Ovarian cancer -- summary

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Ovarian Cancer
Located deep in the pelvis, one at each side of the uterus, the ovaries are a pair of organs in the female reproductive system. Each ovary is about the size and shape of an almond; they produce eggs and female hormones, estrogen and There are several types of ovarian cancers: ‘epithelial’ cancer, which develops from the tissues covering the ovaries, ‘germ’ cell cancer, affecting mostly teenage and young women, developing from reproductive cells. It usually affects only one ovary. There are other types of tumors, affecting tissues that provide support to these organs, and also, although rare, from vascular structures. Women who have a family history of ovarian cancer are at an increased risk of developing the disease, particularly if close relatives suffered from it. The risk is higher if one — or more, first-degree relatives are affected. Ovarian cancer affects approximately 25,000 women a year in the US; ten percent of patients are younger than thirty-five, while the peak age is between fifty Most diagnoses are made on Caucasian women — a rate fifty percent higher than all other ethnic groups. It is also estimated that approximately five to ten percent of women would be diagnosed with this disease in their lifetime. Most ovarian cancers in adult women — eighty-five percent, are ‘epithelial’, while the ‘germ cell’ type is found mostly on young women. Some ovarian cancers are caused by inherited gene mutations: genes carry the hereditary information that is received from parents. Hereditary ovarian cancer makes up approximately five to ten percent of all cases of ovarian cancer. Three hereditary patterns have been identified: ovarian cancer alone, ovarian and breast cancers, and ovarian and colon cancers. Tests that can detect altered genes have been developed; they are sometimes done for members of families with a high risk of cancer. Women with a strong family history of ovarian cancer may consider surgery to prevent it: this procedure is known as ‘prophylactic oophorectomy’, meaning the removal of healthy ovaries Predisposing factors for ovarian cancer are family history, no pregnancies, infertility, age, personal history of breast cancer, changes on the BRCA-1 and BRCA-2 genes, colon cancer in the family and a diet with high fat content. Ovarian cancer is very difficult to detect on its early stages because usually there are no symptoms. Some women may have symptoms such as vague gastrointestinal discomfort — nausea, vomiting, pressure in the pelvis, pain, swelling of the abdomen, vaginal or rectal bleeding, urinary frequency, bleeding, weight loss. Most of the time, there are no symptoms or they are very mild. By the time symptoms do appear, the cancer is usually advanced. When found in its early stages, ovarian epithelial cancer can be cured in many patients. The following tests and procedures are used to rule out the presence of tumors: Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries and
rectum. A Pap test or Pap smear of the cervix is usually done. Ultrasound: A procedure in which high-energy sound waves are bounced off
internal tissues or organs producing echoes; they form a picture of body tissues Barium enema or ‘lower GI series’: x-rays studies of the lower gastrointestinal
tract. A liquid that contains barium is placed into the rectum; it coats the lower gastrointestinal tract and x-rays are taken. IVP or ‘Intravenous pyelogram’: a contrast dye is injected into a vein and a
series of x-rays of the kidneys, ureters, and bladder are taken in order to find out if cancer has spread to these organs, producing blockages. CT scans: is a procedure that makes a series of detailed pictures of areas inside
the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called ‘computed,’ ‘computerized’ and ‘computerized axial’ tomography. MRI or Magnetic Resonance Imaging: as with CT scans, but more detailed in
most cases; it also uses computers to produce clear images of internal organs.
Biopsies: are the removal of cells or tissues so they can be viewed under a
microscope to check for signs of cancer. The tissue is removed by using a procedure called a ‘laparotomy,’ which is a surgical incision made in the wall of the abdomen or by ‘laparoscopy,’ reaching into the pelvis with specialized instruments through smaller incisions and removing small pieces from the ovaries and other organs. Treatment options and prognosis would depend on the patient’s age, general health, type and size of the tumor and the stage of the cancer. After ovarian epithelial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body. Stages are classified from I to IV. The information gathered from the staging process determines if the tumor is contained in the ovaries or has spread to other organs. It is important to know the stage in order to plan the best treatment. An operation called a ‘laparotomy’ is usually done to determine the precise stage of the disease. A surgeon opens the abdomen and carefully look at all the organs to see if they contain cancer. Biopsies are then performed and also removal of tissues and organs if they appear to be affected by cancer. In stage I, cancer is found in one or both of the ovaries. Stage I is divided into A, B and C, depending on the extent of the involvement of both ovaries. In stage II, one or both ovaries are affected, plus it is found in other areas of the pelvis; it is also classified as A, B or C, when other organs are involved. Stage III is when malignant cells are found in other abdominal organs, including lymphatic nodes, and the liver’s surface. This stage is also classified as A, B and C according to the involvement of other organs and also the size of the tumors. Stage IV is when metastases are found beyond the abdominal organs. There are different types of treatment for patients with ovarian epithelial cancer: they are surgery, radiation therapy and chemotherapy. Other treatments such as biologic therapy and high-dose chemotherapy with stem cell transplantation, which Most patients have surgery to remove as much of the tumor as possible. Different types of surgery may include the removal of the uterus, ovaries and Fallopian tubes, depending on the extent of the tumor. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation towards the cancer and internal radiation therapy [Brachytherapy], which uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Some women receive a treatment called ‘intraperitoneal’ radiation therapy, in which a radioactive liquid is put directly in the abdomen through a catheter. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body: ‘systemic’ chemotherapy. When chemotherapy is placed directly into the spinal column, a body cavity such as the abdomen, or an organ, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated. Most commonly used medications are Cytoxan, Melphalan, Cisplatinum, Paclitaxel and Carboplatinum. There are several other medications used when patients do not respond to this ‘first line’ of therapy and Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called ‘biotherapy’ or ‘immunotherapy.’ High-dose chemotherapy with stem cell transplantation is a method of giving very high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells are removed from the blood or bone marrow of the patient or a donor and are frozen for storage. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. Over a short time, these reinfused stem cells grow into the body’s Alternative treatments - Many alternative therapies have been used over the years to treat different types of cancers. At present, only a few disciplines have made a modest contribution towards a reasonable outcome: acupuncture has been helpful for certain patients for control of nausea and vomiting while receiving chemotherapy. High vitamin doses may be provided along a low-fat diet, but they may contribute to certain negative interactions with certain medications. Biofeedback is occasionally helpful by reducing stress and providing a measure of Low malignant potential tumors are considered pre-cancerous and seldom spread beyond the ovaries. They are found while pathology studies are done on biopsies. Treatments for this type of tumors are similar to the ones described above for both epithelial and germ cells tumors… [continued] Health & Life®
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