Ovarian cancer is a disease produced by the rapid growth and division of cells within one or both ovaries-reproductive glands in which the ova, or eggs, and the female sex hormones are made. The ovaries contain cells that, under normal circumstances, reproduce to maintain tissue health. When growth control is lost and cells divide too much and too fast, a cellular mass or tumor is formed. If the tumor is confined to a few cell layers, for example, surface cells, and it does not invade surrounding tissues or organs, it is considered benign. If the tumor spreads to surrounding tissues or organs, it is considered malignant, or cancerous. When cancerous cells break away from the original tumor, travel through the blood or lymphatic vessels, and grow within other parts of the body, the process is known as metastasis.
Ovarian cancer is not a single disease. There are actually more than 30 types and subtypes of ovarian malignancies, each with its own histopathologic (diseased tissue) appearance and biologic behavior.
Causes of OVARIAN CANCER
The exact cause of ovarian cancer isn't known. It's more common in women who live in developed countries. Other factors that are thought to make ovarian cancer more likely include:
a family history of ovarian cancer - women who have two or more close relatives (mother, sister or daughter) with ovarian cancer are more at risk.
having a non-cancerous condition called endometriosis.
starting your period early and having the menopause late.
More research is needed to find out whether the risk of ovarian cancer is increased by : -
having fertility treatment.
having hormone replacement therapy (HRT).
being overweight or obese.
Studies have shown that ovarian cancer may be less common in women who : -
have used the contraceptive pill.
have had children.
have breastfed their children.
have had a hysterectomy.
Symptoms of Ovarian Cancer
Most women with early-stage cancer of the ovary don't have any symptoms for a long time.
When symptoms occur they may include any of the following : -
loss of appetite.
vague indigestion, nausea, excess gas (wind) and a bloated, full feeling.
unexplained weight gain.
swelling in the abdomen - this may be due to a build up of fluid, known as ascites, which can cause shortness of breath.
pain in the lower abdomen.
changes in bowel or bladder habits, such as constipation, diarrhoea or needing to pass urine more often.
lower back pain.
pain during sex.
abnormal vaginal bleeding, although this is rare.
DIAGNOSIS OF OVARIAN CANCER
Pelvic exam (for Ovarian Cancer) includes feeling the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to find any abnormality in their shape or size. (A Pap test, a good test for cancer of the cervix, is often done along with the pelvic exam, but it is not a reliable way to find or diagnose ovarian cancer.)
Ultrasound refers to the use of high-frequency sound waves. These waves, which cannot be heard by humans, are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid-filled cysts, and tumors look different on this picture.
CA-125 assay (for Ovarian Cancer) is a blood test used to measure the level of CA-125, a tumor marker that is often found in higher-than-normal amounts in the blood of women with ovarian cancer.
Lower GI series, or barium enema, is a series of x-rays of the colon and rectum. The pictures are taken after the patient is given an enema with a white, chalky solution containing barium. The barium outlines the colon and rectum on the x-ray, making tumors or other abnormal areas easier to see.
CT (or CAT) scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine.
Biopsy is the removal of tissue for examination under a microscope. A pathologist studies the tissue to make a diagnosis . To obtain the tissue, the surgeon performs a laparotomy (an operation to open the abdomen). If cancer is suspected, the surgeon performs an oophorectomy (removal of the entire ovary). This is important because, if cancer is present, removing just a sample of tissue by cutting through the outer layer of the ovary could allow cancer cells to escape and cause the disease to spread.
If the diagnosis is ovarian cancer, the doctor will want to learn the stage (or extent) of disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, to what parts of the body. Staging may involve surgery, x-rays and other imaging procedures, and lab tests. Knowing the stage of the disease helps the doctor plan treatment.
TREATMENT OF OVARIAN CANCER in India
Treatment
There are three main forms of treatment for ovarian cancer offered in India : -
Surgery to remove cancerous tissue.
Chemotherapy to destroy cancer cells using strong anti-cancer drugs.
Radiotherapy to destroy cancer cells by high-energy radiation exposure.
There are also many combinations of these treatment methods and it is usually worthwhile to get a second opinion about treatment before entering into a specific program. Treatment depends upon a number of factors (e.g., stage and grade of the disease, the histopathologic type, and the patient's age and overall health).
Surgery for Ovarian Cancer in India
Surgery usually is required to treat ovarian cancer. Most patients undergo surgery in addition to another form of treatment (e.g., chemotherapy and/or radiotherapy). Surgery helps the physician to accurately stage the tumor, make a diagnosis, and perform debulking (removal of as much tumor mass as possible). Debulking surgery is especially important in ovarian cancer because aggressive removal of cancerous tissue is associated with improved survival. Patients with no residual tumor mass, or tumor masses that measure less than 1 cm, have the best opportunity for cure.
The surgeon usually performs a laparotomy (through an abdominal incision) or laparoscopy (using a tube containing a light and camera that is inserted into the pelvic cavity through a small incision). A sample of the tumor (called a frozen section) is examined immediately under a microscope to confirm ovarian cancer and rule out metastasis from another site. If the cancer is a metastasis from another organ, the surgeon searches for the primary tumor within the abdominal cavity.
Once ovarian cancer is confirmed, a total hysterectomy (removal of the uterus [womb], bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries on both sides), omentectomy (removal of the fatty tissue that covers the bowels), lymphadenectomy (removal of one or more lymph nodes) may be performed. Tissue removed during debulking is sent for histopathological examination.
Chemotherapy for Ovarian Cancer in India
Chemotherapy involves using drugs to destroy cancer cells. Many of these drugs destroy cancer cells by preventing them from growing and dividing rapidly. Unfortunately, many normal cells also divide rapidly and are damaged by chemotherapy.
Read More.
Radiation for Ovarian Cancer in India
Radiotherapy may be used to kill cancer cells from a cyst that ruptures during surgical removal of an ovary, or it may be used to treat certain patients who appear cancer-free or who have only microscopic evidence of disease at second-look surgery. It is historically the treatment of choice for germ cell tumors known as dysgerminomas. However, recently it has been found that chemotherapy can cure a percentage of such patients.
Read More.
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