<p>Ovarian cancer is the 7th most common cause of death and morbidity among women worldwide. In India, it is the 3rd most common cancer affecting nearly 60,000 women every year and its incidence only keeps rising. It is a highly aggressive cancer that has a very high fatality ratio. In most cases, it remains silent or goes unnoticed for a long time. It can occur in different parts of the ovaries without any prominent symptoms— a patient can experience abdominal bloating, dyspepsia (indigestion) and sometimes even urinary complaints. These are common symptoms of many other problems; therefore, it becomes difficult to identify ovarian cancer at an early stage. However, the only effective way to defeat the cancer is early diagnosis and timely intervention.</p>.<p><strong>What is ovarian cancer?</strong></p>.<p>Ovaries are a pair of organs that are part of the female reproductive system. Ovarian cancer is a disease in which cancer cells form in the tissues covering the ovaries. It usually affects women in their post-menopausal age, presents with very vague symptoms which are often ignored. These symptoms can be bloating or dull aching pain in the abdomen, increase in abdominal girth, indigestion, feeling of fullness even after small meals and urge to urinate frequently. More commonly, these symptoms are attributed to ailments like acidity and mistakenly alternative treatment is sought. Ovarian cancer lacks a definitive symptom or sign, it vague nature of symptoms usually lead to the patients consulting an Oncologist when they’ve reached an advanced stage.</p>.<p><strong>Signs and symptoms:</strong></p>.<p>Pain in the pelvis, lower side of the body, in the lower stomach</p>.<p>Back pain</p>.<p>Indigestion or heartburn</p>.<p>Feeling full rapidly when eating</p>.<p>More frequent and urgent urination</p>.<p>Pain during sexual intercourse</p>.<p>Changes in bowel habits, such as constipation</p>.<p>As ovarian cancer progresses these symptoms are also possible: Nausea, weight loss, breathlessness, fatigue (tiredness) and loss of appetite</p>.<p><strong>Prevalence in India</strong></p>.<p>In around 10% of women, there is a family history of ovarian cancer or certain inherited genetic changes such as impaired BRCA1 /2 genes. This population has a higher risk of developing ovarian cancer. BRCA1/2 are two protective genes and change in the structure of these genes can cause multiple cancers in our body, primarily impacting the breast and ovaries. This group of women should consult an oncologist and undergo cancer risk assessment with genetic counselling and testing to find out how likely they are to develop ovarian cancer. Women with proven increased risk for ovarian cancer may undergo surgery to remove their ovaries prior to the development of cancer. Use of Hormone Replacement Therapy (HRT), being overweight, smoking, nulliparity, early onset of menarche and endometriosis are other risk factors for ovarian cancer. On the other hand, childbirth, breastfeeding, physical exercise, consumption of oral contraceptives, Salpingectomy (removal of Fallopian Tubes), and tubal ligation can protect one from ovarian cancer.</p>.<p>Early diagnosis is most crucial for achieving a long-term cure. In ovarian cancer, 5-year survival is only 45% due to the advanced nature of the disease on presentation. So, women need to be more conscious of these symptoms and seek help from an oncologist within a year of the onset of it. Commonly used tests for screening are clinical examination, ultrasound, and CA 125. However, timely treatment is also essential. Treatment of ovarian cancer depends on the stage of cancer, the type of cells involved, overall health, and the age of the patient. Methods majorly used to treat Ovarian Cancers include surgery, chemotherapy and radiation therapy. For prevention, all women should get their blood calcium levels monitored on regular basis. If the levels are high, then there is an increased risk. While contraceptive pills are usually dogged by controversies and myths, they are effective in protecting women from developing ovarian diseases. These must be taken after consulting a doctor. Women with a family history of cancer of colon, prostate or uterine should never ignore symptoms.</p>.<p><em>(The writer is a Consultant, Surgical Oncology, at a Mumbai-based hospital)</em></p>
