Ovarian cancer: symptoms, causes and how to treat it

Definition

What is ovarian cancer?

Ovarian cancer, also known as ovarian cancer, causes the highest number of deaths among other types of cancer that also attacks female reproduction.

Based on the Center for Disease Control and Prevention (CDC), the definition of ovarian cancer is a group of cancers that occur in the ovaries and surrounding areas, such as the fallopian tubes (fallopian tubes) and peritoneum.

Meanwhile, according to the Mayo Clinic, the definition of ovarian cancer is a type of cancer that develops inside, around, outside the ovary lining.

The ovaries (ovaries) are paired glands in the shape of almonds located on the right and left of the uterus. The function of this gland is to store and produce eggs and produce sex hormones, such as the hormones estrogen and progesterone.

This cancer can form from cysts, but not all cysts are ovarian cancer. Cyst itself is a collection of fluid in the ovary which generally occurs as a result of the ovulation process. These cysts can disappear over time without treatment, and a small percentage of cases develop into cancer.

This early stage of cancer development is indeed quite difficult to detect. However, if caught early and treated early, the patient has a 94% chance of recovery and can live more than 5 years after diagnosis.

Is ovarian cancer contagious?

Cancer is not a contagious disease. Thus, no transmission will occur from a patient with ovarian cancer to a healthy person, through any means, such as kissing, touching, or sharing food.

How common is ovarian cancer?

Ovarian cancer is a type of cancer that is quite common in women. Based on the Indonesian Ministry of Health, the prevalence of cancer in Indonesia in 2018 was 1.79 per 1000 population with the addition of 13,310 new ovarian cancer cases and 7,842 deaths, according to Globocan data in the same year.

Overall, ovarian cancer is ranked 10th and 3rd in women. Generally, it attacks women who have menopause. However, certain types of ovarian cancer can appear at a young age and in children.

Type

What are the types of ovarian cancer?

Ovarian cancer can be divided into three types. This division is based on the location and type of cells where the cancer develops. The following is the classification of ovarian cancer according to the American Cancer Society website:

1. Epithelial tumor

Epithelial tumors or known as epithelial ovarian cancer are the most common types, with a percentage of 75 percent.

This type of cancer occurs on the surface of the cells lining the outer ovaries. Epithelial tumors are divided into several types, namely:

• Benign tumor /benign epithelial tumors: benign tumor cells that do not usually lead to serious health problems.
• The tumor is potentially malignant /borderline epithelial ovarian cancer: tumor cells that do not look like cancer but can turn into cancer over time. It is very common in young and slowly growing women.
• Malignant tumor / malignant epithelial ovarian tumors: As many as 85-90% of cases of epithelial tumors are of this type which can develop into cancer and spread rapidly.

2. Germ cell tumors

The type of ovarian cancer then attacks the germ cells that produce eggs (ovum), with a case percentage of less than 2 percent. Germ cell tumors are then divided into several types, such as:

• Teratoma: Benign tumors that are visible on a microscope are like 3 layers of a developing embryo, common in children and girls under 18 years of age.
• Dysgerminoma: malignant tumor but does not spread quickly and affects adolescents and around 20s.
• Endodermal sinus tumors and choriocarcinoma:These tumors are quite rare and once formed can grow and spread rapidly.

3. Stromal tumor

This type of ovarian cancer is very rare, with only 1 percent of cases. This cancer occurs in cells responsible for producing hormones. Women with stromal tumors will have high levels of estrogen in their bodies.

Signs & symptoms

What are the signs and symptoms of ovarian cancer?

Women tend to experience symptoms of ovarian cancer when the cancer cells have spread or entered an advanced stage. However, there are also some women who experience symptoms at an early stage.

The following are the most common symptoms of ovarian cancer:

• Bloated.
• Pelvic pain and pain around the abdomen.
• Difficulty eating, because the stomach is full quickly even though you eat a little
• Bladder problems, such as urinating more frequently or not being able to resist the urge to urinate.

In addition to the symptoms mentioned above, other common cancer symptoms that generally accompany it, such as:

• Constant fatigue.
• Feeling pain during sex (vaginal penetration).
• Menstrual changes, such as irregular periods or bleeding that comes out more than usual.

When to see a doctor?

You should contact your doctor immediately if your symptoms feel unusual. For example, symptoms do not improve over time and last for more than 3 weeks.

Even though you are not sure whether the symptoms that appear are symptoms of ovarian cancer, you should still see a doctor.

In addition, if you experience any of the following signs, you should visit your doctor as soon as possible:

• There is swelling in the stomach.
• Drastic weight loss for no apparent reason.

In addition, if you are over 50 years of age or have family members who have this cancer, you should check up frequently for prevention.

Each patient's body shows varying symptoms and signs. To get the most appropriate treatment and according to your condition, always consult your doctor.

Cause

What causes ovarian cancer?

Until now, the cause of ovarian cancer is not certain. However, experts say that the cause may not be much different from the cause of cancer in general, namely mutations in DNA in cells.

The DNA in cells stores the command system for cells to grow, develop, die, and divide. When a mutation occurs, the system in the DNA will break down and the cell's command system goes awry. This results in cells working out of control; continues to grow abnormally. These growing cells can form tumors around the ovaries.

The presence of these abnormal cells is not only in the ovaries, but can also come from cells located at the end of the fallopian tube.

Risk factors

What increases the risk of ovarian cancer?

