Ovarian Cancer : Types, Causes, Symptoms and Stage

Table of Contents

Understanding Ovarian Cancer

Ovarian cancer is one type of cancer that affects the female reproductive system and specifically the ovaries. They are also involved in the production of eggs (ova) and the hormones; estrogen and progesterone. Ovarian cancer is often called the “silent killer” because there are rarely any early symptoms and the cancer is already in its advanced stages when it is actually diagnosed. Here’s an in-depth look at this condition:Here’s an in-depth look at this condition:

1. Types of Ovarian Cancer

Epithelial Ovarian Cancer:- This is the most common type accounting for up to 90% of total cases of Ovarian cancer which is cancer of the ovaries. Cystadenoma arises from the capsule of cells which form the outer layer of the ovary. Epithelial ovarian carcinoma is of many types; serous, mucinous, endometrioid, clear cell type among others.
Germ Cell Ovarian Cancer: One of these is the germ layer that emanates from the cells that give rise to the eggs in the ovaries. Germ cell tumors are few in number and can be estimated to be about 5% of the overall ovary cancer. These tumors are however more frequent in women who are single and of reproductive age, say in their teens and twenties.
Stromal Ovarian Cancer: These tumors are developed in the stroma of the ovary, which has connective tissues and these tumors synthesize and release female sex hormones such as estrogen and progesterone. Four subgroups of ovarian carcinoma are; surface and stromal carcinomas affecting about 5% of the ovarian cancer may cause hormonal like symptoms like vagal bleeding and early maturity in females.

2. Causes and Risk Factors

Here’s a detailed explanation of the Causes and Risk Factors for ovarian cancer, broken down by each point:Here’s a detailed explanation of the Causes and Risk Factors for ovarian cancer, broken down by each point:

1. Genetic Mutations

BRCA1 and BRCA2 Mutations: These genes assist in fixing ailment DNA for the purpose of normalcy of cells to grow. When mutated they can also heighten the dangers that are associated with ovarian cancer amongst others. BRCA1 mutated women have had a 35-70% lifetime ovarian cancer risk while women with BRCA2 mutations have had 10-30%. These mutations are inherited and therefore one can be born with this condition thus inherited from the parents. Women with a family history of breast or ovarian cancer will usually be genetically screened for these gene mutations.
Lynch Syndrome: This familial inherited cancer predisposition syndrome also termed Lynch Syndrome or hereditary nonpolyposis colorectal cancer (HNPCC) is associated with ovarian cancer amongst others. Lynch syndrome hospitalized women has a lifetime risk of ovarian cancer to be between 10-12%.

2. Family History

The relative risk increases significantly where there is a family history of ovarian cancer especially from first-degree relatives. This often suggests inherited mutations on genes for instance BRCA1 or BRCA2. But if there are two or more family members that have had cases of ovarian or related diseases like breast or colorectal, the risk is even higher.

3. Age

Ovarian cancer affects women of post menopausal age of above 50 years, and has a tendency to increase with increasing age. The age of diagnosis is about 63 years old and the disease strikes very seldom in those below 40 years of age. It most commonly affects postmenopausal women, but age is another considerable risk factor, for the older one is the higher the risks are.

4. Reproductive History & menstrual factors

Early Menarche and Late Menopause: Those who begin menstruation early, before 12 years of age, and those who have menopause late, after 50 have more ovulatory cycles in their lifetime. The more cycles of ovulation a woman goes through, the more the tissues of the ovaries are subjected to hormonal changes which put her at risk of ovarian cancer.

Nulliparity (Never Having Given Birth): Those women who have no history of pregnancy or pregnancy history at an advanced age have high risks. Pregnancy causes some changes in the ovulation process that leads to the decrease in the frequency in which the ovaries are exposed to estrogen. Some survey studies that attempted to correlate conditions affecting the risk of ovarian cancer with parity suggested that the risk factor was inversely proportional to the number of pregnancies, particularly of multiple pregnancies, carried by a woman.
Fertility Treatment: Research shows that women who receive fertility treatments, especially those treatments that aim at inducing ovulation, could be at a slightly higher risk… Still, the general risk seems rather low and might be compensated by the positive outcomes of the fertility treatment.