<p>Ovarian cancer is the 7th most common cause of death and morbidity among women worldwide. In India, it is the 3rd most common cancer affecting nearly 60,000 women every year and its incidence only keeps rising. It is a highly aggressive cancer that has a very high fatality ratio. In most cases, it remains silent or goes unnoticed for a long time. It can occur in different parts of the ovaries without any prominent symptoms— a patient can experience abdominal bloating, dyspepsia (indigestion) and sometimes even urinary complaints. These are common symptoms of many other problems; therefore, it becomes difficult to identify ovarian cancer at an early stage. However, the only effective way to defeat the cancer is early diagnosis and timely intervention.</p>.<p><strong>What is ovarian cancer?</strong></p>.<p>Ovaries are a pair of organs that are part of the female reproductive system. Ovarian cancer is a disease in which cancer cells form in the tissues covering the ovaries. It usually affects women in their post-menopausal age, presents with very vague symptoms which are often ignored. These symptoms can be bloating or dull aching pain in the abdomen, increase in abdominal girth, indigestion, feeling of fullness even after small meals and urge to urinate frequently. More commonly, these symptoms are attributed to ailments like acidity and mistakenly alternative treatment is sought. Ovarian cancer lacks a definitive symptom or sign, it vague nature of symptoms usually lead to the patients consulting an Oncologist when they’ve reached an advanced stage.</p>.<p><strong>Signs and symptoms:</strong></p>.<p>Pain in the pelvis, lower side of the body, in the lower stomach</p>.<p>Back pain</p>.<p>Indigestion or heartburn</p>.<p>Feeling full rapidly when eating</p>.<p>More frequent and urgent urination</p>.<p>Pain during sexual intercourse</p>.<p>Changes in bowel habits, such as constipation</p>.<p>As ovarian cancer progresses these symptoms are also possible: Nausea, weight loss, breathlessness, fatigue (tiredness) and loss of appetite</p>.<p><strong>Prevalence in India</strong></p>.<p>In around 10% of women, there is a family history of ovarian cancer or certain inherited genetic changes such as impaired BRCA1 /2 genes. This population has a higher risk of developing ovarian cancer. BRCA1/2 are two protective genes and change in the structure of these genes can cause multiple cancers in our body, primarily impacting the breast and ovaries. This group of women should consult an oncologist and undergo cancer risk assessment with genetic counselling and testing to find out how likely they are to develop ovarian cancer. Women with proven increased risk for ovarian cancer may undergo surgery to remove their ovaries prior to the development of cancer. Use of Hormone Replacement Therapy (HRT), being overweight, smoking, nulliparity, early onset of menarche and endometriosis are other risk factors for ovarian cancer. On the other hand, childbirth, breastfeeding, physical exercise, consumption of oral contraceptives, Salpingectomy (removal of Fallopian Tubes), and tubal ligation can protect one from ovarian cancer.</p>.<p>Early diagnosis is most crucial for achieving a long-term cure. In ovarian cancer, 5-year survival is only 45% due to the advanced nature of the disease on presentation. So, women need to be more conscious of these symptoms and seek help from an oncologist within a year of the onset of it. Commonly used tests for screening are clinical examination, ultrasound, and CA 125. However, timely treatment is also essential. Treatment of ovarian cancer depends on the stage of cancer, the type of cells involved, overall health, and the age of the patient. Methods majorly used to treat Ovarian Cancers include surgery, chemotherapy and radiation therapy. For prevention, all women should get their blood calcium levels monitored on regular basis. If the levels are high, then there is an increased risk. While contraceptive pills are usually dogged by controversies and myths, they are effective in protecting women from developing ovarian diseases. These must be taken after consulting a doctor. Women with a family history of cancer of colon, prostate or uterine should never ignore symptoms.</p>.<p><em>(The writer is a Consultant, Surgical Oncology, at a Mumbai-based hospital)</em></p>