For ovarian cancer, radiation therapy may be used to treat the pelvis or other sites of cancer that have spread further away. It may be used after chemotherapy or on its own as a palliative treatment.

Palliative Treatment

This is otherwise known as supportive treatment plan. It is usually used along with other form of treatment (e.g. chemotherapy and radiation therapy). It is a specialized medical care that focuses on helping patient with ovarian cancer gets reliefs from its symptoms and pain.

Treatment Plan by Type of Ovarian Cancer

• Epithelial: For this type of cancer, surgery is the main treatment for all its stages. This is to done so as to remove all form of cancer cells available as soon as it is detected. For its stage one, sometimes chemotherapy is usually accompanied after surgery, while for stage two – both chemotherapy and surgery are combined, although some new targeted therapy drugs are being offered to women with the BRCA mutation.
• Germ Cell: This is treated with surgery or/and chemotherapy.
• Stromal Cell: This is usually treated with surgery, and then followed by targeted therapy or chemotherapy.
• Borderline Tumour: Surgery is only needed in this type of ovarian cancer.

Prevention

Ovarian cancer rarely shows any signs or symptoms at its early stages except it has progressed into an advanced stage. Although there is no proven way to prevent the risk of developing ovarian cancer, yet there are several ways in which one can lower its risk. And these ways include:

• Birth Control Pills: When women take birth control pills (oral contraceptives pills), they have a chance of lowering their risk of having ovarian cancer.
• Pregnancy and Breastfeeding: Having a full term pregnancy especially before the age of 26 years can help reduce the risk of ovarian cancer. Breastfeeding also help to lower the risk of developing ovarian cancer.
• Surgical Procedures: Having surgical procedures such as tubal ligation and hysterectomy can help to lower the risk of developing ovarian cancer, but it is more advisable for a woman who tends not to have children.