Cancer - Ovarian

Ovarian cancer is the fifth leading cause of cancer death in women, the leading cause of death from gynecological malignancy, and the second most commonly diagnosed gynecologic malignancy. It is idiopathic, meaning that the exact cause is usually unknown. The disease is more common in industrialized nations, with the exception of Japan. In the United States, females have a 1.4% to 2.5% lifetime chance of developing ovarian cancer.

Older women are at highest risk. More than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age and approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age. The risk for developing ovarian cancer appears to be affected by several factors. The more children a woman has, the lower her risk of ovarian cancer. Early age at first pregnancy, older ages of final pregnancy and the use of low dose hormonal contraception have also been shown to have a protective effect. Ovarian cancer is reduced in women after tubal ligation.

There is good evidence that in some women genetic factors are important. Carriers of certain mutations of the BRCA1 or the BRCA2 gene, more frequent in some populations are at a higher risk of both breast cancer and ovarian cancer, often at an earlier age than the general population. Patients with a personal history of breast cancer or a family history of breast and/or ovarian cancer, especially if at a young age, may have an elevated risk. A strong family history of uterine cancer, colon cancer, or other gastrointestinal cancers may indicate the presence of a syndrome known as hereditary non-polyposis colon cancer, which confers a higher risk for developing ovarian cancer. Patients with strong genetic risk for ovarian cancer may consider the use of prophylactic oophorectomy after completion of child-bearing.

Surgery is the preferred treatment and is frequently necessary for diagnosis. Studies have shown that surgery performed by a specialist in gynecologic oncology usually result in an improved outlook. Improved survival is attributed to more accurate staging of the disease and a higher rate of aggressive surgical excision of tumor in the abdomen by gynecologic oncologists as opposed to general gynecologists and general surgeons.

Chemotherapy is used as after surgery to treat any residual disease. At present many oncologists are still recommending systemic chemotherapy including a platinum derivative with a taxane as a preferred method of treating advanced ovarian cancer. However, randomized, multicenter clinical trials are beginning to clearly show that Intra-peritoneal chemotherapy produces longer survival times. As this therapy may not always be available in local hospitals, women should consult doctors based in nationally recognized centers as soon after diagnosis as possible in order to select the most effective treatment plan. Chemotherapy can also be used to treat women who have a recurrence.

Radiation therapy is not effective for advanced stages because a high dose can not be delivered because vital organs are in the radiation field.

Ovarian cancer has a poor prognosis. It is disproportionately deadly because symptoms are vague and non-specific. More than 60% of patients presenting with this disease already have stage III or stage IV disease, when it has already spread beyond the ovaries.

Ovarian cancers shed malignant cells into the naturally occurring fluid within the abdominal cavity. These cells then have the potential to float in this fluid and frequently implant on other abdominal structures included the uterus, urinary bladder, bowel, and lining of the bowel wall. These cells can begin forming new tumor growths before cancer is even suspected.

More than 50% of women with ovarian cancer are diagnosed in the advanced stages of the disease because no cost-effective screening test for ovarian cancer exists. The five-year survival rate for all stages is only 35% to 38%. If, however, diagnosis is made early in the disease, five-year survival rates can reach 90% to 98%.

...More at Wikipedia

Related Links:

• Ovarian Cancer National Alliance
• National Cancer Institute
• US National Library of Medicine

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