Ovarian Cancer: The Silent Killer
Background: The dreadful disease cancer shatters the confidence of the sufferer and the family at the very first instance. Amongst all the cancers, ovarian cancer has turned up as an atrocious gynecological cancer in past years. It affects all women from all age group, although is more prominent in post-menopausal women (Dong et al., 2016). Mutations in BRCA-1 and BRCA-2 genes are the most important factor behind an ovarian cyst and/ or endometriosis, that eventually develop cancer in ovaries. Even after massive advancement in science and technology, it can’t be diagnosed at an early stage. Further ignorance of symptoms and lack of self-awareness leads to its advancement and hence this cancer is considered as ‘the silent killer’ (Jos et al., 2011). In women, it is the 5th most common cancer (Dong et al., 2016). More than 48% of cases are seen in women of 50 years of age and above, 54% of cases in women more than 75 years of age (Nandakumar, 2001; Murthy et al., 2004).
Any cancerous growth in ovaries, arising from epithelium lining, primary peritoneum or fallopian tube is regarded as ovarian cancer (Teng et al., 2012)., It is of three types:
a. Epithelial carcinoma (arises from the outer surface of the ovary) b. Germ cell tumor (develops in egg-producing cells) and (c) stromal tumor (forms in connective tissue that holds ovaries together and produce progesterone hormone).
Stages of Ovarian Cancer and Cancer Cell Growth, There are four stages associated with ovarian cancer (Kaku et al., 2003) as described below:
Stage I – Confined to the ovary (or fallopian tube), Stage II – One or both ovaries with pelvic extension, Stage III – One or both ovaries and spread beyond the pelvis and Stage IV – Both ovaries and widely spread throughout the body (metastasis).
Signs and symptoms include fatigue, abdominal swelling, pain in the leg and the pelvic area, pain in the ovaries, swelling in legs, changes in bowel habits, shortness of breath etc. One of the potential sign include disturbance in the menstrual cycle, irregularity, sudden weight loss or gain and struggle in eating (Bankhead et al., 2008).
The preliminary diagnosis involves transvaginal ultrasonography, ultrasounds, biopsy, CT scans, MRI etc. If there is signs of ascites fluid, that are also examined. Special diagnosis includes PET (positron emission tomography) scan and CA 125 (cancer antigen 125) marker blood test, to have a better understanding of the cancer (Ponisio et al., 2016).
The line of action followed for the treatment of ovarian cancer includes the use of chemotherapy followed by surgery. Carboplatin, Cisplatin, Paclitaxel are used alone or in combinations in chemotherapy (Raja et al., 2012). In India, other methods include the use of Ayurvedic, Homeopathy and Unani medicines.
Prevention is always better than a cure for any disease. Women with more weight, irregular menstrual cycle, family history of ovarian cancer are at much higher risk than others (Reeves et al., 2007). The occurrence of ovarian cancer in early age also leads to ovarian dysfunction causing infertility. Self-awareness is very important for prevention against ovarian cancer. One should go through regular checkups and keep an eye on weight, lifestyle and menstrual cycle.
There is no such treatment till date that can completely cure when in the later stages of ovarian cancer. However, it is possible in the early stages. One more peculiarity associated with ovarian cancer is the re-occurrence that results in the loss of life of the patient. It has been found that the side effects of chemotherapy, drug resistance, and development of secondary cancers are the negative aspects associated with ovarian cancer. So, it’s better to prevent rather get into the web of curing and linger on the survival of the person (Chaturvedi et al., 2007).
Sunanda Kulshrestha, M.Sc (Biosciences), Banasthali University, Rajasthan, India.
July 11, 2019
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