Ovarian cancer : Finding cancer specialists for ovarian cancer treatment

Ovaries are paired organ of the female reproductive system. There is one ovary each, on the left and right side of the uterus in the pelvis. The ovaries job is to produce eggs or ova for fertilization by the male sperm. In women of reproductive age, an egg is released from one of the ovaries into the adjacent fallopian tube, once every month during ovulation. The fallopian tubes are tubular structures which connect the ovary to the upper, outer-most part of the uterus, and provide a route for the female egg to undergo fertilization. The ovaries are also the chief source of the female sex hormones estrogen and progesterone.

What are ovarian cancers ?
Ovarian Cancers are basically tumours of the ovaries.

How is an ovarian cancer caused ?

1. Intake of only estrogen without taking progesterone, for example in the treatment of menopause.
2. Using talcum powder : Talcum powder applied on the genital area or on the sanitary napkins may have a carcinogenic (cancer-causing) effect on the ovaries. Earlier, talcum powder was at times mixed with asbestos, a known carcinogen.
3. Being obese or overweight.
4. Having a family history of Ovarian Cancer, Breast or Colorectal Cancer.
5. Being afflicted by Familal cancer syndromes such as hereditary breast and ovarian cancer syndrome. This syndrome has inherited mutations of genes BRCA1 and BRCA2. Hereditary nonpolyposis colon cancer also increases the risk.
6. Reproductive history : Pregnant women before age 26 have a lower risk of ovarian cancer than women who have not become pregnant before that age. The risk decreases with each full-term pregnancy.
7. Getting radiation therapy for another tumour to the pelvis.

What are the types of ovarian cancer ?
There are several types of cancer that can initiate in the Ovaries. The ovaries consist of three chief types of cells. Each cell can give rise to its respective type of tumour. These tumours can either be benign or malignant. Benign tumours are non-cancerous in that they will not extend beyond the ovary. Malignant ovarian tumours can spread or metastasize to other parts of the body and need to be detected and treated early.

1. Epithelial tumours: Epithelial cells line and cover the ovary. Therefore, epithelial tumours start from these covering epithelial cells of the ovary. Most of the ovarian tumours are epithelial cell tumours. They can be either benign or malignant (carcinomas).There are also epithelial tumours of little malignant potential, and do not appear to be frankly cancerous. These specific tumours are of low malignant potential (or LMP tumours) and are borderline epithelial ovarian cancers. The malignant carcinomas are often synonymous with ovarian cancer. They can either be of the serous type (most common), but there are other types of carcinomas as well like the mucinous, endometrioid, and the clear cell carcinoma.
2. Germ cell tumours: These tumours initiate from germ cells that produce the reproductive cells or eggs (the female ova).
3. Stromal tumours: These initiate from the connective tissue cells of the ovary that synthesize the female sex hormones, estrogen and progesterone.

What are the clinical features of ovarian cancers ?
Symptoms of endometrial cancers include feeling bloated and pain or lump in the abdomen or pelvis. Loss of appetite, lethargy, or weight loss can also occur. Frequency and need to urinate can also increase. Other symptoms include changes in menstruation as well as painful menstruation.

How are ovarian cancers diagnosed ?

1. A complete Physical Examination of the body is mandatory.
2. Pelvic Ultrasonography : Although the presence of the pelvic mass can thus be confirmed by pelvic ultrasonography, its origin cannot always be determined.
3. Transvaginal Ultrasonography (TVUS): The role of transvaginal ultrasonography is becoming more established. It helps to examine the vagina, uterus & ovaries by putting an ultrasound probe into the vagina.
4. Cytology : Abnormal or atypical glandular cytology in the absence of any other cervical or endometrial pathology raises the possibility of an ovarian malignancy.
5. Tumour Markers: CA125 are proving to be of help as a screening test in the diagnosis of cancers such as ovarian and fallopian-tube cancers.
6. Biopsy: A pathologist studies the removed tissue under a microscope and confirms the cancer.
7. Imaging Tests: To determine the exact extent of disease, additional tests may need to be performed so doctors can view, assess and judge the cancer and determine how far it has progressed or spread. These tests may include the following such as X- rays, CT Scan, MRI Scan or PET Scans.

How are ovarian cancers staged and graded ?
Grade and Stage describe the tumour, helping to provide guidance in choosing the best treatment option(s). Staging is a careful attempt to find out the extent of the cancer. Staging will define whether the cancer has invaded into adjacent structures, whether the disease has spread, and if so, to what parts of the body.

Staging
The following stages are used for cancer of the ovaries and fallopian tube.

• Stage 1: Cancer is restricted only to one or both of the ovaries or fallopian tubes. This is early stage.
• Stage 2: Fallopian Tube Cancer is found in either one or both ovaries or fallopian tubes and/or has also spread to other organs in the pelvis like the uterus, ovaries and bladder.
• Stage 3: Cancer is present in one or both ovaries and fallopian tubes and has extended outside the pelvis to other abdominal organs or to lymph nodes in the abdomen.
• Stage 4: Cancer is present in one or both ovaries or fallopian tubes and has spread extra-abdominally or to the spleen, liver or lungs.
• Recurrent Cancer: If the cancer recurs after primary treatment, this is recurrent cancer.

Grading
Grade refers to the resemblance of cancer cells to normal cells. Low-grade tumours are better differentiated and grow relatively slowly while high-grade tumours grow faster and spread rapidly. The grade classifies the tumour based on a scale of 1, 2, or 3. Grade 1 epithelial ovarian carcinomas resemble normal ovarian tissue and generally have a good prognosis or outlook. Grade 3 epithelial ovarian carcinomas are dedifferentiated and do not resemble normal tissue much. They generally have a worse prognosis. Grade 2 tumours are intermediate in between grades 1 and 3.

How are ovarian cancers treated ?
Benign tumours can be treated by removing either the ovary or the part of the ovary that contains the tumour.

1. Surgery : Experts recommend that patients consult a gynaecologic oncologist for surgery. The current recommendation for surgery is to remove the uterus (this operation is a hysterectomy), along with both ovaries and fallopian tubes (this is a bilateral salpingo-oophorectomy or BSO). In addition, the omentum is also removed (an omentectomy). The omentum is a layer of fat that covers the abdominal contents and ovarian cancer can sometimes extend to this tissue.
2. Chemotherapy : Another kind of cancer treatment that uses either drugs or chemical substances (hence the name chemotherapy) to kill cancer cells and prevent them from dividing. It appears that chemotherapy is most useful in advanced disease.
3. Radiotherapy : Postoperative pelvic radiotherapy can be useful in treating areas of cancer spread.

What is the care to be taken after the ovarian cancer treatment ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the limbs, thorax, chest, retroperitoneum, and abdomen with radiography, MRI or CT scans.

How to find and reach cancer specialists for ovarian cancer treatment ?
Now you can find and reach cancer specialists for ovarian cancer treatment from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for ovarian cancer treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for ovarian cancer treatment.

Find, reach and choose a cancer specialist for ovarian cancer treatment on Hinfoways. Make an informed choice.

Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.