Ovarian cancer occurs when abnormal cells
start uncontrollably replicating in the ovaries.
and/or fallopian tubes. Before digging any deeper,
let's go over some of the basics of what the
female reproductive system.
looks like. Deep within the female pelvis is the uterus,
a pear-shaped muscular organ,
that houses,
the developing fetus or baby. Beside the uterus are two
small,
oval shaped gland,
that produces eggs and hormones such as estrogen and progesterone,
which help regulate the menstrual cycle.
Connecting the uterus to the ovaries are narrow,
tubes, called Fallopian tubes.
These tubes act as a passageway for the egg to
travel,
from ovaries to the uterus.
It is also the location where the egg is normally
fertilized by the sperm.
Now back to ovarian cancer. There are three main areas where
ovarian cancer can originate from. Let's start with epithelial ovarian cancer.
which counts for 90% of all ovarian cancers. This type of cancer develops in the
outer protective layer of the ovaries and/or Fallopian tubes,
called the epithelium. The second type is ovarian germ cell tumours.
These can be malignant,
meaning cancerous, or benign, meaning harmless
These tumours are clumps of abnormal cells that originate in
germ cells,
which are cells that develop into unfertilized eggs with n
the ovaries.
This type of tumour most commonly
effects just one ovary and usually impacts teenage girls or young women
The malignant tumours account for less than 5% of all
ovarian cancers, and roughly 20 to,
25% of all germ cell tumors are benign. The third type is stromal cell ovarian
cancer.
which originates in the stromal cells of the ovary.
Stromal cells make up the supportive network of tissue called the stroma
the hold the ovary together.
It is also here where hormones like,
estrogen and progesterone are produced. Stromal cells
ovarian cancer.
accounts for roughly 1% of all ovarian cancer and
is most prevalent in women over the age of 50.
But about 5% of ovarian stromal tumours are found in young girls
So,
how does this cancer
even develop? Well, the normal progression of ovarian cancer is
usually as follows. Stage one,
is when the cancer starts in one or both of
the ovaries
and stays there.
Stage two is when the cancer spreads to other parts of
the female reproductive system,
such as the Fallopian tubes,
or the uterus. Stage three is when the cancer starts
to travel to organs in the abdomen,
such as stomach, intestine,
liver, etc.
Stage 4 is when the cancer spreads beyond the abdomen into other organ systems. For example,
the respiratory system, where it could affect the lungs.
Why exactly.
should we care about ovarian cancer?
What is the importance?
Well, did you know that
ovarian cancer is the fifth
most common cancer for women
but has the lowest survival rate of cancers affecting women?
In fact,
one in 78,
women will develop ovarian cancer in their lifetime and
1 in 108 will die from it.
While those numbers may seem small, using 2021's female population
of 3.9
billion, that roughly translates to 50 million.
women developing the cancer and 36 million dying from it.
However,
the most shocking and disturbing part is that only 16% of all ovarian cancer patients
are diagnosed early giving them a 5-year survival rate of
49.1%.
The vast majority,
don't get diagnosed until the cancer
enter the third or fourth stage,
But why is that?
Why is ovarian cancer diagnosed
so late,
especially when this leads to poor outcomes.
Well, one aspect that makes ovarian cancer particularly difficult to detect and control
is the lack of specific symptoms that make the cancer apparent in a timely manner. Often only appearing when the
progression of the disease has made it incredibly difficult to treat. One of the main symptoms to look out for
is abdominal bloating,
which encompasses increased abdominal size, as well as increased abdominal and pelvic pain. Another symptom
is inexplicably feeling fatigued or tired
all of the time.
A few others to look out for include having difficulty
eating either because of a decreased appetite or feeling full too quickly, as well as urinary changes such as
increased or more urgent urination.
As one may guess, these symptoms are very generic and nonspecific. They can be caused by completely benign conditions
as well as perhaps cancers of other organs.
Research has shown that many women who
have ovarian cancer complained about symptoms well before they
were diagnosed.
However,
because the symptoms are so nonspecific and usually caused by
something less serious,
arriving at the diagnosis can be very challenging. Often
most of these symptoms are just as likely to occur
in women who do not have ovarian cancer. However, when caused
by ovarian cancer,
these symptoms tend to be persistent,
and a change from normal.
