Symptoms

Early ovarian cancer is usually difficult to detect because it presents subtle and non-specific symptoms and signs, which may be linked with other common disorders. Common signs and symptoms of ovarian cancer might include the following:

• Fatigue
• Persistent bloating or swelling in the abdomen
• Feeling full quickly during meals
• Abnormal postmenopausal vaginal discharge or bleeding
• New urination frequency
• New changes in bowel movements or constipation
• Pelvic, abdomen, or lower back pain or discomfort
• Unexplained weight loss

Causes and Risk Factors

The exact cause of ovarian cancer is unknown. However, there is a 1.3% lifetime risk of ovarian cancer diagnosis.

Several factors that increase the risk of ovarian cancer include:

• Increased age
• Genetic mutations. About 15% of cases are associated with genetic mutations, mainly BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2). Nevertheless, other genetic mutations, like Lynch syndrome, can also contribute to ovarian cancer.
• Family history. Having a family member, including a sister, mother, aunt, or grandmother, who has been diagnosed with ovarian cancer increases one’s risk of developing the condition.
• Obesity
• Endometriosis
• Not being pregnant
• Early menstruation or late menopause

Diagnosis

Currently, there aren’t any official screening tests for diagnosing ovarian cancer. It’s thus important to make an appointment with a gynecologist if you develop any ovarian cancer signs or symptoms. To find out if you have the condition, the following tests can be performed:

• Pelvic exam: Examination of the vagina, the cervix, and assessment of the size and shape of the uterus and ovaries to determine if there are abnormalities. A pelvic exam alone, however, is not enough to rule out ovarian cancer.
• Imaging tests: MRI, ultrasounds, or CT scans of the pelvic region and abdomen provide a closer look at the ovaries and detection of any abnormalities. These also enable the gynecologist to determine if there is a need for additional tests.
• Blood tests: Blood tests are usually ordered if an ovarian mass is detected by imaging tests so as to determine the possibility of cancer. While blood tests are not conclusive, they enable healthcare providers to decide the appropriate steps to take.
• Surgery: In some cases, surgery to take out one or both ovaries is the only way to confirm ovarian cancer diagnosis. After that, a pathologist examines the ovary for cancerous cells.

Treatment Options

Various forms of ovarian cancer exist, and the treatment may involve a combination of options such as surgery, chemotherapy, or hormonal therapy. A gynecologic oncologist will tailor a treatment plan based on the specific cancer type.

Surgery

The surgery is usually determined by the spread and stage of ovarian cancer and may involve one or more of these procedures:

• Salpingo-oophorectomy: One or both ovaries and fallopian tubes are removed
• Hysterectomy: The uterus is removed
• Pelvic and para-aortic lymphadenectomy: Pelvis and abdominal lymph nodes are removed.
• Omentectomy: The omentum, which is the fatty tissue draping over the intestines, is removed
• Cytoreduction (debulking): For cancer that has extended over the abdomen, surgery may be recommended to take out cancer and invaded organs. This is an extensive procedure that may involve removing organs or sections of the organs like the small and large intestines, spleen, liver, bladder, and peritoneal surfaces. Based on the situation, cytoreduction may be performed before or after chemotherapy.

Chemotherapy

Chemotherapy may be recommended to help destroy the cancerous cells or disrupt their development. The drugs can be administered intravenously and some orally and may be used before/after ovarian cancer surgery. Sometimes, chemotherapy is directly administered into the abdomen through an abdominal port (intraperitoneal chemotherapy) or intraoperatively as hyperthermic intraperitoneal chemotherapy (HIPEC) when performing cytoreductive surgery.

Hormone Therapy

Some forms of ovarian cancer tumors can be treated using hormones or hormone-blocking drugs. These medicines work by blocking estrogen production, lowering levels of estrogen, or inhibiting estrogen from facilitating tumor growth.

Targeted Therapy

These medications focus on particular passages in the development cycle of a tumor. The individual molecular testing of the tumor can help identify the agents that are likely to react better.

Immunotherapy

Immunotherapy works by triggering the immune system in the body to destroy the cancerous cells. A gynecologic oncologist may recommend this option based on the features of the tumor.