Early Symptoms Of Ovarian Cancer

Ovaries are small structures present in the lower part of abdomen adjacent to the uterus. Cancers arising from ovaries can be of different types: 

Germ cell type (these cancers arise from cells that produce ova or cells that grow into the new born upon fertilization), epithelial (these arise from the outer lining of the ovaries) and others (multiple types from remaining tissue in ovaries).

Epithelial ovarian cancer is the commonest type of ovarian cancers and is also the one associated with high fatality. High fatality is related to the aggressive behaviour of cancer but is also due to the fact that majority of epithelial ovarian cancers are diagnosed late.

In the early stages of ovarian cancer, very few symptoms may be present. Many women do not experience any symptoms at all. The symptoms that may be experienced can be associated with other conditions and hence often go unrecognized. However, in the case of ovarian cancer, these symptoms will gradually increase and worsen with time. Some of the symptoms of ovarian cancer are: 

1. Pain in the lower abdomen or pelvic area 
2. Back ache 
3. Frequent urge to urinate 
4. Painful intercourse 
5. Change in bowel habits (constipation usually) 
6. Indigestion 
7. Nausea 
8. Loss of appetite or feeling full without eating too much 
9. Fullness or distension of the abdomen

Ovarian cancer usually affects women over the age of 50 but can occur in younger women also. Women with a family history of breast cancer or ovarian cancer have a higher risk of developing these tumours. Endometriosis and hormone replacement therapy could also increase one’s risk of ovarian cancer. 

As with other types of cancer, treatment for ovarian cancer depends largely on how far it has advanced. The main forms of treatment include surgery and chemotherapy. Surgery is usually the first step of treating ovarian cancer. Surgery for early ovarian cancer is called “staging laparotomy” while surgery for advanced ovarian cancer is called “cytoreductive surgery”. Surgery involves complete hysterectomy with removal of both tubes and ovaries. In addition, lymph nodes in the pelvis and retroperitoneum are removed. Removal of omentum (a fatty layer of tissue attached to stomach and large intestine) is also done.

In addition, biopsy samples are collected from the peritoneal lining of the abdomen. If there are other sites of disease, they are also removed surgically. In very advanced cases, parts of intestine (large intestine, small intestine), spleen, liver etc. may also be removed. In some early stage ovarian cancer that are not very aggressive, uterus and one side fallopian tube and ovarian can be saved. This can permit child bearing and is called fertility sparing surgery. 

Surgery is usually followed by chemotherapy. Usually six cycles of chemotherapy are used. For early stage ovarian cancer that is low grade, chemotherapy may not be required. Ovarian cancer can come back and all patients need regular follow up after surgery and/or chemotherapy. Physical examination, blood tests, ultrasound and/or CT scan of abdomen are used for follow up. If the disease comes back, chemotherapy may be repeated and sometimes additional surgery can be carried out. In case you have a concern or query you can always consult an expert & get answers to your questions!