5. Hormone Replacement Therapy (HRT)

Hormone replacement therapy is another known risk factor associated with ovarian cancer especially in women who have gone through menopause and are on estrogen-only therapy. Long-term use of HRT has been seen to boost this risk. The elderly women are more vulnerable to increased risk than the women undergoing combination HRT that is estrogen with progesterone. But this risk is reduced as soon as hormone therapy is not used any longer.

6. Weight status including obesity and Body Mass Index (BMI)

Specifically, the body mass index which is calculated from one’s weight and height and is expressed in kilograms per meter squared of 30 and above is associated with increased risk of ovarian cancer. Over-accumulation of body fat can result in increased estrogen levels thus potentially causing ovarian cancer. It also produces a detrimental effect on survival because women who are overweight are likely to have poor prognosis when they are diagnosed with ovarian cancer.

7. Lifestyle Factors

Smoking: Tobacco smoking has been said to only be connected with mucinous ovarian cancer, a variation of the disease. Cigarette smoking exposes the body to bad chemicals which may lead to mutations in the ovarian cells hence promoting the growth of cancerous tissues.
Diet: Diet has not been directly connected to ovarian cancer, however, eating foods with high amounts of animal fats and processed foods may be a risk factor. On the other hand, high intake of fruits, vegetables, fiber and others may provide some elements of protection.

8. Endometriosis

Endometriosis is a condition, where the layer of tissue that normally covers the uterus (endometrium) is present outside the uterus, and is capable of causing pain. The risk associated with this condition is that a woman is vulnerable to endometrioid and clear cell ovarian cancers. The continuous inflammation and irritation that endometriosis causes to the ovaries may be a possible reason for normal cells to develop into cancerous cells.

9. Talcum Powder Use

There is evidence that using talcum powder in the genital area is a cause of a slightly elevated risk of ovarian cancer. It is postulated that talc particles move from the uterus to track the Fallopian tubes and finally lodge in the ovaries where they bring about inflammation that may result in malignant transformation. Even though this link is not conclusive there are existing health organizations that suggest that use of talcum powder should be done sparingly.

10. Breast Cancer

It has been established that women who have gone through breast cancer have high chances of getting ovarian cancer especially if they are the carrier of the BRCA I or BRC AII gene. Both of these cancers are found to be closely related genetically; thus any woman with breast cancer, especially one diagnosed after breast cancer before the age of fifty years should look out for signs of ovarian cancer. It is said that female carriers of BRCA mutations or BRCA genes go for more frequent cancer checks.

11. Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder which affects women and is characterized by large ovaries with small cysts. These women have other issues such as irregular menstrual cycle, high levels of androgens or male hormones and difficulty in ovulating. The condition of PCOS may elevate the probability of ovarian cancer but the risk factor of the disease is weaker in such a case. The hormonal disorders and chronic sequelae of ovulation that characterize PCOS may be the cause of ovarian cancer.

12. Previous Cancer Treatment

There is also evidence that women, who had radiation therapy for other cancers especially in the pelvic region, have a slightly higher risk of developing ovarian cancer in the later stages of their lives. In particular, radiation is able to damage ovarian cells, which may mutate in several years and form cancer.

13. Environmental and Occupational Exposure

Another possible risk factor is the worker’s exposure to carcinogenic materials, especially asbestos. Asbestos which is used in areas such as construction can be ingested or inhaled to result in inflammation and scarring of body tissues/ organs including the ovaries. They can go and affect cells in the ovaries and stimulate some changes that are likely to cause formation of cancer.

