A women's reproductive system has two ovaries, one on either side of the uterus. The ovaries, each about the size of an almond, produce eggs (ova) as well as the female sex hormones estrogen and progesterone. Eggs are fertilized by sperm from the male to produce offspring (children).
Ovarian cancer starts in the cells of the ovary or ovaries. The ovaries are two small, oval-shaped organs that lie deep in the pelvis on either side of the uterus (womb), close to the end of the Fallopian tubes. The ovaries are part of the female reproductive system.
Each month, in women of childbearing age, one of the ovaries releases an egg (ovum). This is called ovulation. The egg travels down the Fallopian tube to the uterus, where it may be fertilized by a sperm and develop into a fetus. If the egg is not fertilized, it is shed as part of your monthly period.
The ovaries also produce the female hormones estrogen and progesterone. Estrogen and progesterone help control reproduction and sexual development. As a woman ages and reaches menopause, the ovaries make less of these hormones and periods gradually stop.
There are three main types of ovarian cancer. For each type, the cancer starts in a different type of cell found in the ovaries.
- Epithelial cell cancer starts in the cells that cover the outer surface of the ovary.
- Germ cell tumours start in the egg cells within the ovary and generally occur in younger women. Germ cell cancer can even develop in children.
- Stromal tumours start in the connective tissue cells that hold the ovary together.
SIGNS AND SYMPTOMS
Ovarian cancer in its early stages often does not cause any symptoms at all. When symptoms do start, they are often vague and easily mistaken for more common illnesses.
Often these symptoms can be cause by other less serious health problems, not cancer. Testing is needed to make a diagnosis.
Ovarian cancer, in its early stages, may cause:
- abdominal discomfort, pressure or pain
- abdominal swelling
- change in bowel habits
- feeling full after a light meal
- indigestion
- gas
- upset stomach
- feeling that the bowel has not completely emptied
- nausea
- fatigue
- pain in lower back or leg
- more frequent or urgent urination
- abnormal vaginal bleeding
- menstrual disorders
- pain during intercourse
If these symptoms increase in intensity or severity or last longer than 2 to 3 weeks, you should contact your doctor.
Treatment of ovarian cancer
Treatment depends on the type of ovarian cancer and how far it has spread.Surgery
Almost all women with ovarian cancer will need surgery for the best chance of successful treatment. The extent of surgery depends on the type of cancer and how far it has spread. If it hasn't spread beyond the ovary, it may be possible to remove only the single affected ovary and fallopian tube.
If the cancer has already spread beyond the ovary, both ovaries and your womb, together with nearby lymph nodes and any surrounding tissues that the cancer may have spread to, need to be removed. This is called a total hysterectomy and oophrectomy.
Other types of surgery for more advanced ovarian cancer are used to remove, or 'debulk' as much of the tumour as possible.
Chemotherapy
Chemotherapy uses medicines to destroy cancer cells and can cause side-effects, including tiredness and feeling sick or vomiting. Your chemotherapy treatment will vary depending on the type of ovarian cancer you have. Chemotherapy is usually used to shrink ovarian tumours. However, if you have the rarer type of germ cell ovarian cancer, chemotherapy can sometimes cure the disease.
After surgery, most women with ovarian cancer will be offered chemotherapy to destroy any remaining cancer cells that were not removed by surgery or if there is a risk the cancer may return. Women with very early stage ovarian cancer don't usually need chemotherapy.
If ovarian cancer comes back (relapses), you may be treated with the same chemotherapy medicine or an alternative, depending on the timing of the relapse and whether the cancer has developed resistance to previous chemotherapy medicines.
Your doctor may give you information on clinical trials that are being run to test new treatments for ovarian cancer.
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