Enyeribe Ejiogu ([email protected])
A female Lagos-based corporate executive is still singing alleluia in thanksgiving to God, after she survived a radical surgery that involved removing her ovary and other nearby tissues that had become cancerous. Until it was done, she was in great discomfort and pain. But divine intervention and providence made the difference as resources were assembled by her family for the surgery to be done. The cost involved was enormous. While the whole family waited with bated breathe for the consultant surgeons to carry out the surgery, which incidentally was re-scheduled two times because of the typical bureaucratic shortcomings and integrity deficits in the public tertiary care system, the hapless lady groaned in pain. She cut a pathetic sight. In the face of near hopeless situation that got worse with each passing day and the five weeks that rolled by, she held strongly to faith in the Almighty as her relations prayerfully reassured her with these words: “God is never one minute late.” And Almighty was not, He honoured their faith in Him. Seeing her alive today and recovering well even as she goes through chemotherapy is worth every kobo spent by the family to treat and preserve her life.
As noted earlier in the headline, ovarian cancer can be very stealthy in its “attack” on women. Notwithstanding this fact, ovarian cancer gives signs and shows symptoms which most people clearly miss until it is too late. Below, some of these signs are explained.
What is ovarian cancer?
Current research suggests this cancer begins in the fallopian tubes and moves to the ovaries, the twin organs that produce a woman’s eggs and the main source of the female hormones estrogen and progesterone. Treatments for ovarian cancer have become more effective in recent years, with the best results seen when the disease is found early.
Ovarian cancer symptoms
The symptoms of the disease include: bloating or pressure in the belly; pain in the abdomen or pelvis, feeling full too quickly during meals and urinating more frequently
These symptoms can be caused by many conditions that are not cancer. If they occur persistently for more than a few weeks, report them to your health care professional.
Major predisposing risk factors
Family history: A woman’s odds of developing ovarian cancer are higher if a close relative has had cancer of the ovaries, breast, or colon. Researchers believe that inherited genetic changes account for 10 per cent of ovarian cancers. This includes the BRCA1 and BRCA2 gene mutations, which are linked to breast cancer. Women with a strong family history should talk with a doctor to see whether closer medical follow-up could be helpful.
Age: The strongest risk factor for ovarian cancer is age. It’s most likely to develop after a woman goes through menopause. Using postmenopausal hormone therapy may increase the risk. The link seems strongest in women who take estrogen without progesterone for at least 5 to 10 years. Doctors are not certain whether taking a combination of estrogen and progesterone boosts the risk as well.
Obesity: Obese women have a higher risk of getting ovarian cancer than other women. And the death rates for ovarian cancer are higher for obese women too, compared with non-obese women. The heaviest women appear to have the greatest risk.
Ovarian cancer screening tests
There is no easy or reliable way to test for ovarian cancer if a woman has no symptoms. However, there are two ways to screen for ovarian cancer during a routine gynecologic exam. One is a blood test for elevated levels of a protein called CA-125. The other is an ultrasound of the ovaries. Unfortunately, neither technique has been shown to save lives when used in women of average risk. For this reason, screening is only recommended for women with strong risk factors.
Diagnosing ovarian cancer
Imaging tests, such as ultrasound or CT scans, can help reveal an ovarian mass. But these scans can’t determine whether the abnormality is cancer. If cancer is suspected, the next step is usually surgery to remove suspicious tissues. A sample is then sent to the lab for further examination. This is called a biopsy.
Stages of ovarian cancer
The initial surgery for ovarian cancer also helps determine how far the cancer has spread, described by the following stages:
Stage I: Confined to one or both ovaries
Stage II: Spread to the uterus or other nearby organs
Stage III: Spread to the lymph nodes or abdominal lining
Stage IV: Spread to distant organs, such as the lungs or liver
Types of ovarian cancer
The vast majority of ovarian cancers are epithelial ovarian carcinomas. These are malignant tumours that form from cells on the surface of the ovary. Some epithelial tumours are not clearly cancerous. These are known as tumours of low malignant potential (LMP). LMP tumours grow more slowly and are less dangerous than other forms of ovarian cancer.
Ovarian cancer survival rates
Ovarian cancer can be a frightening diagnosis, with five-year relative survival rates that range from 93 per cent to 19 per cent for epithelial ovarian cancer, depending on the stage when the cancer was found. For LMP tumors, the five-year relative survival rates range from 97 per cent to 89 per cent.
Ovarian cancer surgery
Surgery is used to diagnose ovarian cancer and determine its stage, but it is also the first phase of treatment. The goal is to remove as much of the cancer as possible. This may include a single ovary and nearby tissue in stage I. In more advanced stages, it may be necessary to remove both ovaries, along with the uterus and surrounding tissues.
Chemotherapy
In all stages of ovarian cancer, chemotherapy is usually given after surgery. This phase of treatment uses drugs to target and kill any remaining cancer in the body. The drugs may be given by mouth, through an IV, or directly into the belly (intra-peritoneal chemotherapy). Women with LMP tumors usually don’t need chemo unless the tumors grow back after surgery.
Targeted therapies
Researchers are working on therapies that target the way ovarian cancer grows. A process called angiogenesis involves the formation of new blood vessels to feed tumours. A drug called Avastin blocks this process, causing tumours to shrink or stop growing.
Life after treatment
Early menopause: When women have both ovaries removed, they can no longer produce their own estrogen. This triggers menopause, no matter how young the patient. The drop in hormone levels can also raise the risk for certain medical conditions, including osteoporosis. It’s vital that women have regular follow-up care after being treated for ovarian cancer.
Moving on: After some women have been fully treated for ovarian cancer, they may discover that it takes a long time for their energy to return. Fatigue is a very common problem after treatment for cancer. Beginning a gentle exercise programme is one of the most effective ways to restore energy and improve emotional well-being. Check with your health care team to determine which activities are right for you.
Reduction of ovarian cancer risk
Pregnancy: Women who have biological children are less likely to get ovarian cancer than women who have never given birth. The risk appears to decrease with every pregnancy, and breastfeeding may offer added protection.
Contraceptive pills: Ovarian cancer is also less common in women who have taken birth control pills. Women who have used the pill for at least five years have about half the risk of women who never took the pill. Like pregnancy, birth control pills prevent ovulation. Some researchers think ovulating less often may protect against ovarian cancer.
Tubal ligation: Getting your tubes tied, medically known as tubal ligation, may offer some protection against ovarian cancer. The same goes for having a hysterectomy, which is a surgical removal of the uterus.
Removal of ovaries: For women with genetic mutations that put them at high risk for ovarian cancer, removing the ovaries is an option. This can also be considered in women over 40 getting a hysterectomy.
Low-fat diet: While there is no definitive diet to prevent ovarian cancer, there is evidence that what you eat can make a difference. In one recent study, women who stuck to a low-fat diet for at least four years were less likely to develop ovarian cancer. Some researchers report the cancer is also less common in women who eat a lot of vegetables, but more studies are needed.
►Adapted from Webmd.com