Introduction
Ovarian cancer is a disease in which malignant cells are found in the ovaries, which are the female reproductive organs containing eggs. The disease has been termed the “silent killer” since ovarian cancer is often silent and can hardly be detected early when its symptoms are barely visible or mistaken for some other conditions. It is essential to know the stages of ovarian cancer and its symptoms, including the treatment that can be available.
Ovarian cancer symptoms
The symptoms of ovarian cancer can be challenging to determine since most of them are nonspecific and may resemble some common medical conditions. Some of the symptoms will last and, in time, become worse; therefore, they require further medical investigation. Most of the commonly observed symptoms for ovarian cancer include:
Abdominal bloating and distension: Persistent bloating or distension in the abdomen is a common symptom that may be early ovarian cancer signs.
Pelvic or abdominal pain: Some patients simply develop lower abdominal and pelvic pain for which they do not have a cause.
Inability to eat or feeling too full: A loss of appetite is another symptom that may be observed, or sometimes, even a feeling of being too full, even after minimal intake of food.
Urination is frequent or the patient feels urgent: Ovarian cancer can affect women, who may feel urgently compelled to urinate as a result of the pressure in their bladder.
Fatigue: A lot of the patients with ovarian cancer present with unexplained tiredness.
Menstrual changes: Some women may have irregular periods or postmenopausal bleeding.
If these symptoms occur for weeks or worsen over time, medical care should be consulted to rule out or make an early diagnosis of ovarian cancer.
Stages of Ovarian Cancer
Ovarian cancer is divided into four stages that can outline severity and the most appropriate course of treatment. The staging of ovarian cancer is:
Stage I: In this first stage, the tumor is confined entirely to one or both ovaries. If it involves one ovary, it is classified as stage IA, and when it affects both ovaries, it becomes stage IB. The stage progresses to IC if the cancer cells are found outside the ovaries or have ruptured.
Stage II: Cancer has invaded other pelvic organs besides the ovaries, including the fallopian tubes or uterus. IIA is referred to when the cancer has involved the uterus or fallopian tubes, and IIB when the spread has reached tissues adjacent to the pelvis.
Stage III: Cancer may have spread from the pelvic region to the abdomen or lymph nodes. Sub-stages (IIIA, IIIB, and IIIC) describe and further elaborate on the progression of the spread. For example, stage IIIA states that microscopic deposits of cancerous tissue may be found in the abdomen. However, stage IIIC shows larger masses of cancer in the abdomen or lymph node involvement.
Stage IV: This is the most advanced stage of ovarian cancer, as stage IV means the cancer is spread to distant parts of the body. Stages IVA and IVB have further divisions; IVA will cover cancer cells found in the fluid around the lungs, while stage IVB covers cancer spread to all parts in the organs other than the abdomen to include the liver.
Treatment
The stage at which the patient is diagnosed with ovarian cancer is very influential in determining the treatment, apart from the general health and preferences of the patient. The main treatments are outlined below:
Surgery: The best accepted form of treatment for ovarian cancer is through surgery. Most of the doctors perform debulking surgery, whereby the tumor is removed entirely or as much as possible. The extent of the surgery may differ; in some cases, only one ovary and fallopian tube may be removed in the early stage, while in more advanced stages, the ovaries, fallopian tubes, the uterus, and other tissues affected are removed.
Chemotherapy: Chemotherapy is usually administered after surgery to eliminate any remaining cancerous cells. The treatment involves drugs that can be orally taken or given intravenously to destroy rapidly cycling cells. It can be delivered as neoadjuvant chemotherapy prior to the actual surgical intervention to shrink the size of the tumor or as adjuvant chemotherapy after surgery to eradicate any remaining cancerous cells.
Targeted Therapy: Targeted therapy is one principal component of the treatment of ovarian cancer. Drugs for ovarian cancers are made in such a way that they recognize and kill specific cancer cells but spare the normal ones. This type of targeted therapy is the PARP inhibitors; they work best for people whose cancer has been caused by a mutation in either the BRCA1 gene or the BRCA2 gene.
Radiation therapy: is not very commonly used in the treatment of ovarian cancer and may be recommended if there are a few scattered foci that persist even after surgery or chemotherapy. This is basically a technique wherein high-energy rays are used to destroy cancerous cells.
Immunotherapy: This is the treatment strategy that develops the body’s natural defense mechanisms in order to fight cancer. Immunotherapy identifies substances that enhance, rebuild, or improve the immune system’s ability to sense and destroy cancerous cells. However, for ovarian cancer, immunotherapy is still experimental and mainly applies in advanced or recurrent cases.
Hormone Therapy: Some cancers of the ovaries are hormone sensitive. Hormonal therapy is a class of drugs that block the estrogen effect, which can make the cancer cells grow more slowly or even not at all.
Early detection and prognosis
The most treatable ovarian cancers are those identified at early stages. However, only about 20 percent of ovarian cancers are caught at an early stage. Treatment for those diagnosed in more advanced states becomes much more complicated and symptom-focused with the intent to extend life. While the treatment has improved the prognosis for many, early detection remains crucial to improving survival rates.
But for women with a family history of ovarian or breast cancer, especially with a known BRCA mutation, early detection may be facilitated by genetic testing. Women at highest risk may be screened with routine pelvic exams, ultrasounds, and blood tests, which can include markers such as CA-125-protein, often elevated in women with ovarian cancer.
Conclusion
Ovarian cancer is the hardest disease to diagnose and treat because of its many latent, nebulous signs and intricate pathogenesis. Understanding the important signs of the disease, the staging process, and the treatments available will give women and their families a greater awareness that they can use in making choices. Vigilance, combined with medical attention should the symptoms persist, can mean earlier diagnosis and a possibly more favorable prognosis. Ongoing studies and advancements in screening techniques and treatments will ensure survival for the victims of ovarian cancer in the following years.
