Ovarian Cancer: Understanding The Silent Killer.
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 (Gaona-Luviano et al., 2020). Ignorance of symptoms and lack of self-awareness leads to its advancement and hence this cancer is considered as ‘the silent killer’ (Nersesian et al., 2019). In women, it is the 5th most common cancer with only 50.7% of survival rates (Cancer Statistics, 2024). Women over age of 50 are more prone to ovarian cancer with 45% of cases reported all over the world (Torre et al., 2018).
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. With advancement in science and technology, Ovarian cancer which was not detectable at early stage is been explored for its diagnosis using the protein biomarkers, miRNA, circulating DNA, RNA, etc for early age detection. Clinical validation of such methods are still in the research phase (Radu et al., 2021).
Any cancerous growth in ovaries, arising from epithelium lining, primary peritoneum or fallopian tube is regarded as ovarian cancer (Lheureux et al., 2019)., 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 as 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) (Shea, 2022).
Symptoms often appear late, effective screening tests are lacking, and there is a lack of awareness (Ashraf I et al., 2023). Some of the 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 (Ebell et al., 2016).
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). Use of miRNA and circulating DNA is also being investigated nowadays for the detection of ovarian cancer. Researchers have also reported the use of nanotechnology based biosensors to detect CA125 protein from the samples for the detection of ovarian cancer along with the implication of artificial intelligence (Akazawa et al., 2020; Barani et al., 2021)
Whenever any women is diagnosed with ovarian cancer, the line of action of followed for treatment includes use of chemotherapy like Carboplatin, Cisplatin, Paclitaxel or their combinations (Orr and Edward, 2018) followed by surgery, other methods includes use of Ayurvedic, Homeopathy and Unani medicines as adjuvant therapies with the main stream action. Also new avenues in the field of immunotherapy, nanoparticles, targeted therapies are being explored by the researchers which need to validated clinically (Akhter et al., 2022).
Prevention is always better then cure, and same is the case with ovarian cancer. Women with more weight, irregular menstrual cycle, negative reproductive history, family history of ovarian cancer are at much risk than others (Reeves et al., 2007). Occurrence of ovarian cancer in early age also leads to ovarian dysfunction causing infertility. Self-awareness in the only way out for prevention against ovarian cancer and one should go through regular checkups and keep eye on weight, lifestyle and menstrual cycle, etc. to avoid getting into such jeopardy.
Author:
Sunanda Kulshrestha, Ph.D (Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India).
References:
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