Ovarian cancer
Definition
Ovarian cancer is a malignant tumor, i.e. a group of your own cells who lost ability to repair themself or to die, and will then grow uncontrollably, invading nearby parts of the body.
Ovarian cancer is the 7th cause of women cancers. In France, it affects 4.430 women every year, predominantly women around 65.
Major risk factors are:
- Having a family history of ovarian cancer (genetic inheritance)
- Early 1st menses
- Late menopause
- Age
Neither oral control pills (oral contraceptive), nor childbearing, nor breastfeeding can be related to a lower risk to develop ovarian cancer.
Development
Ovarian cancer will begin with a small amount of abnormal cells, growing in the tissue covering the ovaries. It can spread easily within the abdominal cavity, leading quickly to metastases on other organs far away from the original point (such as liver or lung). Malignant cells can invade pelvic nodes and major blood vessels (aorta, vena cava).
Ovarian cancer classification:
Stage I : Tumor limited to one or both ovaries.
Stage II : Tumor extended to nearby organs (uterus, fallopian tubes, bladder, rectum).
Stage III : Peritoneal lining metastases.
Stage IV : Distant metastases to the liver or anywhere outside peritoneal cavity.
Diagnosis
Ovarian cancer often starts silently, not showing symptoms until its later stage. Fatigue (feeling of tiredness or exhaustion), trouble eating and important weight changes, frequent bloating (with abnormal increase of abdominal perimeter) are most common ovarian cancer symptoms.
Ovarian cancer diagnosis is mainly done unexpected, either during a surgery for another topic, or further to imagery exam (ultrasound, scan, MRI), finding ovarian cysts associated to abnormal intra-abdominal fluids.
Certified diagnosis will be made during exploratory surgery.
Treatment
First surgery will be performed in order to certify diagnosis (usually by laparoscopy) and to treat in the meantime (mainly by laparotomy).
In case of high suspicion of ovarian cancer, your doctor will let you know that analysis will be realized during the surgery, in order to have a certified diagnosis.
If the analyzed cells confirmed an ovarian cancer, the surgeon will have to remove all damaged tissue and organs, that is to say at least uterus, cervix, ovaries, fallopian tubes, nodes around the uterus and all along the large vessels, as well as appendix and epiploon (layer on the bowels).
This surgery can be long, may require help of other specialized surgeons (digestive, urologist, vascular) and lead to heavy postoperative outcomes (advance life support emergency, long stay at the hospital).
A portacath will be inserted to facilitate any further chemotherapy.
A multidisciplinary staff will concert in order to find the most appropriate treatment, which usually includes chemotherapy.
Medical control
Meeting doctors involved in your treatment is required every 4 months during 2 years, then every 6 months during 3 years, and finally every year (with blood exam).
Ovarian cancer usually has a very poor prognosis, because it lacks clear early detection.
Last update: 10/2/2013
