Types of Ovarian Cancer

Ovarian Cancer: Detailed Overview

Ovarian cancer is a type of cancer that begins in the ovaries — the female reproductive glands that produce eggs and hormones (estrogen and progesterone). It is often called a “silent killer” because symptoms usually appear only in advanced stages, making early diagnosis difficult.

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🧬 Types of Ovarian Cancer

There are three main types, based on where the cancer starts:

1. Epithelial Ovarian Cancer (most common – ~90%):
   • Arises from the outer lining of the ovary.
   • Subtypes include serous, mucinous, endometrioid, and clear cell carcinomas.
2. Germ Cell Tumors:
   • Begin in the egg-producing cells.
   • More common in teenagers and young women.
   • Usually very treatable, even when found late.
3. Stromal Tumors:
   • Begin in the hormone-producing tissues.
   • Often detected earlier due to hormonal symptoms (e.g., irregular bleeding).

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🧪 Causes and Risk Factors

While the exact cause is unknown, several risk factors are associated with ovarian cancer:

Increased Risk Factors:

• Age: Risk increases with age, especially after menopause.
• Family History: Close relatives with ovarian, breast, or colon cancer.
• Genetic Mutations: BRCA1, BRCA2, or Lynch syndrome significantly raise risk.
• Never Giving Birth or infertility
• Endometriosis
• Hormone Replacement Therapy (HRT)
• Obesity

Decreased Risk Factors:

• Oral contraceptives (birth control pills)
• Pregnancy and breastfeeding
• Tubal ligation or hysterectomy

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⚠️ Signs and Symptoms

Symptoms are often vague and develop gradually, making early detection difficult:

• Abdominal bloating or swelling
• Pelvic or abdominal pain
• Early satiety or difficulty eating
• Frequent urination
• Fatigue
• Changes in bowel habits (e.g., constipation)
• Unexplained weight loss
• Menstrual irregularities

Persistent symptoms (more than 2 weeks) should not be ignored.

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🔬 Diagnosis

Diagnosis often involves a combination of tests:

1. Pelvic Examination: Doctor feels for masses or abnormalities.
2. Transvaginal Ultrasound (TVUS): Detects ovarian masses.
3. CA-125 Blood Test: A tumor marker often elevated in ovarian cancer (but not specific).
4. CT Scan or MRI: For detailed imaging and staging.
5. Biopsy or Surgery: The definitive diagnosis is made by examining tissue, often after surgery.

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📊 Staging of Ovarian Cancer

• Stage I: Confined to one or both ovaries.
• Stage II: Spread to pelvic organs (e.g., uterus, fallopian tubes).
• Stage III: Spread to abdominal lining or lymph nodes.
• Stage IV: Spread to distant organs (e.g., lungs, liver).

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💉 Treatment Options

Treatment is usually multimodal, depending on cancer type, stage, and patient’s health.

1. Surgery:
   • Primary treatment for most ovarian cancers.
   • Involves removal of ovaries, fallopian tubes, uterus, and sometimes surrounding tissues and lymph nodes.
   • Goal: Remove as much of the tumor as possible (debulking).
2. Chemotherapy:
   • Typically given after surgery.
   • Drugs like carboplatin and paclitaxel are standard.
   • In some cases, neoadjuvant chemotherapy is given before surgery.
3. Targeted Therapy:
   • Medications like PARP inhibitors (e.g., olaparib) are used in women with BRCA mutations.
   • These therapies attack specific cancer cell weaknesses.
4. Immunotherapy:
   • Still under research but may be used in advanced or resistant cases.
5. Hormonal Therapy:
   • For slower-growing tumors, such as some stromal tumors.

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🔄 Prognosis and Survival

Prognosis depends on the stage at diagnosis, tumor type, and overall health:

• Stage I: ~90% 5-year survival.
• Stage III–IV: Drops to around 25–40%.
• Epithelial ovarian cancer often recurs, requiring ongoing treatment and monitoring.

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🛡️ Prevention and Risk Reduction

1. Genetic Counseling and Testing:
   • Women with family history should consider testing for BRCA1/2 or Lynch syndrome.
2. Prophylactic Surgery:
   • Risk-reducing salpingo-oophorectomy (removal of ovaries and fallopian tubes) in high-risk women.
3. Oral Contraceptives:
   • Long-term use significantly lowers ovarian cancer risk.
4. Regular Checkups:
   • While there’s no standard screening test, regular pelvic exams help monitor ovarian health.

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✅ Conclusion

Ovarian cancer is a serious but often silent disease. Early detection is challenging, but awareness of symptoms, risk factors, and genetic links can lead to timely diagnosis and treatment. Advances in surgery, chemotherapy, and targeted therapy have improved outcomes, especially when detected early.

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