3. Symptoms of Ovarian Cancer

1. Abdominal Bloating or Swelling

Persistent and Unexplained Bloating: It is one of the typical signs that a woman has ovarian cancer. The symptom that needs particular concentration is bloating; many women with ovarian cancer will have this for a long period of time, and although it could be normal bloating, it is much worse than the typical bloating menstruating, or experiencing gastrointestinal issues, brings. This swelling could be as a result of formation of fluid in the abdominal cavity known as ascites as a result of spread of cancer to the abdominal area.
Increased Abdominal Size: Some women may feel that the fitting of the clothes they wear or even the waistband feels tighter than before despite them not having put on some weight. This variation in the size of the abdomen is mostly asymptomatic and should therefore be reviewed, especially where it is persistent.

2. Pelvic or Abdominal Pain

Persistent Pain: Pelvic or abdominal pain which persists for weeks is also an early sign of ovarian cancer. Fibro pain is usually characterized as being intermittent and non-cyclical, and may be sharp or a dull ache, which is often confused with menstrual cramps, irritable bowel syndrome or other gastrointestinal disorders.
Pressure and Discomfort: Dysphoria may be experienced as an ovarian tumor develops in size to compress the neighboring organs and tissue which will manifest as discomfort or fullness in the lower abdomen or pelvis area. This pressure can also result in what is referred to as referred pain in the back or legs.

3.Difficulty Eating or Feeling Full Quickly

Loss of Appetite: It’s demonstrated by early satiety, a condition whereby one feels full even after eating a small portion of food. This is due to the fact that the tumor which is situated in the abdominal cavity puts pressure on the stomach and other features of the digestive tract, so women cannot consume larger portions of food.
Weight Loss or Unintentional Weight Changes: Whereas some women might find themselves shedding some weight because of reduced appetite, others will find themselves gaining more weight in particular parts of the body such as the belly, which might be as a result of fluid retention in the form of ascites. Such modifications can happen without much alteration of the eating habits.

4. Urinary Symptoms

Increased Frequency of Urination: Another early sign of ovarian cancer is being affected with a condition that causes you to have to urinate very often. This symptom is usually not distinguishable from a typical urinary tract infection, or other types of bladder disorders.
Urgency: Another sign of ovarian cancer is the uncontrolled urge to urinate on an unjustified basis irrespective of the bladder content. This occurs due to the intensity of the growing tumor putting a pressure on the bladder.

5. Fatigue

Chronic and Unexplained Fatigue: The different symptoms of ovarian cancer include fatigue and the affected women will always feel extremely exhausted than usual and this is not a result of hard work or stress. This symptom can be masked and therefore, most people fail to recognize it but it worsens when the disease has advanced.
Loss of Energy: Treatment related fatigue in women with ovarian cancer may be different from the general fatigue and may affect normal functioning.

6. Changes in Bowel Habits

Constipation or Diarrhea: Some of the changes in bowel movements are decreased bowel movements or constipation that are apparent for ovarian cancer symptoms. Gradually the tumor may compress the intestines and this will become difficult for one to pass stool. Also, some women may suffer from changing bowel habits which will include constipation and diarrhea at different times.
Feeling of Incomplete Bowel Movements: Some of the symptoms of ovarian cancer include, women with the condition may have the feeling that they have not evacuated their bowels fully, after using the latrine. This symptom is quite non-specific and can be attributed to many other conditions of the gastrointestinal tract but any durability of this symptom one should consider medical check-up.

7. Unusual Vaginal Bleeding

Postmenopausal Bleeding: Although ovarian cancer typically has an intestinal and urinary profile, some of the women may present with vaginal bleedings particularly after menopause. Vaginal bleeding after menopause is always abnormal and should be investigated,” This is a saying every doctor will literally enshrine in his/her heart.
Irregular Periods: For postmenopausal women, ovarian cancer signs include: There’s no regular period or normal periods are irregular Weight loss or gain that isn’t due to diet or exercise changes New vague abdominal pain or pelvic pain that doesn’t go away Feels full quickly or has trouble eating certain foods that they were able to eat before In premenopausal women, symptoms may include: Irregular periods or bleeding between periods. Even though this symptom is not very frequent, it may be present in combination with other signals.

