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Regular
Exams: Best Way To Detect Ovarian Cancer
Each year, according to
statistics of the National Cancer Institute, an
estimated 20,000 new cases of ovarian cancer are
diagnosed. That means that about one out of every 70
newborn girls will develop the disease during her
lifetime.
Ovarian cancer causes
more deaths than any other cancer of the female
reproductive system; perhaps because it is a
“silent” disease, showing no obvious signs or
symptoms until late in it’s development. Although
the causes of ovarian cancer remain unknown, research
indicates that this kind of cancer tends to run in
families. Childbearing appears to be the most
important known factor in preventing ovarian cancer,
which suggests that hormones may play a role in its
development.
Women who have had
children are half as likely to develop ovarian cancer
as women who have not or who have delayed childbearing
to their later years. Several pregnancies appear to
confer even more protection. Use of birth control
pills, which create a hormonal balance similar to that
found during pregnancy, may reduce the risk of this
disease by 10 to 50 percent.
Women who have had
breast, colorectal or endometrial cancer are also at
increased risk for ovarian cancer. Conversely, women
who already have ovarian cancer are three to four
times more likely to develop breast cancer.
Although no one knows
exactly why, white women 40 to 50 years old living in
highly industrialized countries develop the disease
most often. Japan, has the lowest rate and (surprise!)
Denmark has the highest. This suggests that there may
be one or more environmental dietary influences.
THE OVARIES AT WORK
The ovaries - two
almond-sized glands containing egg cells that like in
the lower abdomen, one on each side of the uterus -
secrete hormones that help regulate menstruation and
pregnancy. In addition to egg cells, the ovaries
contain several other types of cells. Although cancer
can affect any one of these, 80 to 90 percent of
ovarian cancers arise from the layer of epithelial
cells that surround the ovary. Epithelial cancers
can develop in either ovary and develop in both
ovaries at once in about one third of the cases.
Some ovarian tumors are
benign and, while they may interfere with body
functions and require removal, they do not invade
neighboring tissue. Malignant tumors, on the other
hand, do invade and destroy surrounding normal tissue.
Cancer cells can break away from the tumor and spread
through the bloodstream or lymphatic system to other
Parts of the body
(metastasis). Ovarian cancer metastasizes through the
lymphatic system.
EARLY DIAGNOSIS IS
IMPORTANT
There are currently no
fully effective methods of mass screening to detect
ovarian cancer. A thorough pelvic exam remains the
most effective way to guard against undetected
development and spread of the disease. During the
examination, the doctor may be able to find a mass in
an ovary, fallopian tube or the uterus in its early
stages before it has a chance to spread. If the doctor
suspects a tumor, an ultrasound exam, magnetic
resonance imaging (MRI), or a CAT (computer assisted
topography) scan may be ordered to confirm a
diagnosis.
Unfortunately, there
are no early symptoms of cancer of the ovary.
The most frequent symptoms associated with ovarian
cancer are enlargement of the abdomen (generally due
to an accumulation of fluid or, less often, due to the
presence of the tumor itself) and pelvic pain. Upper
abdominal fullness and indigestion, fatigue, urinary
frequency and shortness of breath may also be present
as the disease progresses. Elevated estrogen
production in certain kinds of tumors may cause
abnormal uterine bleeding, but this is not usually
associated with ovarian cancer.
It is important to
point out that the Pap test - an excellent tool in the
diagnosis of cancer of the uterine cervix - does
not reveal ovarian cancer.
TREATMENT OPTIONS
If the diagnosis
imaging tests indicate that a tumor is present, the
next step may be Laparoscopy to determine the extent
and nature of the disease. This procedure involves
cutting a tiny incision in the abdomen to allow the
ovary to be examined with a special fiber-optic
instrument. During Laparoscopy, a sample of tissue can
be removed for microscopic examination. This biopsy
is the only sure way of determining whether a growth
is malignant or benign.
The physician may
instead arrange for an operation called a laparotomy,
which involves making an incision in the abdomen to
reach the ovaries, conduct a biopsy, and then - if the
diagnosis is cancer - proceed immediately with
surgical removal of the entire cancerous growth.
Beforehand, the patient should be thoroughly briefed
so she understands that major surgery may be necessary
if the biopsy shows malignancy.
Because operative
management of ovarian cancer is aimed at removing as
much tumor as is safely possible, a thorough abdominal
exploration during the surgery is important. Usually,
both ovaries, the uterus (hysterectomy) and fallopian
tubes are removed, and any suspicious surfaces in the
peritoneal cavity are also biopsied. Any grossly
abnormal lymph nodes in the area are considered
metastasis and removed, as well. In advanced disease,
every effort is made to remove all intra-abdominal
disease to enhance the effect of chemotherapy.
There are a number of
factors that significantly influence survival rates;
the stage of the disease and when diagnosed, the cell
type, the grade of the tumor, the success of the
surgery, and response to therapy. If ovarian cancer is
diagnosed and treated early, about 85 percent of such
patients live five years or longer. When diagnosis at
an advanced stage, however, the survival rate drops to
23 percent. The survival rates for ovarian cancer are
improving with modern chemotherapeutic agents.
If you are in the
high-risk categories or have any reason to suspect
ovarian cancer, or if you have not had a pelvic exam
during the last 18 months, call your gynecologist as
soon as possible. Your best chance of beating ovarian
cancer is regular check-ups. Schedule one today.
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