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ovarian cancer - Symptoms, Causes, Diagnosis & treatment

Ovarian cancer is a growth of cells on or inside your ovaries that appear to be the cancer. There are more than 500,000 new cases of ovarian cancer diagnosed each year in the United States. It is the leading cause of death for women between 40 and 64 years old. Early detection can make a world of difference in treatment outcomes. There are many symptoms that may indicate an ovarian cancer diagnosis - from pain, weight gain, bloating or loss of appetite to changes in your menstrual cycle or vaginal bleeding. 

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Symptoms of Ovarian cancer:

- A bloated feeling

- Abdominal or pelvic pain that does not go away or comes back again and again.

- A feeling of pressure in your pelvis

- Changes in bowel habits, such as constipation or diarrhea

- Difficulty eating or feeling full quickly

- Feeling tired for no clear reason, not just from physical activity.

- Heavier than normal or irregular vaginal bleeding, including after sex and between periods.

Ovarian cancer can also be a symptomless disease until it is too late. In fact, 80 percent of women with ovarian cancer have no symptoms until the disease has spread.

When to see a doctor?

If you have any of the symptoms or signs above, or you are at high risk for ovarian cancer (based on genetic risk factors), it is a good idea to see a doctor. Recognizing the early warning signs of ovarian cancer can help save your life.

Causes:

The exact cause of ovarian cancer is unknown. Most ovarian cancers develop in the epithelial cells, which line tubal and ovarian structures. The cells in these tissues grow and divide to form new cells as needed to replace damaged cells, or die when no longer needed. To be able to divide and form new cells, these epithelial cell need several different growth factors that stimulate cell division.

- Some of these growth factors are produced by normal body cells (autocrine), such as estrogen.

- Others are produced by other tissue or organs (paracrine), such as adrenal glands or the placenta.

– Others are produced by tumors (endocrine).

- Most ovarian cancers develop when malignant (cancer) cells form and then start to grow, divide, and spread.

- Some tumors gain the ability to spread from one place in the body to another. This is called metastasis (pronounced "met-ass- TAS -is").

Ovarian cancer can run in families—twelve percent of women over 40 whose mothers had ovarian cancer may get it themselves. While the risk of a first degree relative developing ovarian cancer is higher than average, only two percent of women over 40 who do not have a strong family history will go on to develop the disease.

- Genes carry the information for your body to grow and function. Sometimes, changes in the genes cause problems, such as cancer. Normally, your cells divide only when needed, and repair any damage that occurs in DNA until they die or are replaced. In cancer, the DNA of these cells is damaged and they divide too fast or do not die at the right time. This can lead to a tumor.

Diagnosis :

There is no single test that can diagnose ovarian cancer, but if a doctor suspects that you have it, they will do a biopsy. A biopsy is the only way to be certain of the diagnosis. A doctor can remove a small piece of tissue and look at it under a microscope. If they find cancer cells, they know that you have ovarian cancer. The tissue might also be tested for genetic mutations or proteins that are associated with ovarian cancer.

It may be difficult for a doctor to see cancer cells in the fluid or tissue removed from your ovary. The pieces of tissue from the biopsy can be tested in the lab to try to find cancer cells. Your doctor will look at the results of these tests and make a diagnosis.

Treatment:

Treating ovarian cancer depends on many things, including its stage when diagnosed, as well as your overall health and personal goals.  Many women with early-stage ovarian cancer are cured by surgery (removed). This is the best way to treat any cancer.

You may have surgery to remove your ovaries, fallopian tubes, and uterus if you are of childbearing age (if you want to be able to have children in the future). Because this surgery can be complicated and recovery is slow, it is done with extra care.

If you have early-stage ovarian cancer, treatment will also include some combination of chemotherapy and radiation therapy. These treatments use powerful drugs or high-energy x rays or other types of radiation to kill cancer cells.

This article is not meant for self-diagnosis and self-treatment - please consult your doctor before acting on anything written here.

Ovarian Cancer = Uncommon Disease?

Some people believe that ovarian cancer is an uncommon disease.  A recent study done in the US showed that the number of newly diagnosed cases between 2002 and 2011 nearly doubled from about 40,000 per year to about 80,000 every year.

However, this was an unusual change and not necessarily a pattern of increasing incidence or increasing mortality rates.  Most experts believe that this might be due to advances in healthcare, such as the increased use of CT scans and less invasive surgery for detecting cancer earlier.

About a third of all women who have the disease are at high risk because they have one or more defective genes known to predispose them to developing cancer. The risk of ovarian cancer is even higher for women who carry both defective genes.

Most cases of ovarian cancer are found in women over the age of 60.  The disease most commonly occurs in postmenopausal women.  This is because when the ovaries stop making estrogen, they no longer make enough of other hormones that suppress the growth of cancer cells.

If you get a high-risk genetic test and it finds that you have one or more faulty genes and/or genetic mutations, you may want to talk to your doctor about adding other drugs to your treatment or having alternative treatments like surgery.

However, if you are positive for the BRCA1 or BRCA2 genes, the key thing to know is that the risk of getting ovarian cancer is still low.  The lifetime risk of getting ovarian cancer among women with the BRCA1 gene mutation is about 40 percent; for women with the BRCA2 gene mutation, it's about 20 percent.

So, not knowing your cancer risk can lead to more anxiety—not a good thing when you have a chronic disease.

prevention:

If you get the ball rolling for testing, you can take some actions to help reduce your risk of breast and ovarian cancer.

- The most important is to catch the disease early on when it is easier to cure.

- Avoid alcohol—it increases your risk of developing cancer, and drinking also makes it harder for your ovaries to make hormones.

- Have your breasts and ovaries checked regularly by a medical professional who is trained in the diagnosis of these conditions.  Regular self-checks are not enough information.

- If you have strong family history of ovarian or breast cancer, check with a genetic counselor before embarking on testing (see link below).

- Start having regular mammograms when you turn 40, and continue them until 75 years of age.

- Research shows that eating more fresh fruits and vegetables may lower the risk of ovarian cancer.

"To know you have an opportunity to do something very different and to do it, there's no better reward."

-- Katie Couric

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