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Ovarian cancer is often called the silent killer because many times there are no symptoms until the disease has progressed to an advanced stage, and it becomes too late for treatment.

One-third of American women develop some form of cancer in their lifetime. Approximately 1.5% of those cases will be a cancer involving one or both ovaries, which is huge problem. When we hear so many women have trouble with this disease, it is normal we want to learn as much about ovarian cancer as possible. It is necessary to know the causes, risk factors, and symptoms of ovarian cancer. Many people are also interested in the treatment and prevention of this frightful disease.

Symptoms of ovarian cancer

Early symptoms are often mild, making this disease difficult to detect. Some early symptoms may include an unusual feeling of fullness or discomfort in the pelvic region. Unexplainable indigestion, gas, or bloating not relieved with over-the-counter antacids, pain during sexual intercourse, abnormal bleeding, and swelling and pain of the abdomen are also symptoms of ovarian cancer. Although these symptoms do not necessarily indicate ovarian cancer, if any woman experiences them, she should discuss them with her clinician. Early detection of ovarian cancer offers a 90% cure rate, but, sadly, a lack of symptoms from this silent disease means that about 75% of ovarian cancer cases will have spread to the abdomen by the time they are detected. That is why, unfortunately, most patients die within five years – they did not get the chance to cure this disease.

Risk factors for ovarian cancer

Any woman who has one or more first-degree relatives (mother, sister, daughter) with ovarian or breast cancer is in risk of developing ovarian cancer. A personal history of breast, endometrial, or colon cancers, and a history of infertility or use of fertility drugs are risk factors as well. It is estimated that only 5% to 10% of all ovarian cancers are hereditary, and the rest are sporadic, which means they occur with no known cause. However, women with two or more first- or second-degree relatives (mother, sister, daughter, or grandmothers, aunts) with breast or ovarian cancer may have a significantly increased risk of developing the disease.

Of course, while the presence of one or more risk factors, including hereditary factors, may increase a woman’s chance of developing ovarian cancer, it does not mean that she will get this disease for sure. Any woman concerned about her chances of developing ovarian cancer because she has one or more of the above risk factors, could consider participating in the Ovarian Cancer Screening Program. 

Diagnosis of ovarian cancer

Symptomless ovarian cancer is most often detected during a woman's regular gynecological examination, where the physician palpitates ovaries during pelvic and rectal exam, searching for the presence of ovarian cysts or fibroid tumors. If any abnormalities are noted, he will follow up with further testing which may include an ultrasound and chest X-ray, as well as laparoscopy if needed. There are some new methods for early screening of ovarian cancer currently being investigated, including ultrasound in conjunction with a blood test. The blood test may detect an antigen called CA 125 which has been detected in the blood of women who have ovarian cancer. These tests are useful in evaluating tumor growth, and the ultrasound can detect changes, but it does not give enough information alone to diagnose ovarian cancer. The CA 125 blood test can return positive results when no cancer is present due to some other conditions, such as fibroid tumors, endometriosis, pelvic infection, pregnancy, or other non-gynecological problems. Although these methods of screening for ovarian cancer look promising, further study is needed before either of these tests is routinely used to screen for ovarian cancer diagnose. 

Ovarian cancer prognosis by stage

As with many other types of cancer, the outcome depends on how advanced a patient's cancer is when diagnosed. Between 40-50% of all women diagnosed with cancer of the ovary survive the next 5 years.

Stage 1
Very few clinical trials have been done with stage 1 ovarian cancer, so finding out the statistics on long term survival rates is quite difficult. However, there is a study that about 9 out of 10 women diagnosed with stage 1A and 1B ovarian cancer will be alive 5 years later. This is a general figure and individual situations do vary, because 5-year survival rates may drop below this level, due to women with a poorer outlook because of general ill health, age, or the type of tumor they have.

Stage 2
Between 60-70% women diagnosed with stage 2 ovarian cancer has chance to survive next 5 years, which is confirmed by numerous researches.

Stage 3
As you might expect, the survival statistics fall with these more advanced stages; 15 - 35% women with ovarian cancer diagnosis at this stage will live at least 5 years after their diagnosis. There is a wide range of error, because the figures vary depending on how far the cancer has spread into the upper abdomen, and each woman is different.

