Ovarian cancer is a malignancy of the cells in the ovaries and is the seventh most common type of cancer among women today. Epithelial ovarian carcinoma is the most common type of ovarian cancer, accounting for over 70% of ovarian carcinomas and is considered one of the leading causes of death for all gynecologic-related malignancies, 90% of ovarian malignancies are epithelial tumors. The diagnosing and staging of ovarian cancer will very much fluctuate between women and their genetic and environmental backgrounds, the strongest known risk factor for ovarian cancer is based on family history, and are known as familial ovarian cancer syndromes. Despite the benefits associated with early detection of the disease and good prognosis for cure, only 45% of women with ovarian cancer achieve an overall 5 year survival rate, however, most cancers have spread beyond the ovaries at the time of diagnosis.
The high risk factors associated with ovarian cancer are usually identified by genetic factors such as age, women who are diagnosed with infertility, endometriosis or when the woman is on post-menopausal hormone therapy. The risks of ovarian carcinoma seem to decrease in women who have already undergone pregnancy and birth, breastfeeding, who have used oral contraceptives or who have undergone tubal litigation or hysterectomy.
The first signs of development of ovarian carcinoma are carried by symptoms of abdominal discomfort, increased overall abdominal size or urgency to urinate. Ovarian cancer can be initially detected by a routine pelvic examination. Since ovarian cancer starts in the hip area, it is almost undetectable at early stage, thus tumors detected by a routine pelvic examination are usually found at an already advanced level. A transabdominal/transvaginal CA 125 ultrasonography is one of the first choices for screening, allowing for a detailed visualization of the ovaries and localization of the tumor.
Treatment for this ovarian carcinoma focuses on destroying as much cancerous tissue as possible, in parallel to administering preventive therapies such as chemotherapy, if be necessary depending on the stage of the disease. The first line of treatment as soon as ovarian carcinoma is detected is surgery or cytoreduction. A successful removal of as much cancerous tissue as possible improves a woman’s prognosis and may also influence the choice of chemotherapy treatment.
An exploratory laparotomy is usually recommended for women suspected of having ovarian cancer. A loparotomy is a minimally invasive procedure made by a small incision in the abdomen in which a laparascope, or a small tube with a camera at the tip of the tube, can explore the tissues and remove any suspicious masses. Based on the findings of the surgery, the samples are taken for pathological examination where a final diagnosis is made along with the stage of cancer. Depending on the morphological stage of the tumor, the most suited chemotherapy agent will be recommended. A good prognosis is made at the end of both surgery and chemotherapy treatments. A positive response is made when CA125 levels in the blood and radiologic examination show no signs of remaining tumors. However, the likelihood of recurrence or relapse the disease may depend on the staging in which the disease was diagnosed at the time of rebulking, even when these conditions are met, microscopic amounts of carcinoma may still be found in the body.