8. Back Pain

Lower Back Pain: Lower back pain that lasts for several days that can be unrelated to any physical exercise or injury might be a sign of ovarian cancer. The pain can be boring and constant or occasional and severe. The pain felt in the back is only felt when the tumors grow to a size that they will compress nerves or muscles in the back.
Referred Pain: Thus, as the cancer grows and spreads to the pelvis or abdomen the pain may refer to the lower back or legs.

9. Pain During Intercourse

Dyspareunia: It is also important to note that some woman who suffer from ovarian cancer may have pain while making love. This pain may be as a result of pressure from the tumors on the pelvic organ or when the tumors extend to the reproductive organs. If a woman feels pain during intercourse especially if it is a new pain she should report it to a doctor or a physician.

10. Menstrual Changes

Changes in Menstrual Cycle: While ovarian cancer is often diagnosed in post menopausal women, pre menopausal women complain about menstrual irregularities, heavier than normal, lighter than normal, no periods for the first time, or frequent periods than normal. Such changes, in other words, should be indicative of the need for further examination when coupled with other symptoms.

11. Breathing Issues

Shortness of Breath: Last but not the least, the late stage of ovarian cancer may result in pleural effusion-lung congestion, which is manifested in shortness of breath. They checked this symptom as a rule appearing in the later stages of the disease but possibly one of the first signs of an advanced tumor.
Chest Pain: Women can also have chest pain or discomfort due to the formation of the fluid which affects the lungs’ expansion process.

12. Ascites (Fluid Buildup in the Abdomen)

Abdominal Swelling: Abdominal distension is a typical sign of the disease that can occur at the final stages of ovarian cancer: the presence of liquid in the abdominal cavity called ascites, or free fluid as seen in the image below. This can lead to pronounced edema, an impression of voluminousness and shame.
Difficulty Breathing: It can also cover the diaphragm with pressure reducing the ability to breathe especially when lying down. This is usually found in the post primary stages of ovarian cancer but it may be an indication of the advancement of the disease.

13. Unexplained Weight Loss or Gain

Rapid Weight Gain: The symptoms are basically the same as for any other ovarian cancer, including sudden, unexplained weight gain owing to ascites that lead to accumulation of fluids in the abdomen causing swelling and bloating.
Unintentional Weight Loss: Sometimes, ovarian cancer causes an individual to lose the ability to eat because of malnutrition or metabolic change, and since the cancerous tissues intercede and modify the normal pathways of digestion they may lead to weight loss.

14. Indigestion or Nausea

Persistent Indigestion: Indeed, women with ovarian cancer suffer from disordered eating, constant indigestion, heartburn or even nausea. These symptoms are because the growing tumor may affect digestion and compress the stomach.
Feeling of Fullness or Discomfort After Eating: Women also may have the feeling that the stomach is full even if they took only a small meal where the tumor is exerting pressure to the digestive organs.

3. Stages of Ovarian Cancer

Ovarian cancer progresses through several stages:Ovarian cancer passes through various phases which entail the following;

Stage I: It occurs to one or both the ovaries with the cancer being localized on these glands.
Stage II: This cancer has usually spread to the other organs of the pelvis, when it reaches out for other organs in the pelvic region such as the uterus or the fallopian tubes.
Stage III: Cancer has also affected lining or tissue of abdomen or lymph nodes lining or tissue.
Stage IV: They of course know that the cancer has moved to other internal organs, say the liver or the lungs.

The stage of cancer at the time of its diagnosis impacts the types of treatment that the patient is likely to receive and his or her probability of survival.

Conclusion

There is a need to be aware of its nature, causes, signs and therapies as ovarian cancer has almost no early symptoms. Risk reduction includes refusing carcinogens and implementing the alteration of diet as well as genetic testing. It is crucial for early detection by use of diagnostic methods like pelvic examination and CA 125 tests,bUt this is difficult.

Follow up care is also essential for patients, which includes regular check-ups, dealing with side effects and seeking counseling or other practical support. Friendly words and practical assistance from doctors, close ones, and members of support communities raise the patients’ quality of life.

From more research and progress in treatments it can be understood that a more holistic approach to the diagnosis, early detection, and care for the patients diagnosed with ovarian cancer can improve rates of survival in these patients.