Ovarian Cancer.

Ovarian cancer occurs when a cancerous tumor is in a woman’s ovary. In most cases, there are no known causes. There are often no symptoms, but ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, and nausea and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy.

Symptoms.

Ovarian cancer does not cause many symptoms in its early stages. This is why most cases are not found until the cancer has spread. Most women do have symptoms in the 6 to 12 months before ovarian cancer is found. Symptoms that occur in later stages are most likely caused by the pressure of the growing cancer. Symptoms include:

- Ongoing cramps or pain in your belly.
- Ongoing pain in your pelvis or lower back.
- Abnormal bleeding from your vagina, especially after menopause if you are not using
any hormonal medicines.
- Abnormal discharge from your vagina, containing mucus that may be tinged with
blood.
- Pain or bleeding during sex.
- Nausea or loss of appetite, or you cannot eat normally.
- Ongoing bloating or intestinal gas that is not relieved by home treatment measures.
- Bigger belly size or a lump that can be felt in your belly.
- Decreased energy level.
- A change in your bowel habits, such as constipation or diarrhea.
- A change in your bladder habits, such as urinary frequency or urgency.
- Weight loss.

Diagnosis.

There are no reliable screening tests for ovarian cancer. Ovarian cancer is confirmed and staged by biopsies that are taken during laparotomy surgery.

Some initial exams and tests are done before surgery if ovarian cancer is suspected. These tests include:

- Your medical history, to check what symptoms you have and what your chance of developing ovarian cancer is.
- A physical exam, including a pelvic exam and Pap test. An ovarian lump may be felt during a pelvic exam. A rectovaginal exam may also be done to feel the pelvic organs.
- A complete blood count (CBC), to check for anemia and other abnormal blood values.
- A chemistry screen to check for liver and kidney problems.
- A human chorionic gonadotropin (hCG) level may be done to rule out pregnancy or an ectopic pregnancy.
- A cancer antigen 125 (CA-125) level, to measure a protein found on the surface of many ovarian cancer cells.
- A pelvic and transvaginal ultrasound to look for an ovarian lump.

Additional tests may be done before surgery to determine if other areas of the body are involved. These tests include:

- A pelvic or abdominal CT scan or MRI to check for the spread of cancer.
- A chest X-ray to check for the spread of cancer.

Early Detection.

For most women, the United States Preventive Services Task Force (USPSTF) does not recommend having a CA-125 blood test or a transvaginal ultrasound to find ovarian cancer early. There is no evidence that having regular tests helps women live longer by finding ovarian cancer early. Still, experts recommend that women who have inherited a BRCA gene change and have not had their ovaries removed have a transvaginal ultrasound and a CA-125 blood test at least once a year, starting at age 35. Women who have inherited a BRCA1 gene change (not a BRCA2 gene change) may want to start having these regular tests as early as age 25.

Treatment.

The choice of treatment and the long-term outcome (prognosis) for women who have ovarian cancer depends on the type and stage of cancer. Your age, overall health, quality of life, and desire to have children (preserve fertility) must also be considered.

- Surgery is done to confirm and treat cancer. Removal of all cancerous tissue and taking biopsies to check for the spread of cancer (surgical staging) is important for diagnosis and treatment, because the amount of cancer remaining (residual cancer) after the initial surgery may affect your outcome.

- Chemotherapy, which uses medicines to kill cancer cells, is recommended after surgery for most stages of ovarian cancer. Recent studies show that the addition of chemotherapy after surgery improves the outcome for some early-stage ovarian cancer. Chemotherapy is also recommended for all other stages of ovarian cancer. Chemotherapy that is given after a surgery is called adjuvant therapy.

Source.