Although the exact cause of ovarian cancer is not known, scientists have found a variety of things that can increase the risk, such as:

• Increasing age

Ovarian cancer is mostly found in women aged 63 years and over or those who have passed menopause.

• Heredity

Having a family member who has ovarian cancer, colon cancer or breast cancer, makes the chances of developing this disease even greater.

• Have or are currently suffering from breast cancer

Being diagnosed with breast cancer by a doctor increases the risk of this cancer.

• Obesity

Being overweight increases the risk of many types of cancer, including ovarian cancer.

• Smoking habit

Cigarette chemicals are carcinogenic, so they can increase the risk of cancer.

• Never been pregnant or had frequent miscarriages

Never being pregnant and not past a period where you don't produce eggs, you can potentially get this disease.

• Have had hormone replacement therapy

Women who undergo estrogen therapy after menopause have a great chance of developing this cancer.

Stages & levels

What are the stages and levels of ovarian cancer?

The stage of cancer indicates how severe a disease is and how it has spread. Just like cancer in general, ovarian cancer stages are divided into 4, namely:

• Stage 1

At this stage, the cancer cells are still located only in the ovaries. Surgical removal of cancer cells is performed, sometimes followed by chemotherapy. At this stage, you can still get pregnant and have children.

• Stage 2

Cancer cells have grown to the outside of the ovary and spread to the hip or stomach. Cancer cells can be treated with chemotherapy and surgery.

• Stage 3

Cancer cells have spread to the lymph nodes or abdominal cavity. Treatment is still the same as stage 2 cancer.

• Stage 4

Cancer cells have spread to other organs, such as the liver and lungs. Cancer cannot be cured, but symptoms can be relieved and the severity can be slowed down.

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is ovarian cancer diagnosed?

Since ovarian cancer symptoms resemble other health conditions, the diagnosis process is not easy. However, if the disease is detected at an early stage, the effectiveness of treatment and the opportunity to increase life expectancy is even greater.

First of all, the doctor will ask you what symptoms you are experiencing, what your family history of illness is, and any other risk factors you may have. After that, the doctor will check for lumps or swelling in the stomach.

If the doctor suspects cancer, additional ovarian cancer diagnostic tests will be performed.

• Ultrasound test

An image scan test that relies on sound waves to see if there are tumors in the ovaries, how big they are, and their severity.

• CT scan test

Tests to find out whether cancer cells have spread to other organs, such as the liver, kidneys, or lymph nodes.

• MRI test

The scanning test uses magnetic technology to see cancer cells in the ovaries in more detail.

• Laparoscopy

A medical procedure by inserting a small tube into the body to directly see the presence of cancer cells on the inside of the stomach or hips.

• Biopsy

A biopsy is done to detect the development of cancer cells by removing a portion of the tumor tissue.

• Blood test

Blood tests to determine the levels of red blood cells, white blood, and platelets in your body. Some types of ovarian cancer cells can also affect the hormone levels in your blood.

In addition to diagnosis, the above medical tests are also sometimes used to detect ovarian cancer early.

What are my treatment options for ovarian cancer?

Over time, cancer can cause complications. Therefore, cancer treatment must be done immediately so that complications of ovarian cancer can be prevented.

Ovarian cancer treatment, from early to late stages, are generally:

1. Operation

The surgical procedure or surgical removal of the ovaries for people with cancer depends on the stage.

In the early stages, surgery is usually only performed on one part of the ovary, which is the ovary that has been attacked by cancer cells.

However, if cancer cells attack both ovaries, the surgical team may remove both of your ovaries or fallopian tubes.

Ovarian cancer that is more severe and has entered the final stage requires the surgeon to remove your entire ovary and uterus. In some cases, your lymph nodes and fallopian tubes also need to be removed.

2. Chemotherapy

Chemotherapy is done to kill cancer cells that develop in the body. Chemotherapy drugs are generally injected through your vein, but there are drugs that can be taken directly.

This treatment is usually carried out after the surgical procedure. The goal is to kill any cancer cells that may remain in the body. However, in the case of chemotherapy, the goal is to shrink the tumor first.

3. Palliative care

Palliative care is focused on helping patients relieve pain and other serious symptoms. The goal is to improve the quality of life for patients, especially for stage 4 cancer patients.

Home remedies

What are some lifestyle changes or home remedies that can be done to treat ovarian cancer?

Because this disease is not certain what causes it, there is no way that is believed to be effective in preventing its appearance.

However, health experts recommend implementing a lifestyle for cancer patients, such as:

• Eat healthy foods for ovarian cancer patients, such as vegetables, whole grains, with little fat content. Avoid various foods that are challenged, such as high fat, preservatives, and high sugar.
• Maintain your weight by exercising regularly and managing stress.
• Further consultation with the doctor if you want to take herbal remedies for ovarian cancer that are sold in the market.

Prevention

How do you prevent ovarian cancer?

Cancer prevention can be done by reducing the various risks. The following are ways to prevent ovarian cancer are:

• Consider taking birth control pills. The use of these contraceptive pills for 5 years or more can reduce the risk of ovarian cancer by 50 percent. However, you must first consult with your doctor about this plan.
• Reproductive system operation. Having surgeries such as tubal ligation and hysterectomy is known to reduce the risk of this type of cancer. It's just that, you need a doctor's consideration about the benefits and effects of this medical procedure.