What is Ovarian Cancer?

Often touted as “The Silent Killer of women,” ovarian cancer is often misunderstood at best. Afflicting at least 5,500 women in the US each year, ovarian cancer rings in as one of the leading causes of death in females. Before understanding why this disease is so devastating, it is important to understand what it is and how it forms. This article, courtesy of medicalnewstoday.com, will help to shed some light on the parts of the body this cancer effects and the genesis of the condition.

Ovarian cancer is any cancerous growth that may occur in different parts of the ovary. The majority of ovarian cancers arise from the epithelium (outer lining) of the ovary. According to the American Cancer Society it is the 8th most common cancer among women in the USA (excluding non-melanomaskin cancers). In the UK ovarian cancer is the fifth most common cancer among females, after breast cancer, bowel cancer, lung cancer and uterine cancer (cancer of the uterus).

Approximately 5,500 women in the UK and 21,000 women in the USA are diagnosed with ovarian cancer each year. Worldwide, around 140,000 women die of ovarian cancer every year.

Tragically, the overall five year survival rate is only 46 per cent in most developed countries (it is lower for more advanced stages). However, according to the National Cancer Institute, if diagnosis is made early, before the tumor has spread, the five year survival rate is nearer 93 per cent. In 2009 scientists in the US said that current tests for diagnosing ovarian cancer are not good enough .

Even modern screening tests for ovarian cancer, which include a blood test for the CA 125 marker, combined with ultrasound, often result in unnecessary surgery and "..are failing to catch early signs of the disease..", a study at the University of Alabama at Birmingham Comprehensive Cancer Center revealed.

What are the ovaries?

The ovary is the female gonad, while the testis is the male gonad. A gonad is a reproductive gland that produces germ cells (gametes). A male sperm is a gamete, and a female egg is also a gamete. Each human gamete has 23 chromosomes, half the number of chromosomes contained in most types of human body cells. 

The ovary, also known as the egg sac, is one of a pair of reproductive glands in women. The ovaries are located at either side of the uterus (womb), in the pelvis. Each ovary is about the size and shape of an almond. The ovaries produce ova (eggs) and female hormones, such as estrogen and progesterone. These hormones regulate the menstrual cycle, pregnancy, and control the development of female characteristics, such as body shape, body hair, breasts, etc.

During the female menstrual cycle, which lasts about one month, one egg is released from one of the two ovaries - the egg travels through the fallopian tube and into the uterus. This is known as ovulation.

Cancer of the ovary can spread to other parts of the reproductive system as well as surrounding areas, such as the stomach, vagina and uterus. Ovarian cancer more commonly occurs in women aged 65 or over, but can affect women of any age.

What is cancer?

Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer that occur in various parts of the body - each is classified by the type of cell that is initially affected.

Usually our cells divide (multiply, form new ones) only when old and dying ones need to be replaced. However, the controls that regulate when a cell divides as well as when a cell should die sometimes become faulty. This may result in cells not dying when they should, while additional cells are still being added - an uncontrolled accumulation of cells. Eventually a mass of cells is formed - a tumor. 

Malignant and benign tumors

Tumors that stay in one place and demonstrate limited growth are usually considered to be benign. Malignant, or more dangerous tumors emerge when two things occur:

Invasion - the cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue - this process is called invasion.

Angiogenesis - the cancerous cells manage to divide and grow, making new blood vessels to feed themselves.

Metastasis
When a tumor manages to spread to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is extremely hard to treat.

Education is one of the most important tools we can use to protect ourselves against ovarian cancer. Learning about the causes of the disease is simply the first step on the road to decreasing the number of victims of the disease.  

New Research Programs Will Study Genetic Risk For Ovarian Cancer

The USC Norris Comprehensive Cancer Center recently announced that its team will expand their ovarian cancer research efforts thanks to the National Institutes of Health (NIH). The NIH awarded two grants totaling over $4 million to the USC Norris Comprehensive Cancer Center for use on two important ovarian cancer research projects.

One project being funded by these grants will focus on studying how certain genes and mutations may impact a woman’s risk of developing ovarian cancer. Set to last at least five years, this project is being led by Simon Gayther, a professor of preventive medicine at the Keck School of Medicine of USC, and Susan Ramus, an associate professor of preventive medicine.

The hope is that this project will ultimately contribute to a decreased ovarian cancer mortality.

“We expect to identify, in the population, ovarian cancer susceptibility genes that confer substantial risks of ovarian cancer,” Gayther said about the project. “We will calculate these risks by comparing the frequency of gene mutations in ovarian cancer cases compared to unaffected controls. We expect the size of disease risks caused by these genes to be quite substantial, and anticipate this information could soon be used to screen unaffected women in the population to identify those individuals at greatest risk.”

In addition to working on this first project, Susan Ramus is leading the second ovarian cancer research study being funded by these grants. This second project, which is currently the world’s largest ovarian cancer tumor tissue study, will evaluate signs of ovarian cancer risk at a molecular level. This could help researchers develop new ways of testing for and treating ovarian cancer and is a significant endeavor, as no treatment for ovarian cancer based on tumor profiling currently exists.

Click here to read more about these two important ovarian cancer research projects.

Dogs: An Oncologist’s Best Friend?

We all know that dogs are man’s best friend. But soon, they could also be a doctor’s best friend as well.

Researchers at the University of Pennsylvania’s Work Dog Center have discovered that dogs can detect the smell given off by certain chemical compounds that are produced during the early stages of ovarian cancer.

