Ovarian cancer presents challenges in diagnosis and, consequently, treatment. Symptoms are often absent until the tumor has already grown and spread to other organs. When present, the symptoms are general and are often misattributed to other conditions. Ovarian cancer is treated with a combination of surgery and chemotherapy.
Ovarian Cancer
In 2009, 21,550 women will be diagnosed with ovarian cancer, according to estimates generated by the National Cancer Institute Surveillance, Epidemiology and End Results Program. The cancer will be fatal in 14,600 women. If ovarian cancer is diagnosed in its earliest stages, 93 percent of women will survive five years. Unfortunately, the condition is rarely discovered in the early stages, and only 20 percent of cases are diagnosed before the tumor has spread, or metastasized, to neighboring organs, according to the Mayo Clinic. Most ovarian cancers occur in the epithelium, which is a thin tissue covering the ovary. Tumors may also occur in the germ cell layer, or the cells that produce the eggs, or the tissues that produce the hormones estrogen and progesterone.
Symptoms
The difficulty in diagnosing ovarian cancer in the early stages is due to the lack of specific symptoms. Early-stage ovarian cancer does not cause obvious symptoms. By the time symptoms become noticeable, the cancer has grown and metastasized. The symptoms of ovarian cancer are often overlooked or attributed to other conditions such as depression or irritable bowel syndrome. Symptoms commonly include abdominal pressure, bloating or swelling, discomfort or pain in the pelvis, or urinary urgency. Additional symptoms may include indigestion, flatulence, nausea, appetite loss, changes in bowel or bladder habits, pain during intercourse, lack of energy, low-back pain and menstrual changes. Symptoms caused by ovarian cancer persist longer than two weeks and are unresponsive to antibiotics or other treatments.
Treatment
Treatment for ovarian cancer depends on the size of the tumor and its aggressiveness -- that is, whether it has metastasized. A surgical procedure called a laparotomy is performed to examine the abdominal cavity for sings of cancer in other organs. Tissue samples, or biopsies, may be taken for further testing. Treatment typically includes a combination of regimens.
Surgery
The goal of surgery is to remove as much of the tumor as possible. Along with the affected ovary, the surgeon will usually remove the second ovary along with the Fallopian tubes and uterus, according to the Mayo Clinic. Neighboring lymph nodes and the omentum, a layer of fatty abdominal tissue, may also be removed because these are common sites of ovarian cancer metastasis.
Chemotherapy
Chemotherapy is generally administered after surgery to kill any remaining cancer cells. A combination of intravenous carboplatin and paclitaxel is administered first. The most common side effects are abdominal pain, nausea and vomiting. If that regimen is ineffective, bevacizumab is administered. Bevacizumab interrupts the blood supply to the tumor, causing it to shrink. The most serious side effect associated with bevacizumab is bowel perforation.
Radiation Therapy
Radiation therapy is ineffective for treating ovarian cancer, although it may be used for advanced cases.
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