Ovariantumours are found in women of all ages but only 25% of these are malignant(cancerous). In South Africa the incidence is only two in every 100,000 womenbut it is more common in developed countries.

Cancers ofthe ovary may develop from any layer and can also be as a result of thespreading of a different cancer, such as intestinal cancer. Cancers from theouter layer (epithelial cancers) are most common and more common in post-menopausalwomen.

Symptoms

As womenwith ovarian cancer usually present with vague symptoms, it is oftenmisdiagnosed until it reaches an advanced stage. The symptoms include abdominaldiscomfort, constipation, swelling, menstrual irregularities, urinary symptoms,etc. The most important sign is the presence of a pelvic growth and,occasionally, fluid in the abdomen. Early detection is pivotal for long-termsurvival.

Treatment

As mostwomen present late for treatment, the cure usually requires surgery and chemotherapy.The surgery is extensive and chemotherapy has significant side effects. Ovariancancer also presents in younger women and, if caught early enough, the surgerycan be aimed at preserving the ability to fall pregnant.

Spread

Ovariancancer usually spreads within the pelvis and the abdomen. Most women only presentto hospital when it has already spread, making treatment very difficult. It canaffect the liver and cause kidney obstruction - all of which can be treated iffound early enough. The cancer can spread to lymph nodes and other structures,making treatment difficult and threatening long-term survival.

Stages

Ovariancancer may originally present with only one ovary involved but spread to the lungs,liver and brain. The stage at which the cancer is discovered will determine theoperation required, the need for chemotherapy (or not) and long-term survival prospects.

Screening

Women witha spinal cord injury are at particular risk as they may have diminishedsensation in the abdominal area and many of the symptoms are common to spinalcord injury. Unlike other cancers there are no tests to facilitate earlydetection. A PAP smear detects cervical cancer, not ovarian cancer.

Genetic factors can increase your risk ofdeveloping ovarian cancer. If you have relatives who have had breast, bowel or ovariancancer it is possible that your family has a genetic predisposition and you,and your blood relatives, should be tested for the BrCa1 and BrCa2 genes. Ifyou have these BrCa genes then annual ultrasounds and Magnetic ResonanceImagings (MRIs) may increase the potential for early detection of ovariancancer but MRIs are expensive. You should also contact the Genetic Clinic for counseling and advice. Regular ultrasound andblood tests alone have not proven effective at detecting early stage ovariancancer.

Some womenwho have the BrCa1 or BrCa2 gene choose to voluntarily remove theirreproductive organs and undergo bilateral, radical mastectomies – but thiscomes with its own risks and these risks should be carefully considered beforetaking such drastic step.

Thisarticle only skims the surface of this complex topic. For more information pleaseemail me or speak to your doctor. Best wishes and good health!

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