The two ovaries are the organs of reproduction in females present in the abdomen. Cancer of the ovaries occurs in older age group.
Cancer of the ovary is the most fatal female cancer, one of the reasons for this being that it cannot be diagnosed early enough.
Causes
No definite cause is known.
Symptoms
· Discomfort in the lower abdomen.
· Swelling of the abdomen, due to the spread of the cancer and presence of fluid.
· Loss of weight.
· Occasional shortness of breath due to presence of fluid in the pleura.
Diagnosis
Routine: Blood: Hb, TLC, DLC, ESR may be almost normal.
Special: Ultrasound examination of the abdomen and pelvic region may show an enlargement of the involved ovary.
CT scan also may show an enlarged ovary. If fluid is present in the abdomen, a little of it is taken for examination for the presence of cancer cells.
Substances produced by cancer cells of the ovary and circulating in the bloodstream arc used for diagnosis of the condition. These substances called * markers’, arc carcinoembryonic antigen (CEA), Alpha-fetoprotein (AFP), Human chorionic gonadotrphin (HCG) and an enzyme Lactate dehydrogenase (LDH). They are found to be increased in ovarian cancer. Estimation of them can help establish diagnosis.
Diagnosis can only be clinched by opening the abdomen and seeing the organ and by biopsy examination.
Treatment
The type of treatment given depends on the stage of the disease.
Surgery: The chance of cure is high with surgery alone in stage I, when the disease is confined to the ovary only. Both the ovaries, the fallopian tubes, as well as the uterus are removed.
Radiation: If the cancer has entered into stage II (i.e. it has spread beyond ovaries but is confined in the pelvic region), after surgery radiation is given with fair chance of success. Radiation is also given in stage HI and TV but the chances of success arc not much.
Chemotherapy: This is given in stage II to TV of the disease. A group of drugs called alkylating agents are given with a good response. These drugs usually given by mouth are taken for two to three weeks each month, for several months, even years.
The side-effects are not much. Some centres give a combination of drugs. The drugs used are:
· Adriamycin
· Cyclophosphamide
· Chlorambucil
· Cisplatin
· Hexamethyl melamine
· 5-Fluorouracil
· Methotrexate
Prognosis
Survival is best in stage I or II of the disease.
Early Detection
Signs & Symptoms
· Discomfort in the lower abdomen.
· Loss of weight.
Investigations
· Ultrasound and CT scan of the ovary.
· Opening the abdomen and examination of the biopsy taken.