Every year, over 20,000 Americans are diagnosed with ovarian cancer, but due to generic symptoms like bloating, weight gain, and constipation, it can be difficult for physicians to offer a precise diagnosis. However, like most cancers, early diagnosis is key. In fact, women who are diagnosed with ovarian cancer in its early stages have a five-year survival rate of 90 percent. And this discovery could very well help diagnoses ovarian cancer before it spreads.

Over at Monell Chemical Sensess Chemical Center, researchers are trying to replicate the dogs’ ability with an electronic sensor. Said organic chemist George Preti on The Animal Rescue Site’s blog:

“Because if the dogs can do it, then the question is, “Can our analytical instruments do it?” We think we can,” said George Preti, Monell organic chemist.

Although dogs’ senses haven’t directly made any major breakthroughs for ovarian cancer, the American Cancer Society is hopeful that dogs may eventually play a role in patient care. Cindy Otto, director of the Working Dog Center, on the other hand, can see this happening sooner than later:

“If we can figure out what those chemicals are, what that fingerprint of ovarian cancer is that’s in the blood — or maybe even eventually in the urine or something like that — then we can have that automated test that will be less expensive and very efficient at screening those samples,” said Cindy Otto, director of the Working Dog Center.

Click here to read the full story on the Animal Rescue Site’s blog!

Risk Factors of Ovarian Cancer

As with many types of cancer, there are some factors known to increase and decrease the risk of developing ovarian cancer. If ovarian cancer runs in your family, you are more likely to develop the disease, but there are other procedures and factors that may put you at risk. It is important to understand the risks and speak with your doctor about any health concerns you have. The National Cancer Institute has outlined some of these factors:

Avoiding risk factors and increasing protective factors may help prevent cancer.

Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking, eating a healthy diet, and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

The following risk factors may increase the risk of ovarian cancer:

Family history of ovarian cancer

A woman whose mother or sister had ovarian cancer has an increased risk of ovarian cancer. A woman with two or more relatives with ovarian cancer also has an increased risk of ovarian cancer.

Inherited risk

The risk of ovarian cancer is increased in women who have inherited certain changes in the following genes:

BRCA1 or BRCA2 genes.

Genes that are linked to hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome).

Hormone replacement therapy

The use of estrogen -only hormone replacement therapy (HRT) after menopause increases the risk of ovarian cancer. The longer estrogen replacement therapy is used, the greater the risk may be. It is not clear whether the risk of ovarian cancer is increased with the use of HRT that has both estrogen and progestin.

Fertility drugs

The use of fertility drugs may be linked to an increased risk of ovarian cancer.

Talc

The use of talc may increase the risk of ovarian cancer. Talcum powder dusted on the perineum (the area between the vagina and the anus) may reach the ovaries by entering the vagina.

Obesity

Having too much body fat, especially during the teenage years, is linked to an increased risk of ovarian cancer. Being obese is linked to an increased risk of death from ovarian cancer.

Height

Being taller than 5 feet 8 inches is linked to an increased risk of ovarian cancer.

The following protective factors may decrease the risk of ovarian cancer:

Oral contraceptives

The use of oral contraceptives (“the pill”) lowers ovarian cancer risk. The longer oral contraceptives are used, the lower the risk may be. The decrease in risk may last up to 25 years after a woman has stopped using oral contraceptives.

Taking oral contraceptives increases the risk of blood clots. This risk is higher in women who also smoke. There may be a slight increase in a woman’s risk of breast cancer during the time she is taking oral contraceptives. This risk decreases over time.

Pregnancy and breastfeeding

Pregnancy and breastfeeding are linked to a decreased risk of ovarian cancer. Ovulation stops or occurs less often in women who are pregnant or breastfeeding. Some experts believe that women who ovulate less often have a decreased risk of ovarian cancer.

Bilateral tubal ligation or hysterectomy

The risk of ovarian cancer is decreased in women who have a bilateral tubal ligation (surgery to close both fallopian tubes) or a hysterectomy (surgery to remove the uterus).

Prophylactic oophorectomy

Some women who have a high risk of ovarian cancer may choose to have a prophylactic oophorectomy (surgery to remove both ovaries when there are no signs of cancer). This includes women who have inherited certain changes in the BRCA1 and BRCA2 genes or in the genes linked to hereditary nonpolyposis colon cancer (HNPCC). (See the PDQ summary on Genetics of Breast and Ovarian Cancer for more information.)

It is very important to have a cancer risk assessment and counseling before making this decision. These and other factors should be discussed:

Early menopause: The drop in estrogen levels caused by removing the ovaries can cause early menopause. Symptoms of menopause include the following:

Hot flashes.

Night sweats.

Trouble sleeping.

Mood changes.

Decreased sex drive.

Heart disease.

Vaginal dryness.

Osteoporosis (decreased bone density).

These symptoms may not be the same in all women. Hormone replacement therapy (HRT) may be needed to lessen these symptoms.

Risk of ovarian cancer in the peritoneum: Women who have had a prophylactic oophorectomycontinue to have a small risk of ovarian cancer in the peritoneum (thin layer of tissue that lines the inside of the abdomen). This may occur if ovarian cancer cells had already spread to the peritoneum before the surgery or if some ovarian tissue remains after surgery.

Cancer prevention clinical trials are used to study ways to prevent cancer.

Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.

The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

New ways to prevent ovarian cancer are being studied in clinical trials.

Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check NCI's list of cancer clinical trials for ovarian cancer prevention trials that are now accepting patients.

If you think you may be at risk for ovarian cancer, speak with your gynecologist.