Ovary is a female reproductive organ which produces ova (egg) and secretes female hormones-estrogen and progesterone. Ovarian cancer is one of the most common type of cancer in women. Every year around 67000 women in India die due to ovarian cancer. Factors such as obesity, smoking, fertility drugs and use of intrauterine devices increase the likelihood of ovarian cancers.
Ovarian cancer is usually asymptomatic in the initial stages. As the cancer progresses, women may experience symptoms such as
- Vaginal bleeding
- Abnormal periods
- Weight gain or loss
- Abdominal and pelvic pain
- Frequent or urgent urination
These symptoms are seen in other non-cancerous tumors of the ovaries also but in ovarian cancer the symptoms are worsened over a period of time. If these symptoms are noticed for more than 12 times a month, it is recommended to consult a physician.
Diagnosis of Ovarian Cancer:
Early detection and treatment of ovarian cancer can increase the survival rate in 94% of the patients by almost 5 years.
Early Detection/ Screening Tests
Screening tests helps in detecting cancer even before the symptoms of cancer start appearing. Screening tests for ovarian cancer include-
- Tumor marker test: CA125 is a tumor marker for ovarian cancer. A tumor marker is a chemical produced by both normal cells and cancerous cells which is present in body fluids. Its blood levels are raised in ovarian cancer. However, we cannot confirm the presence of ovarian cancer based on CA125 levels alone as other conditions such as endometriosis and uterine fibroids can also cause elevated levels of CA125. Other markers such as serum alpha-fetoprotein, neuron-specific enolase, and lactate dehydrogenase indicate ovarian cancer in young girls and adolescents.
- Ultrasound: A transvaginal or transabdominal ultrasound is used to obtain images of the pelvic structures such as the uterus, fallopian tubes and the ovaries. This can detect the presence of abnormal growths in the ovaries. However, ultrasound is not useful to indicate whether it is ovarian cancer or a harmless cyst.
Diagnostic tests for cancer
The various diagnosis tests for ovarian cancer include imaging tests and biopsy:
- Pelvic Ultrasound: It is the first test done if ovarian cancer is suspected. Pelvic ultrasound helps in detecting lumps in the ovaries.
- CT scan: In this type of scan, x-rays from different angles are taken to obtain a detailed cross-sectional image of the internal structures. CT can detect large tumors can be and also the spread of cancer to the bladder, kidneys or liver.
- Positron emission tomography (PET) scan: Cancer cells uses glucose at higher rate than normal tissue. In this technique, a radioactive sugar is administered to the patient and as cancer cells use more sugar radioactive substance is concentrated in tumor. A scanner can identify the tumor with high radioactive deposits. It is used to find small ovarian cancers and to find when cancer has spread.
- Laparoscopy: A laparoscope consist of a tube with a camera and high intensity light at the front. It is inserted through a small incision in the abdomen and the images of the pelvic and abdominal structures are obtained. This technique helps in assessing the stage of cancer, and planning management of the cancer.
Once the presence of tumor is confirmed based on the results of the imaging tests, biopsy is done to confirm whether the tumor is cancerous and to find out other characteristics of the tumor cells.
Treatment of Ovarian Cancer
Ovarian cancers can be treated by combining two or more of the following:
- Surgery: Surgery is done to resect the tumor from the ovaries and other tumors which are developing after the cancer has spread.
- Chemotherapy: Chemotherapy involves use of drugs to control growth of cancer cells, kill cancer cells or stop cancer cells from spreading.
- Radiation therapy: This therapy involves killing of cancer cells with the use of high energy radiation.
- Hormone therapy: Hormone therapy involves using hormones or hormone blocking drugs. It acts by reducing the amount of estrogen in body as high estrogen favors tumor growth.
Prevention for Ovarian Cancer
The following steps can be taken to prevent ovarian cancer
- Decreased intake of oral contraceptives can reduce the risk of developing cancer. It reduces the risk in women with family history of ovarian cancer (BRCA1and BRCA2 mutations)
- Tubal ligation and hysterectomy reduces the risk of ovarian cancer, but it should be done only for a serious issue. It is unclear if tubal ligation reduces the risk in patients with family history of ovarian cancer.
- Foods such as adding fish, red onions, ginger and mushrooms have anticancer properties.
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- Jindal D et al. Epidemiology of epithelial ovarian cancer: a tertiary hospital based study in Goa, India. Int J Reprod Contracept Obstret Gynecol. 2017 Jun;6(6):2541-2546
- Amita Maheshwari, Neha Kumar, and Umesh Mahantshetty. Gynecological cancers: A summary of published Indian data. South Asian J Cancer. 2016 Jul-Sep; 5(3): 112–120.
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- Ovarian Cancer. https://medlineplus.gov/ovariancancer.html. Accessed on 21-Oct-2017.
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- Tests to diagnose. http://www.cancerresearchuk.org/about-cancer/ovarian-cancer/getting-diagnosed/tests-diagnose. Accessed on 21-Oct-2017