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OVARIAN CANCER

Ovarian cancer is the seventh most commonly diagnosed cancer worldwide with India having the second highest occurrence of ovarian cancer globally.

Ovarian cancer is the seventh most commonly diagnosed cancer worldwide with India having the second highest occurrence of ovarian cancer globally. As per globocan 2018 by 2035 there will be a worldwide increase of 55% in incidence to 371,000, and an increase in deaths of 67% to 254,00013.

Listen to the warning signs of ovarian cancer

Always pay close attention to your body and visit your doctor if you notice any of the following:
• Vaginal bleeding (particularly if you are post-menopausal), or discharge from your vagina that is not normal for you
• Pain or pressure in the pelvic area
• Abdominal or back pain
• Bloating
• Feeling full too quickly, or difficulty eating
• More frequent / urgent need to urinate

Types of ovarian cancer

The type of ovarian cancer you have is based on the type of cell where it began. Ovarian cancer types include:

Epithelial tumoursStromal tumoursGerm cell tumours
Originates in the thin layer of tissue that covers the outside of the ovariesOriginates in the ovarian tissue that contains hormone-producing cellsOriginates in the egg-producing cells
90% of ovarian cancers are epithelial tumours7% of ovarian tumours are stromalThey are rare and tend to occur in younger women
Subtypes: Serous (52%), endometrioid (10%), mucinous (6%), and Clear cell (6%)Usually diagnosed at an earlier stage than other ovarian tumours
Grade 2Cancer cells appear slightly abnormalMay grow faster than normal cells

‘’Early detection makes a marked difference in how you can survive cancer and get on with living a healthy, full and long life.’’

What are your chances of getting ovarian cancer?

Unfortunately, researchers still don’t know the exact cause of this disease. However, there are factors that may increase or decrease your risk of getting ovarian cancer.

Factors that may increase riskFactors that may decrease risk
Increasing age (50 years and older)Oral contraceptives (> 10 years of use reduces risk by 50%)15
Family health history of breast, ovarian, colon, or endometrial cancer4Breastfeeding (20% reduction for each year)15
History of breast cancer4Parity (Giving birth; 25% reduction for first birth, 20% for subsequent births)15
Faulty version of a gene called BRCA1 (lifetime risk of up to 40%) or BRCA2 (lifetime risk of 11% to 17%)Salpingo-oophorectomy (surgery to remove the ovaries and fallopian tubes; more than 90% reduction)15
Endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body)15Tubal ligation (having your tubes tied to prevent pregnancy; 20% to 50% reduction)15
Lynch Syndrome (an inherited disorder)4
Never had children & Infertility

‘’A woman’s strongest defence against this disease is merely to ‘listen’ to her body and be attuned to changes’’

Know your treatment options

Your treatment options depend on how far the cancer has spread, your general health and whether you’re still able to have children. Curing the cancer is the primary aim of any treatment. However, if the cancer is too advanced to be cured, the purpose is to relieve symptoms and control the cancer for as long as possible. Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy.

Surgery is the first choice of treatment for ovarian cancer. The aim is to remove all of the cancerous growth or as much as possible. It usually involves removal of both ovaries, fallopian tubes, womb, a layer of fatty tissue in the tummy.

Chemotherapy is where medication is used to kill or shrink the cancer.

Chemotherapy may be used:
• Post-surgery to kill any remaining cancer cells
• Prior to the surgery to shrink the cancer
• In case of recurrence after initial treatment

Chemotherapy for ovarian cancer usually involves giving a combination of two different types drug. Usually, the combination includes a platinum compound (usually cisplatin or carboplatin), and a taxane, (such as paclitaxel or docetaxel).,

Some of the chemotherapy drugs that may be helpful in treating ovarian cancer include:

DrugMechanism of Action
CisplatinKills the cancer cells by binding to DNA and interfering with its repair mechanism
DocetaxelInhibit cell division by binding to proteins needed for cell division
EtoposideInhibits DNA synthesis by forming a complex with an enzyme (topoisomerase II) and DNA
GemcitabineDisrupt DNA replication; some replace natural components of DNA, essentially tricking the cell so that it cannot perform the functions it needs to live and replicate
Liposomal doxorubicinPrevent cell division by binding to DNA or inhibiting RNA
TopotecanInhibit an enzyme (topoisomerase I) needed for cell division

Radiotherapy uses carefully directed beams of radiation to kill cancer cells. Although not commonly used to treat ovarian cancer, it may be used:

• Post-surgery for early ovarian cancer, to kill any cancer cells left behind
• To shrink tumours and reduce symptoms if ovarian cancer has spread and can’t be cured

Targeted cancer therapy drugs are designed to stop the spread of cancer by identifying and blocking the genetic changes responsible for the cancer’s growth and progression. Many clinical trials are testing new targeted therapies. Examples of a few targeted therapies are:

• Bevacizumab: Stops cancer from developing new blood vessels
• PARP inhibitors (olaparib and niraparib): Inhibit a protein called PARP from helping damaged cells repair themselves

Living life with ovarian cancer

Talk to someone: Discuss your feelings with a friend/family member, or you could also join a formal support group.

Let people help you: Let people around you know what would be most helpful for you.

Set reasonable goals: Setting goals may give you a sense of purpose. But be reasonable while setting them.

Take out time for yourself: Eat well, relax and get enough rest to battle the stress and exhaustion of cancer.

Suggested Links :
• https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html
• https://www.medicinenet.com/ovarian_cancer/article.htm

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