If they occur more often,
and more severely than normal and occur consistently for a few weeks
it is important to notify your phsician so that the problem can
be treated as necessary.
But that's not all that's difficult about identifying ovarian cancer.
Diagnostic testing for ovarian cancer is just as tricky. But why?
But why? It is important to highlight the fact that it is quite difficult to
get a clear diagnosis.
of ovarian cancer as symptoms are often masked and many tests require
further testing.
This is partly because there are no reliable and specific
screening test that can detect cancer with in the early
stages of disease progression.
The only real way to know
if you have ovarian cancer or not is to get
a biopsy –
a procedure where piece of your own ovarian tissue
is taken for examination for cancerous cells.
However,
there are a number of diagnostic tests that can help
a physician decide whether you need a biopsy to
determine if you have ovarian cancer or not.
One of these diagnostic tests is a transvaginal ultrasound,
which uses sound waves, to take
a look at the uterus, fallopian tubes,
and ovaries, by inserting an ultrasound wand in the genital area.
It is able to detect tumors in the ovaries,
but it wouldn't be able to tell you whether the
mass is malignant,
(or cancerous) or benign,
(or harmless) Therefore,
more testing
is often done.
A second diagnostic test that could be done,
is the cancer antigen 125 blood test.
This is done considering women with ovarian cancer have high
levels of CA 125 in their blood.
However,
this is also the case in other common conditions such
as endometriosis and pelvic inflammatory disease.
This makes it hard to identify if ovarian cancer
is the root cause for elevated.
blood levels of CA-125 and physicians need to further test
to cancel out
all other possibilities. The third
diagnostic test is a pelvic exam alongside imaging techniques.
During the pelvic exam,
the Physician examines the pelvic organs and checks for enlarged
ovaries or signs of fluid in the abdomen as these
are signs of ovarian cancer.
During Imaging tests,
,like CT scans,
pictures are taken of the abdomen and pelvis to
help determine whether the mass (cancerous
or harmless) has spread to other tissues and organs.
As you may have noticed,
none of these tests alone provide a hundred percent diagnosis of
ovarian cancer.
This is why often a biopsy is done.
So to recap, ovarian cancer is a silent killer because 1) the symptoms
are delayed and only develop after the disease has reached
an advanced stage and is largely
incurable. 2) The symptoms are often not specific to
ovarian cancer.
It is easy to pass off
the symptoms for benign or more common reasons such
as having menstrual cramping. And 3)
there is a lack of reliable
screening tools to detect ovarian cancer,
Despite pelvic,
exams, transvaginal ultrasound, and CA-125 blood tests
being used in a diagnostic process.
Knowing this, what can you do to be aware of his condition?
Other than monitoring your own symptoms
to see if there's ever a change,
be aware of the various risk factors associated with increased
chances of developing ovarian cancers,
Sometimes ovarian cancer manifest in a family pattern.
Although it is unclear,
whether the pattern is due to shared lifestyle
factors, genetic risks, or even chance. Women with a first
degree relative with the disease have a greater chance of developing
ovarian cancer.
A family history of breast, colorectal,
uterine, or pancreatic cancer also increases the chance for ovarian
cancer. Moreover, mutations in Breast Cancer Gene
1, and Breast Cancer Gene 2
, which increases the risk of breast cancer,
also increase the risk for ovarian cancer.
Another risk factor includes never having been pregnant,
as hormones present during pregnancy have been hypothesized to have
a protective effect.
Now that you know why
exactly ovarian cancer can be so dangerous, and what to
be aware of
and to monitor within yourself,
share this video with your friends and family to help
unmask the silent killer.
If you are a Canadian citizen looking to get more involved,
consider fundraising for Ovarian Cancer Canada,
the only national charity,
that advocates for the health
and well-being of women
living with and at risk of this disease,
through research advocacy and support. By raising your voice on
social media,
donating to
further this important work,
educating others on the disease,
and hosting fundraisers in your community,
you can help further progress against the disease to help.
save lives. For more information,
visit ovariancanada.org