Ovarian Cancer

Symptoms

In early stages, ovarian cancer usually presents no symptoms or very vague complaints, such as:

• Abdominal fullness
• Heaviness
• Bloating after eating food
• Loss of appetite

In late stages, symptoms may include:

• Abdominal distension
• Urinary complaints
• Altered bowel habits

Sometimes, ovarian tumors are found incidentally during an ultrasound.

Risk Factors

• Family history of ovarian and breast cancer
• Genetic mutations like BRCA1 and BRCA2
• Early menarche
• Late menopause
• Unmarried women or women with no children
• Late childbirth
• Multiple infertility treatments using ovulation induction drugs

Protection

• Using oral contraceptives for 5 years reduces the risk of ovarian cancer by 50%.
• First pregnancy before the age of 25 years.
• Breastfeeding also reduces the risk of ovarian cancer.

Reason for Delayed Diagnosis

Due to vague symptoms, ovarian cancer is often diagnosed at an advanced stage. Regular screening with annual abdominal ultrasounds after the age of 40 in the general population, and 10 years earlier in cases of family history of breast or ovarian cancer, or BRCA gene mutation positivity, helps in early detection of ovarian cancer.

Tests

There is no single specific test to screen for ovarian cancer. Diagnosis is made using:

• Examination
• Ultrasound
• Tumor markers like CA 125, Alpha FP, Beta HCG, HE4
• CT Scan / MRI / PET-CT

Treatment

Treatment involves staging through surgery, which includes:

• Staging laparotomy
• Removal of ovarian mass
• Total hysterectomy
• Bilateral salpingo-oophorectomy
• Total omentectomy
• Pelvic and para-aortic lymphadenectomy
• Cytoreduction

Treatment involves a combination of surgery and chemotherapy. The sequence depends on the stage of the disease:

• In early stages, surgery is performed and may be followed by chemotherapy.
• In advanced stages, both surgery and chemotherapy are used depending on the patient’s general condition.

Follow-Up

Every cancer requires follow-up, as there is always a chance of recurrence even after treatment. Regular follow-ups help detect recurrence early. The recommended schedule is:

• Once every 3 months for the first 2 years
• Once every 6 months for the next 3 years
• Annually for life