Ovarian Cancer

Ovarian Cancer

The ovaries, situated on each side of the uterus within the pelvis, are essential female reproductive organs responsible for egg production and hormone secretion. Ovarian epithelial cancer, the most prevalent type of ovarian cancer, occurs when malignant cells develop in the tissue covering the ovary.

According to the National Cancer Registry, ovarian cancer ranks as the fourth most common cancer among women in Peninsular Singapore, constituting five percent of all female cancer cases.

Risk Factors

Several factors may heighten the likelihood of ovarian cancer development. Women with a family history of the disease, particularly first-degree relatives like mothers or sisters, face increased risk. Advanced age, a history of breast or colon cancer, nulliparity, and older age are other contributing factors. Notably, the use of oral contraceptives has been associated with reduced ovarian cancer risk. However, having one or more risk factors doesn't guarantee ovarian cancer development but may elevate risks.

Early Detection:

Early detection significantly enhances treatment outcomes, yet ovarian cancer is challenging to diagnose promptly. Symptoms are often absent or nonspecific until the disease reaches an advanced stage. Research focuses on improving early detection methods, including transvaginal ultrasound and CA-125 blood level measurements.

Symptoms

Common symptoms encompass abdominal discomfort, bloating, indigestion, urinary changes, unexplained weight changes, and abnormal vaginal bleeding. Given the nonspecific nature of these symptoms, consultation with a physician is imperative.

Diagnosis

Diagnostic procedures include pelvic examinations to detect palpable pelvic masses, ultrasound scans to differentiate between cysts and tumors, and CA-125 assays to measure tumor marker levels. Additional tests, such as CT scans, barium enemas, and intravenous urograms, may be conducted for comprehensive evaluation.

Stages of Ovarian Cancer

Staging via laparotomy reveals the disease's extent:

- Stage I: Cancer is confined to one or both ovaries.
- Stage II: Cancer involves the ovaries and adjacent pelvic areas.
- Stage III: Cancer spreads beyond the ovaries to abdominal regions.
- Stage IV: Cancer metastasizes to distant organs, including the liver.

Treatment Options

Standard treatments include

1. Surgery: The primary approach involves hysterectomy with bilateral salpingo-oophorectomy to remove ovaries, fallopian tubes, uterus, and cervix. Lymph node and omentum removal may also be performed, along with tumor debulking if cancer has spread.

2. Chemotherapy: Drugs are administered to destroy remaining cancer cells post-surgery, control tumor growth, or alleviate symptoms.

3. Radiation Therapy: High-energy radiation targets cancer cells, although its use is less common now.

Experimental treatments under clinical trials include targeted therapies and immunotherapy.

Patients typically undergo a combination of surgery and chemotherapy, with favorable responses observed in advanced-stage patients. Modern chemotherapy regimens offer improved quality of life, with minimal side effects and outpatient treatment options.

Multidisciplinary cancer care involving a team of specialists is crucial for effective ovarian cancer management.