A form of cancer known as epithelial ovarian cancer has been diagnosed in girls as young as age 15. Epithelial ovarian cancer is a metastatic disease of the tissues covering the ovary (or ovaries). Surgical removal of the cancer and at least some surrounding tissue is considered essential to stopping the cancer. This surgery may be a:
- Unilateral salpingo-oophorectomy: Surgery to remove one ovary and one fallopian tube.
- Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
- Omentectomy: Surgery to remove the omentum (a piece of the tissue in the lining of the abdominal wall).
- Lymph node biopsy: The removal of part or all of a lymph node. The pathologist examines the tissue under a microscope to look for cancer cells, sometimes during the surgery
- Total hysterectomy: An operation to remove the uterus and cervix. If the uterus and cervix are removed through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are removed through a large incision in the abdomen, the procedure is called a total abdominal hysterectomy. If the uterus and cervix are removed through a small incision in the abdomen using a device called a laparoscope, the operation is called a total laparoscopic hysterectomy.
After surgery, there may be radiation therapy. Sometimes doctors use a procedure called intraperitoneal radiation therapy, in which a radioactive liquid is perfused directly into the abdomen. There may be chemotherapy with one or more chemotherapy agents. Chemotherapy may also be delivered directly to the abdomen through a thin tube called a catheter, in a procedure known as intraperitoneal chemotherapy. Women with this form of cancer may receive biological agents or targeted therapies, chosen on the basis of genetic testing.
Epithelial ovarian cancer has a 90 percent five-year survival rate when it is caught at stage I, before it has spread to the lymphatic system and organs elsewhere in the body. Another form of ovarian cancer known as a germ cell tumor, or dysgerminoma, accounts for only 2 percent of all ovarian cancers but is most common among women under 30. It can sometimes be treated without hysterectomy, sparing the ability to bear children in the future. Either way, it is necessary to recognize symptoms of the disease at the earliest possible stage. Here's what to look for.
- Epithelial tumors and dysgerminomas usually cause worse symptoms on one side than the other.
- A dysgerminoma can be felt by palpating the abdomen. An epithelial tumor
- In women under 30, urinary problems (a feeling of needing to urinate some more even after urinating, urinating just a little but very often, not urinating at all until you just "have to go") are more common than digestive complaints (vomiting, nausea, flatulence).
- Feeling full after eating just a little may occur in this kind of tumor.
- Ovarian tumors can appear even during pregnancy.
- Tumors that cause specific symptoms (problems with urination, failure to have a period, one-sided pain) are usually easier to treat than tumors that cause vague symptoms (nausea, vomiting, fullness). A tumor that causes torsion (a tendency to twist the ovaries and even the uterus) is easier to treat, usually, than one that does not.
For older women, there may be a surgical way to prevent the more aggressive forms of ovarian cancer usually diagnosed after the age of 50. Most aggressive ovarian cancers originate in the fallopian tubes. Since women at the age of 50 are not going to have any more children any way, a surgical procedure called a salpingectomy, the removal of just a fallopian tube, may prevent many cases of ovarian cancer. Women who are at higher risk of ovarian cancer because of genetics or a history of endometriosis (women who have endometriosis have a higher lifetime risk of developing ovarian cancer) may be able to reduce the risk of cancer with this procedure.
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