Narayana Health Care

The almond-shaped ovaries are one of the parts of the primary female reproductive organ. Ovaries produce and store eggs in them and ovulate one egg or more during each reproductive cycle. They also secrete female hormones, which are crucial for reproductive functioning.

Cancer is a condition in which cells of any organ start proliferating uncontrollably, leading to the formation of growth or mass (tumor), which can be non-cancerous (benign) or cancerous (malignant).

Ovarian cancers are a group of conditions characterizes as an abnormal growth of cells in the ovaries or the surrounding areas of fallopian tubes or peritoneum. Ovarian cancer is an emerging concern related to the female reproductive organ.

Symptoms of ovarian cancer

In the early stage, ovarian cancer does not show or has few symptoms. So you must beware of any change or signs in your body. Sometimes, the symptoms of ovarian cancer resemble other conditions, such as irritable bowel syndromes, bladder-related problems, or premenstrual syndrome. But if symptoms are constant and worsen with time, you should consult your doctor to rule out the prime cause.

Early symptoms of ovarian cancers are:

• Pain and discomfort in the lower abdomen and pelvic area
• Abnormal vaginal discharge or bleeding
• Changes in the menstrual cycle, such as heavy or irregular periods
• Distended abdomen and indigestion
• Quickly feeling full while eating and loss of appetite
• Pain in the lower back
• Alteration in bowel routine such as constipation
• Frequency of urination increases
• Some may feel pain during sexual intercourse
• Unexplainable weight loss
• Nausea and vomiting
• Tiredness

When ovarian cancer metastasis to other organs, you can feel symptoms of the related organ also. If any of these symptoms persist for more than two weeks, consult your healthcare provider.

Risk factors of ovarian cancer

Ovarian cancers are not common cancer. Following are some risk factors for ovarian cancers:

• Family history of ovarian or breast cancer
• Previous history of breast cancer
• Pregnancy after 35 years of age
• Multiple miscarriages
• Having a BRCA1 or BRCA2 gene mutation
• Hormonal replacement therapy (HRT) after menopause
• Frequent intake of hormonal medications and infertility treatment
• Endometriosis
• Obesity
• Increase with age

Diagnosis of ovarian cancer

To rule out ovarian cancer, your doctor may suggest some investigation, such as:

• A brief history of experiencing symptoms
• A thorough personal, family, and medical history
• Blood test: Your doctor may suggest a blood test to distinguish the ovarian cancer marker CA-125. It is a blood protein that increases in an advanced ovarian tumor. The protein CA-125 test is more accurate in postmenopausal ovarian cancer cases and is deceptive in early ovarian cancer. This test also helps observe the progress and effectiveness of treatment and detect recurrence of ovarian cancer after treatment.
• Pelvic examination: The examiner places one or two fingers into your vagina and another hand on the abdomen for inspection. It interprets the size, shape, and position of both ovaries. Pelvic examination rarely detects ovarian cancer in the early stage.
• Transvaginal ultrasound: A doctor can visualize a woman’s reproductive organs, bladder, cysts, and any mass or irregularities in the ovaries. The examiner inserts a probe into the vagina, which sends sound waves. The computer receives these sound waves and turns them into a picture. The doctor can detect any abnormalities in these pictures.
• Recto-vaginal or bimanual pelvic examination: The doctor can identify and inspect any abnormalities in the pelvic area, including ovaries, fallopian tubes, uterus, cervix, anus, and rectum, through the bimanual exam.
• Genetic testing: your healthcare provider recommends genetic counseling and testing if you have epithelial ovarian cancer. The most commonly mutated genes are BRCA1 and BRCA2. Other ovarian cancers are due to mutation in other genes, including the NTRK gene, ATM, MSH2, MSH6, MLH1, PMS6, BRIP1, and RAD51C and RAD51D.
• Computerized tomography or CT scan: A doctor gets a three-dimensional picture of the organ of interest with the help of a CT scan. It helps to recognize the outer periphery of the cancerous mass and its extension to surrounding areas. CT scan also helps monitor the progress of treatment and recurrence of cancer.
• Positron emission tomography (PET) scan: It can diagnose whether the abnormal areas or masses are cancerous or not, as cancerous cells uptake radioactive glucose differently from normal cells, and a PET scan detects it efficiently.
• Biopsy: It is a confirmative test to know the presence of ovarian cancer. In this procedure, the doctor takes an ovarian tissue sample with the help of laparoscopic surgery. After that, a lab pathologist examines the tissue for the presence of cancerous cells.

The diagnosis of ovarian cancers at early stages is crucial. So you should be aware of your body, and if you feel any changes or symptoms, you should consult your gynecologist. Annual screening helps in the early detection of any abnormalities, and ovarian cancers have a higher survival rate in early detection.

Dr. Satinder Kaur, Clinical Lead and Senior Consultant – Gynaecology – Oncology, Oncology, Dharamshila Narayana Superspeciality Hospital, Delhi