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Cancer / Oncology Treatments


Ovarian Cancer

A cancerous growth that develops in many different parts of the ovary is known as ovarian cancer. Ovaries are basically a pair of female reproductive glands that helps in the formation of eggs or ova. A number of ovarian cancers occur from the epithelium (outer lining) of the ovary. A majority of these cancers are either malignant germ cell tumors or ovarian epithelial carcinomas.

Types of Ovarian Tumors

There are a number of tumors that may start in the ovaries. These tumors can be benign (non-cancerous) or malignant (cancerous). These tumors can be categorized into three types –

Stromal Tumors: These tumors begin from those cells that are responsible for holding the ovary together and also for making female hormones.

Germ Cell Tumors: These tumors begin from those cells that are responsible for producing the eggs.

Epithelial Tumors: These tumors begin from those cells which cover the outer surface of the ovary. A majority of ovarian tumors are epithelial tumors. Serous is considered as the most common type of epithelial cancers.

Ovarian cancer is considered as one of the most common cancer among women. Some of its major causes include –

  • The usage of hormone replacement therapy for more than five years especially when only estrogen is used
  • Inherited gene mutation
  • Women who are 50 years or above
  • Obesity
  • Family history of breast cancer or ovarian cancer
  • Having never been pregnant
  • Having had cancer before such as colon, breast or uterine

Early Symptoms of Ovarian Cancer

  • Changes in bowel habits like constipation
  • Pelvic pain
  • Heartburn or indigestion
  • Pain on the lower side of the body
  • Pain during sexual intercourse
  • Back pain
  • Urgent and more frequent urination
  • Pain in the lower stomach
  • Feeling full rapidly while eating

The progression of ovarian cancer may result into following symptoms that include –

  • Loss of appetite
  • Nausea
  • Breathlessness
  • Weight loss
  • Fatigue

Although there is no reliable test to detect ovarian cancer, several procedures may help Gyneconcologist diagnose the disease. Screening for ovarian cancer begins with a pelvic exam. The doctor examines the vagina, rectum and lower abdomen for masses or growths.

If the pelvic exam reveals growths on the ovaries, Gyneconcologist can order tests that produce detailed images of the ovaries, as well as other tests and procedures. Depending on the situation, these tests and procedures might include:

  • Ultrasound. Ultrasound uses high-frequency sound waves to produce precise images of structures within the body.
  • CT scan. A CT scan generates two-dimensional images of the body and can show whether the cancer has spread.
  • Positron emission tomographic scan (PET). A PET scan defines areas with altered blood supply and can help to identify cancer.
  • Magnetic resonance imaging (MRI). This test uses magnetic energy to generate highly detailed images of the anatomy, including tumors.
  • Upper G. I. and lower G.I. Scopy - To rule out primary cancer in G. I. Tract.
  • Blood tests. For women who suspect ovarian cancer or who have previously had ovarian cancer, Gyneconcologist often use the CA125 blood test to detect a protein antigen found at abnormally high levels in the blood serum of women who have ovarian cancer.
  • Mammography - To rule out metastatic tumours.
  • Exploratory surgery. Gyneconcologist may use exploratory surgery to confirm a diagnosis of ovarian cancer. They enter the pelvic and abdominal cavities to determine if cancer is present. They may use an instrument that permits a small incision (laparoscopy) or make a larger abdominal incision (laparotomy).

If cancer is present, Gyneconcologist identify the type of tumor and check to see if the cancer has spread. They may remove and examine multiple samples of tissue (biopsies) within the abdomen and may remove some lymph nodes, if necessary. The biopsies help Gyneconcologist determine the stage and extent of the cancer and develop the most appropriate treatment plan for the patient.

Staging ovarian cancer

Gyneconcologist use the results of your surgery in order to determine the extent - or stage - of your cancer. Your doctor may also use information from imaging tests, such as computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET), to determine whether cancer has spread within the abdomen. Your cancer's stage helps determine your prognosis and your treatment options. Stages of ovarian cancer include:

  • Stage I. Ovarian cancer is confined to one or both ovaries.
  • Stage II. Ovarian cancer has spread to other locations in the pelvis, such as the uterus or fallopian tubes.
  • Stage III. Ovarian cancer has spread beyond the pelvis or to the lymph nodes within the abdomen.
  • Stage IV. Ovarian cancer has spread to organs beyond the abdomen, such as the liver or the lungs.

Gyneconcologists treat ovarian cancer, Fallopian tube cancer and peritoneal cancer using several approaches. Commonly, they perform surgery to remove cancerous tumors and determine the stage of your cancer. Patient will likely receive surgery and chemotherapy, and occasionally she may receive radiation therapy. Other potential treatments being evaluated include immunotherapy, bone marrow transplant, gene therapy and hormone therapy.

Surgery

  • Laparotomy. Gyneconcologist perform laparotomy through a large abdominal incision, most often removing your ovaries, uterus, fallopian tubes, nearby lymph glands, a fold of fatty tissue called the omentum and as much of the tumor as possible. This process is known as surgical debulking or cytoreductive surgery.
  • Frozen section tissue analysis. This technique involves rapid analysis of your tissue under a microscope. Surgeons determine in minutes whether your tumor is noncancerous or cancerous, dramatically increasing their ability to perform the most appropriate procedure during the first surgery.
  • Laparoscopy . Laparoscopy is a minimally invasive surgery that may be used depending on the extent of cancer present when your cancer is diagnosed. Researchers are studying this procedure with the goal of using it more frequently.

Chemotherapy

After surgery, you'll most likely be treated with chemotherapy - drugs designed to kill any remaining cancer cells. Chemotherapy may also be used as the initial treatment in some women with advanced ovarian cancer. Chemotherapy drugs can be administered in a vein (intravenously) or injected directly into the abdominal cavity, or both methods of administering the drugs can be used. Chemotherapy drugs can be given alone or in combination.

Radiation therapy

Radiation therapy uses high-energy beams to kill cancer cells. The use of radiation therapy to treat ovarian cancer has declined in recent years, but Gyneconcologist use it in certain cases, such as when patient have a recurrence of cancer at the original site or if she can't tolerate chemotherapy. Gyneconcologist may use whole abdominal radiation to treat ovarian cancer that remains or recurs in the abdomen.



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