Cardiovascular

What Is Ovarian Cancer? What Causes Ovarian Cancer?

cancers occur in women over 65 years of age. A higher percentage of post-menopausal women develop ovarian cancer compared to pre-menopausal women. High number of total lifetime ovulations There is a link between the total number of ovulations during a woman"s life and the risk of ovarian cancer. Four principal factors influence the total: *Never having been pregnant - women who have never become pregnant have a higher risk of developing ovarian cancer compared to women who have became pregnant. The more times a woman has become pregnant the lower her risk is. *Never having taken the contraceptive pill - women who have never been on the contraceptive pill have a higher risk of developing ovarian cancer compared to women who have. Taking the Pill for 15 years halves the risk of ovarian cancer, a study by the Collaborative Group on Epidemiological Studies of Ovarian Cancer found. *Early start of menstruation (early menarche) - women who started their periods at an early age have a higher risk of developing ovarian cancer. *Late start of menopause - women whose menopause started at a later age than average have a higher risk of developing ovarian cancer. Scientists at the Centers for Disease Control and Prevention (CDC) found that survival among women with ovarian cancer is also influenced by age of menarche (when periods start) and total number of lifetime ovulatory cycles. Some gynecologic surgeries may reduce the risk Women who have had their fallopian tubes tied (tubal ligation) are estimated to have a 67% lower risk of ovarian cancer. A hysterectomy is said to reduce the risk by about one third. Infertility or fertility treatment Some studies have found a link between infertility treatment and a higher risk of ovarian cancer. Nobody is yet sure whether the risk is linked to infertility treatment, just infertility itself, or both. A Danish study published in the peer-reviewed British Medical Journal concluded that the use of fertility drugs does not increase a woman"s risk of developing ovarian cancer. The study involved 54,362 women with infertility problems referred to all Danish fertility clinics between 1963 and 1998. Breast cancer Women who have been diagnosed with breast cancer have a higher risk of developing ovarian cancer. HRT (Hormone replacement therapy) HRT slightly increases a women"s risk of developing ovarian cancer. Experts say the risk grows the longer the HRT continues, and returns to normal as soon as treatment stops. Danish scientists reported that compared with women who have never taken hormone therapy, those who currently take it or who have taken it in the past are at increased risk of ovarian cancer, regardless of the duration of use. A UK study that was published in the peer-reviewed medical journal The Lancet suggested that between 1991 and 2005, an extra 1,000 women in the UK died of ovarian cancer because they were on Hormone Replacement Therapy. Foods high in acrylamide A study in the Netherlands found a link between acrylamide, a carcinogenic compound found in cooked, and especially burned, carbohydrate rich foods, and increased risk of endometrial and ovarian cancer in postmenopausal women. Obesity/overweight Being obese or overweight increases the risk of developing many cancers. The more overweight you are, the higher the risk. Several studies have also shown that obese cancer patients are more likely to have faster advancing ones compared to cancer patients of normal weight. Obese older women who have never used hormone replacement therapy have nearly twice the risk of their normal weight peers of developing ovarian cancer, according to a study by the researchers at the National Cancer Institute. Endometriosis Women who develop endometriosis have an approximately 30% higher risk of developing ovarian cancer compared to other women. Endometriosis is a condition in which cells that are normally found inside the uterus (endometrial cells) are found growing outside of the uterus. Danazol, a medication used to treat endometriosis has been linked to ovarian cancer risk. Diagnosis of ovarian cancer There is a tragic myth among many health care professionals and patients in too many countries about early stage ovarian cancer having no symptoms. A UK study, called The Target Ovarian Cancer Pathfinder study which surveyed 400 UK general practitioners and over 1,000 women, including 132 with ovarian cancer, found that 80% of GPs in the UK were wrongly of the view that women have no symptoms in the early stages of ovarian cancer. Studies in countries with top healthcare services have come up with similar findings. The GP (general practitioner) will carry out a vaginal examination and check for any visible abnormalities in the uterus or ovaries. The doctor will also check the patient"s medical history and family history. Further tests will be ordered - these are usually done by a gynecologist - a