Ovarian Cancer (Carcinoma)
Ovarian cancer is the most lethal malignancy of the female reproductive organs. According to the American Cancer Society, about 27,000 new cases are diagnosed each year, with a death toll of almost 15,000. The high mortality rate is attributed to the fact that by the time ovarian cancer is detected, it usually has spread. The cause remains unknown, though it is believed that hereditary factors play a role because ovarian cancer tends to run in families.
It can occur at any age, but is more prevalent after menopause. Women who have never had children show a somewhat higher incidence; women who have used oral contraceptives seem to be at lower risk. In general, early ovarian cancer is asymptomatic, but as the tumor grows, there may be vague abdominal discomfort and gas. As the cancer advances, abdominal swelling, pain, and weight loss often occur. In unusual cases, there may be vaginal bleeding.
Diagnostic Studies and Procedures
Women over age 40 should have a thorough pelvic examination every year or two that includes palpation of the ovaries because any enlargement of an ovary raises a suspicion of cancer. When ovarian cancer is suspected, ultrasound can be used to detect the presence of a mass. Blood tests using monoclonal antibodies to search for specific substances called tumor markers show promise in screening for ovarian cancer, but are still experimental.
A definitive diagnosis usually requires laparoscope a procedure in which a viewing tube is inserted into the pelvic cavity through a small incision near the navel, to allow examination of the ovaries and collection of biopsy samples. If the biopsy confirms cancer, additional tests will be done to determine whether or not it has spread to other parts of the body. These may include bone and CT scans, a chest X-ray, and laboratory examination of fluid obtained during laparascopy.
Medical Treatments
Surgery to remove one or both ovaries is the first line of treatment. In young women with localized cancer in only one ovary, the operation, an oophorectomy, may be confined to that ovary. More commonly, however, both ovaries are removed, along with the uterus, the fallopian tubes, and adjacent lymph nodes, a procedure known as salpingo-oophorectomy and hysterectomy. Chemotherapy and/or radiation therapy usually follow surgery. With a new technique, anticancer drugs are infused into the abdominal cavity, a procedure called intraperitoneal administration. This approach not only increases the effectiveness of the drugs, but it also reduces their side effects.
A premenopausal woman who has had both of her ovaries removed will enter menopause immediately and frequently will experience hot flashes and other menopausal symptoms more intensely than a woman in whom it has occurred normally. In such a case, estrogen replacement therapy will usually be added to her drug regimen as long as there are no contraindications for use.
Alternative Therapies
Ovarian cancer always requires intensive medical and surgical treatment, although alternative therapies may play an adjunctive role. In addition to meditation, visualization, self-hypnosis, and other techniques to control pain, alternative therapies may include:
Nutrition Therapy. With ovarian cancer, as with many types of cancer, nutrition may play a role in prevention. In particular, vitamins A, C, and E, the antioxidant vitamins, and beta carotene (a precursor of vitamin A) are believed to help avert genetic changes in cells that contribute to the cancer development. Foods that contain high levels of vitamins A and C and beta carotene include citrus fruits, orange and dark green vegetables, and cruciferous vegetables such as broccoli, cabbage, brussels sprouts, and cauliflower. Those high in vitamin E are wheat germ, vegetable oils, nuts and seeds, green vegetables, and egg yolks. Although the role of other dietary components remains controversial, some studies suggest that a low-fat diet may reduce cancer risk.
Self-Treatment
As noted, removal of both ovaries results in an abrupt menopause. If you are unable to take estrogen, devise other strategies to minimize symptoms, to help mitigate night sweats, lower the thermostat in your bedroom, use light covers, and take a tepid shower before going to bed. During the day, wear light, layered clothing that can be removed easily if hot flashes occur.
While undergoing cancer chemotherapy and radiation treatments, practice visualization, self-hypnosis, or meditation to control side effects such as nausea and vomiting. Distractions such as listening to music or becoming absorbed in a good book or movie can also help. Get adequate rest, but try to exercise for at least a few minutes each day. Simply going for a short daily walk can help. Consider joining a support group of other cancer patients; its comforting to know you are not alone, and helpful to share coping tips with others. Other Causes of Pelvic Symptoms Abdominal pain and discomfort is most often caused by a gastrointestinal disorder, ranging from simple indigestion to cancer. Ovarian swelling is more often due to a benign cyst than cancer.