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Ovarian Cancer - The Silent Killer

It is a silent killer and stalks women young and old. Ovarian cancer is extremely difficult to detect as it displays no symptoms during the early stages, when all a sufferer may feel is mild abdominal discomfort or bloatedness. Consequently, about seven in 10 women with the disease are diagnosed only after the cancer has spread and is very difficult to treat successfully.

Ovarian cancer is triggered by the rapid growth and division of cells within one or both ovaries, the reproductive glands that produce eggs and female sex hormones. Under normal circumstances, the ovaries contain cells that reproduce to maintain tissue health but when these cells divide too much and too fast, a tumour is formed. This tumour may be benign or cancerous.

Experts say early detection offers a 90 per cent cure rate, but no effective method of screening for ovarian cancer has yet been devised. The disease is most often detected during regular gynaecological examinations, when the doctor looks for the presence of ovarian cysts or fibroids. If any abnormalities are noted, then further tests will be ordered.

Other methods include a blood test, which may detect an antigen called CA125, which is usually present in the blood of women with ovarian cancer. However, the CA125 blood test is unreliable as it can return positive results when no cancer is present. Doctors say the recovery rate of patients depends on the type of ovarian cancer and how far it has spread before it is diagnosed.

Three Main Types Of Ovarian Tumours

There are three main types of ovarian tumours, each named according to the type of cells that give rise to the cancer, and whether it is benign or cancerous:

Epithelial Ovarian Cancer

Develops from the cells that cover the outer surface of the ovary. Most of these tumours are benign. The cancerous tumours, however, are the most deadly of all types of ovarian cancers and account for 85 to 90 per cent of all cancers of the ovaries. The standard treatment for women with epithelial ovarian cancer is surgery to remove the tumour. Then the patient undergoes chemotherapy.

Germ Cell Ovarian Cancer

Develops from the cells that produce the ova or eggs. Most are benign, although some are aggressively cancerous and may be life-threatening. Experts says that this cancer occurs most often in teenagers and women in their 20s. These patients require surgery to remove the affected ovary and fallopian tube. Some younger patients are given chemotherapy or radiation therapy after their operations. Usually 90 per cent of patients with ovarian germ cell malignancies can be cured and fertility preserved.

Patients with the early stages of the cancer may just need to have the affected ovary and fallopian tube removed without any follow-up treatment. Only those with advanced cancer have to undergo a full hysterectomy, with the removal of both ovaries and fallopian tubes.

Stromal Tumours

These are a rare class of ovarian cancer and develop from connective tissue cells that hold the ovary together and those that produce the female hormones, estrogen and progesterone. The tumour is usually considered low-grade cancer, and about 70 per cent of those afflicted are usually diagnosed in the early stage of the disease. It is not known what causes ovarian cancer but several factors such as hormones, environment and genes may play a role.

Family history is the most important factor when estimating the risk of ovarian cancer. Some studies suggest a woman has a 50 per cent chance of contracting ovarian cancer if two or more immediate family members, say a mother or sister, or second-degree relatives like a grandmother or aunt, have had the disease. The risk of developing ovarian cancer, particularly epithelial ovarian cancer, increases with age. Most cases occur after menopause, which usually takes place around the age of 51. Over half of all ovarian cancers occur in women older than 65.

Experts also believe there is a relationship between the number of menstrual cycles a woman has in her lifetime and her risk of ovarian cancer. They say the risk of ovarian cancer is higher among women who began menstruation before age 12 and/or experience menopause after the age of 50. Others say women who never completed a pregnancy are also at risk, as are those who have their first child after 30.


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