doctor who specializes in treating diseases of the female reproductive organs. If the woman is diagnosed with ovarian cancer the doctor will want to identify its stage and grade. The stage of a cancer refers to the cancer"s spread while the grade refers to how aggressively it is spreading. By identifying the stage and grade of the cancer the doctor will be able to decide on the best treatment. The stage and grade of ovarian cancer alone cannot predict how it is going to develop. The following tests are used to diagnose ovarian cancer: *Blood test There is a cancer marker called CA 125 (cancer antigen 125) which is made by certain cells in the body. A high blood level of CA 125 may indicate the presence of cancer, but could also be due to something else, such as infections of the lining of the abdomen and chest, menstruation, pregnancy, endometriosis, or liver disease. This blood test is just one test among others, designed to help the doctor make a diagnosis. Normal blood levels of CA125 alone do not definitely mean there is no cancer either. They are just indications. *Ultrasound This is a device that uses high frequency sound waves which create an image on a monitor of the ovaries and their surroundings. A transvaginal ultrasound device may be inserted into the vagina, while an external device may be placed next to the stomach. Ultrasound scans help doctors see the size and texture of the ovaries, as well as any cysts. *Laparoscopy and possibly Endoscopy A laparoscope - a thin viewing tube with a camera at the end - is inserted into the patient through a small incision in the lower abdomen. The doctor can examine the ovaries in detail, and can also take a biopsy (extract a small sample of tissue for examination). The patient will undergo a general anesthetic for this procedure. The doctor may carry out an endoscopy to determine whether the cancer has spread to the digestive system. *Colonoscopy If the patient has had bleeding from the rectum, or constipation the doctor may order a colonoscopy to examine the large intestine (colon). The colonoscope - a thin tube with a camera at the end - will be inserted into the rectum. *Abdominal fluid aspiration If the patient"s abdomen is swollen the doctor may decide to carry out this test. A build up of fluid in the abdomen might indicate that the ovarian cancer has spread. A thin needle goes through the skin into the abdomen and a sample of the liquid is extracted. Some of the liquid may be drained into a bag if there is a lot of it (abdominal tap). The fluid is checked in the laboratory for cancer cells. *Chest X-ray This test will help the doctor see if the cancer has spread to the lungs, or to the pleural space surrounding the lungs. *CT (computerized tomography) scan X-rays are used to create a 3-dimensional picture of the target area. *MRI (magnetic resonance imaging) scan Magnets and radio waves produce 2-dimensional and 3-dimensional pictures of the target area. Combined positron emission tomography (PET) and computed tomography (CT) scanning of patients in the early stages of ovarian cancer can enable physicians to determine whether the cancer has spread to nearby lymph nodes without having to perform surgery, reported scientists at San Gerardo Hospital, Monza, Italy. The 4 stages of ovarian cancer Ovarian cancer is classified into four stages, with stage 4 being the most advanced. *Stage 1 - the cancer is confined to one or both ovaries. This is subdivided into three groups: *Stage 1a - the cancer is confined to just one ovary (contained inside it). *Stage 1b - the cancer is confined to both ovaries (contained inside them). *Stage 1c - either 1a or 1b, but there is come cancer on the surface of one or both ovaries, or cancer cells are found in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery. *Stage 2 - the cancer has spread to the uterus, fallopian tubes or some other areas in the pelvis (tummy area). This is subdivided into 3 groups: *2a - the cancer has spread into the uterus (womb) or the fallopian tubes. *2b - the cancer has spread into other tissues in the pelvis, such as the rectum or bladder. *2c - 2a and 2b, and there is cancer on the surface of one or both ovaries, or cancer cells are identified in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery. *Stage 3 - the cancer has spread into the peritoneum (the lining of the abdomen), or to the lymph nodes in the upper abdomen, groin or behind the uterus. Most ovarian cancers are diagnosed at this stage. This stage is divided into three subgroups: *3a - an examination with a microscope of tissue taken from the peritoneum (lining of the abdomen) or the omentum (fatty layer over the top of the intestines) detects cancer cells. *3b - tumor growths are identified in the peritoneum 2cm or smaller. *3c - tumor growths larger than 2cm are identified in the peritoneum. Cancer is found in the lymph nodes in the groin, behind the

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