Ovarian Cancer

Ovarian cancer usually occurs after the change of life (menopause). if the growth metastasises, it usually travels through the Lymphatic system rather than taking the bloodstream as its route.

Symptoms

Lumps in the ovaries may cause no symptoms whatever and are usually first discovered on pelvic examination.

The only common sign, but rather a late one, associated with ovarian cancer, is enlargement of the abdomen. This is rarely due to the tumour itself but more often to accumulation of fluid in the abdomen produced by the presence of cancer. More rarely, abnormal vaginal bleeding occurs with ovarian cancer. Even less frequent symptoms are abdominal pain or a feeling of indigestion.

Diagnosis

To confirm the diagnosis of ovarian cancer, an ultrasound examination may be performed which helps to locate any abnormal growth. It is carried out by an instrument which picks up the echoes of sound waves beamed into the body.

Outlining neighbouring organs, such as the intestine or kidneys, by the injection of a special dye or barium, will sometimes show compression of these structures by the ovarian tumour and so reveal its presence. It is useful at the same time to carry out a chest X-ray to exclude the possibility of ovarian metastases.

Further methods of establishing the diagnosis include insertion of a lighted instrument through a small peep-hole cut in the skin of the abdomen (laparoscopy), or opening the abdomen and having a look (laparotomy). This is carried out under a general anaesthetic and frequently a piece of the tumour is removed for biopsy.

Treatment

Treatment can consist of the removal of the tumour together with the ovary from which it arise, but such limited surgery is rare. More often both ovaries and the uterus are removed as a precautionary measure or because the tumour has already spread. After surgery either radiotherapy or chemotherapy, or both, may be given to treat any remaining cancer. After the completion of treatment periodic check-ups are essential to determine the progress and in particular to guard against a recurrence of the disease.

Summary

While cancer of the ovary is less common, it is more dangerous by far than cancer of the uterus or cervix, because the ovaries lie deeper in the abdomen and are therefore not easy to reach for early diagnosis. It usually causes symptoms very late and as a result, is less curable than other tumours. Prior to treatment, a chest X-ray and an intravenous pyelogram (an X-ray of the kidney after intravenous injection of a dye which is excreted by the kidney) is routinely carried out to find out how far the disease has spread. When cancer cells fall off the surface of the ovary, which they often do, they spread throughout the abdominal cavity and may irritate its lining and cause fluid to be formed. This condition is called ascites; it is a common problem to which, so far, there is no answer.