Stage 4
Understandably, the survival statistics are lower for stage 4 ovarian cancers than they are for stage 3, where statistics vary quite a bit between reports. This is because this stage covers a lot of different situations; the cancer has spread, but it will have different effects depending on where to it has spread. Around 5% and 14% women with stage 4 ovarian cancer will live for at least 5 years.

Other factors affecting the prognosis of ovarian cancer

There are 2 other factors that can affect prognosis apart from the stage of the cancer, and those are the grade, and how well the woman is overall. Doctors also have a way of grading how well you are, and they call this your performance status. This is relevant to survival because overall, the fitter a woman is, the better will she be able to withstand their ovarian cancer and treatment.

Statistics for ovarian cancer

Doctors collect statistical information about the different types of cancer and prognosis, evaluating the likely outcome of disease and treatment. In other words, chances of getting better and how long a patient is likely to live. Although many people have asked for statistics, not everyone who is diagnosed with cancer wishes to read this type of information. However, it should be clear that statistics are averages based on a large numbers of patients. They cannot predict exactly what will happen to you, because no two patients are exactly alike, and response to treatment also varies from one person to the next. Patients diagnosed with ovarian cancer should feel free to ask their doctor about the prognosis, but not even the doctor can tell for sure what will happen. It is important to know that if you hear your doctor use the term “5-year survival”, this does mean you will only live for the next 5 years! The point is that doctors follow what happens to people for 5 years after the treatment in most research studies, because there is only a small chance that an ovarian cancer could come back 5 years later. The same type of cancer can grow at different rates in different people, so the statistics are not detailed enough to tell us about the different treatments people may have had.

Therapy of ovarian cancer

The most common treatment for ovarian cancer involves surgery and chemotherapy, where the type of surgery depends on the general health of the patient and the extent of the cancer. Most patients diagnosed with ovarian cancer will have surgical procedures that remove the ovaries, fallopian tubes, uterus and as much of the tumor as possible.  This will cause pre-menopausal women to undergo surgical menopause, so a patient could expect typical menopausal symptoms such as hot flashes and vaginal dryness.  They may also be at increased risk of osteoporosis and cardiovascular events, so the patient could discuss with the doctors the use of hormone replacement therapy to relieve some of these symptoms.

Chemotherapy: Most chemotherapy treatments can be administered on an outpatient basis and do not require an overnight stay in the hospital, but there are side effects. The chemotherapy side effects that patients experience generally depend on the type and duration of the treatment regimen for ovarian cancer.
The most common chemotherapy treatment for ovarian cancer is a combination regimen consisting of carboplatinum and paclitaxel administered intravenously over 3-5 hours; the most common side-effects of this type of chemotherapy treatment involve nausea and vomiting. Patients also report hair loss, fatigue, numbness and tingling in the hands and feet, and hearing problems.

Most side-effects are temporary and resolve after the treatment ends; effective anti-nausea medications are usually administered and often relieve these symptoms entirely. Hair loss can be very upsetting to many women, so they might consider turbans or wigs during treatment. It should not be too worrying, because hair generally begins to grow back once chemotherapy stops. There are more side effects such as numbness and tingling in the hands and feet, diarrhea or constipation, taste changes, and an increased risk of infection. It is important that women with ovarian cancer identify their social and emotional support networks during and after treatment for ovarian cancer. It is normal for some patients to feel overwhelmed or depressed at various points during treatment, so friends and family members can play important roles.

Read More: Ovarian Cancer: Treatments, Drugs and Risks

Nutrition during ovarian cancer treatment

Adequate nutrition is very important during cancer treatment, because the food that a woman eats provides nutrients which can help maintain energy levels, heal wounds, and build the immune system.

It is important to try to reach the following goals while going through treatment for ovarian cancer:

- Each woman should maintain her current weight, and if she experiences weight loss during treatment, she should be sure to add extra calories to the food she eats.
- Nutrient dense foods, such as whole milk, jam, honey, oil, and salad dressings may be used to fortify the food she is already eating.
- It is also important to drink adequate amounts of fluids, because this is essential to a body's proper functioning.
- Patients of ovarian cancer should also consume enough protein to maintain a lean body mass, and try to include a protein source with each meal and snack.