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Definition: It is a solid, tumoral growth arising in the ovary, which has the capacity to spread to the second ovary and other organs of the body. It usually leads to filling of the abdomen with fluid and can spread to the uterus, intestines, lymph nodes, liver, urinary bladder, etc.
Exact cause is not known but various factors have been implicated in the causation of ovarian cancers:
- More in affluent classes due to higher animal fat content in diet.
- Industrial pollutants and chemicals like asbestos.
- Ovulation inducing drugs used for a very long time are suspected to increase its occurrence but there is no definite proof.
- Family history of ovarian and breast cancers in 1st degree relatives.
- There is a protective role of oral contraceptives pills, pregnancy & breast feeding.
- Tumors in adolescent girls and post-menopausal women are more often malignant than benign and deserve urgent attention.
Early disease is usually asymptomatic. The most common symptom of ovarian cancer is the feeling of a lump in the abdomen or abdominal swelling. Disturbance of menstrual cycle or bleeding after menopause may be seen in some types of cancers. Pain is usually present in late cases but may be absent in small and early cancer.
Large tumors can cause weight loss, loss of appetite, dyspepsia swelling of legs & difficulty in breathing.
A detailed gynaecological check-up is required in all cases. The tumor can be diagnosed by ultrasound, more clearly on the transvaginal scan (TVS). In some cases a blood test called CA 124 level may need to be done. Colour flow Doppler, CT scan and MRI Scan can also aid in diagnosis. However, sometimes an ultrasound guided aspiration from the tumor or fluid in the abdomen has to be done and examined by a pathologist
Treatment requires a surgical operation called debulking laparotomy where the surgeon removes the ovaries, uterus and as much of the tumor as be possible. In young girls it is sometimes possible to save the uterus and one ovary so as to enable future child bearing. The tissues removed at surgery have to be sent to a pathologist for examination. Most patients also require chemotherapy after the surgical wound has healed. This involves giving medicines which have the ability to destroy cancer cells. They are given in an intravenous drip at the interval of 4 – 6 weeks for 6 – 8 cycles.
Early gynaecological consultation for any menstrual disturbance or abdominal swelling.
Post-menopausal women and younger women with positive family history should get a gynaecological check-up done every 6 months.