Ovarian Cancer


Ovarian Cancer

Ovarian cancer is a common type of cancer in women. The ovaries (ovaries) in the female reproductive system can become cancerous, resulting in ovarian cancer.

Symptoms of ovarian cancer are often vague at first and can be associated with other conditions. Usually, symptoms such as abdominal pain or swelling in the abdomen, constipation, diarrhea, vaginal bleeding, changes in the menstrual cycle, etc. become apparent over time.

To diagnose ovarian cancer, a doctor may first assess the patient's medical history and symptoms. After these examinations, a series of tests may be performed. These tests may include pelvic examination, blood tests, ultrasonography, biopsy.

Ovarian cancer, a significant health concern worldwide, is a type of cancer that begins in the ovaries, the female reproductive glands responsible for producing eggs and hormones like estrogen and progesterone.

Notoriously difficult to detect in its early stages due to its subtle symptoms, ovarian cancer often goes undiagnosed until it has spread within the pelvis and abdomen, at which point it becomes more challenging to treat effectively.

Common symptoms include bloating, pelvic pain, abdominal swelling, and rapid weight loss, but these can easily be mistaken for less serious conditions.

Risk factors for ovarian cancer include age (most common in women over 50), family history, genetic mutations (such as BRCA1 and BRCA2), and reproductive history. Early detection through regular check-ups and awareness of symptoms is crucial for improving treatment outcomes.

Advances in medical research continue to provide new insights into diagnosis, treatment options, and prevention strategies for this complex disease.

Why is Ovarian Cancer a Significant Health Concern?

Ovarian cancer is a significant health concern for several reasons:

  1. Late-stage diagnosis: One of the primary reasons is that ovarian cancer is often diagnosed at an advanced stage. Its symptoms in the early stages are subtle and can be easily mistaken for other less severe conditions. As a result, many women do not seek medical attention until the cancer has already progressed, making it more challenging to treat effectively.
  2. Limited screening options: Unlike some other cancers, there is no highly effective and widely recommended screening test for ovarian cancer available to the general population. This lack of early detection methods further contributes to late diagnoses.
  3. Aggressive nature: Ovarian cancer can be aggressive and has a higher likelihood of spreading within the pelvis and abdomen before it is detected. This metastasis can make treatment more complex and decrease the chances of a successful outcome.
  4. Limited awareness: Ovarian cancer awareness is lower compared to some other cancers, such as breast or lung cancer. As a result, women may not be as informed about the risk factors, symptoms, and the importance of regular check-ups, leading to delayed diagnosis.
  5. Limited treatment options: While advances in treatment have been made, ovarian cancer can still be challenging to treat, especially in advanced stages. Treatment often involves a combination of surgery and chemotherapy, and not all cases respond well to these therapies.
  6. Risk factors: Certain risk factors, such as a family history of ovarian or breast cancer and genetic mutations like BRCA1 and BRCA2, increase the likelihood of developing ovarian cancer. Understanding and addressing these risk factors are crucial for prevention and early detection.

Due to these factors, ovarian cancer poses a significant health concern, and efforts in early detection, prevention, and research are essential to improving outcomes for those affected by this disease.

What Are The Common Symptoms of Ovarian Cancer?

Common symptoms of ovarian cancer can be subtle and often resemble those of other less serious conditions. It's important to note that these symptoms can vary from person to person, and not everyone with ovarian cancer will experience all of them. Some of the common symptoms include:

  1. Bloating: Persistent and unexplained bloating or a feeling of fullness in the abdomen is a common symptom of ovarian cancer. This sensation may be accompanied by discomfort or pressure.
  2. Pelvic Pain: Women with ovarian cancer may experience ongoing pelvic or abdominal pain. This pain can range from mild to severe and may be constant or intermittent.
  3. Abdominal Swelling: An increase in abdominal size or persistent abdominal swelling can be a sign of ovarian cancer. This can sometimes be mistaken for weight gain.
  4. Difficulty Eating: Some women with ovarian cancer may have difficulty eating, or they may feel full quickly when they eat, even if they have not consumed much food.
  5. Frequent Urination: Increased frequency of urination, often accompanied by a sense of urgency, can be a symptom of ovarian cancer. This may be mistaken for a urinary tract infection.
  6. Changes in Bowel Habits: Changes in bowel habits, such as diarrhea or constipation, that persist for an extended period may be a symptom of ovarian cancer.
  7. Unexplained Weight Loss: Rapid and unexplained weight loss without changes in diet or exercise can be associated with ovarian cancer.
  8. Fatigue: Persistent fatigue or a lack of energy that does not improve with rest is another symptom that some women with ovarian cancer may experience.
  9. Painful Intercourse: Pain or discomfort during sexual intercourse can sometimes be a symptom of ovarian cancer, although it is less common.

It's essential to remember that these symptoms are not unique to ovarian cancer and can be caused by various other medical conditions. However, if you experience any of these symptoms regularly, especially if they are new, severe, or persistent for more than a few weeks, it is crucial to consult a healthcare professional for a proper evaluation and diagnosis. Early detection and diagnosis are essential for improving the chances of successful treatment for ovarian cancer.

How Can Ovarian Cancer Detected Early?

Early detection of ovarian cancer is challenging because there is no highly effective and widely recommended screening test for the general population, similar to mammography for breast cancer or colonoscopy for colorectal cancer. However, there are several strategies that can help increase the chances of early detection:

  1. Know the Risk Factors: Understanding your risk factors for ovarian cancer can be crucial. Women with a family history of ovarian or breast cancer, those who have certain genetic mutations (such as BRCA1 and BRCA2), and women with a personal history of breast, colorectal, or endometrial cancer are at higher risk. Knowing your risk can help you and your healthcare provider determine the appropriate monitoring and screening plan.
  2. Regular Check-ups: Routine gynecological check-ups are essential. During these visits, your healthcare provider can perform pelvic exams and may order blood tests, such as the CA-125 test (although this test is not always reliable for early detection). While pelvic exams are not highly effective for detecting early-stage ovarian cancer, they can help identify any abnormalities.
  3. Transvaginal Ultrasound (TVUS): In some cases, especially for women at higher risk or those with concerning symptoms, a transvaginal ultrasound may be recommended. This imaging test uses sound waves to create images of the ovaries and may detect ovarian masses or abnormalities.
  4. Pelvic Imaging: In addition to TVUS, other imaging techniques like CT scans or MRI scans may be used to evaluate the pelvis and abdomen if ovarian cancer is suspected or if there are concerning symptoms.
  5. Genetic Counseling and Testing: If you have a family history of ovarian cancer or carry certain genetic mutations associated with the disease, genetic counseling and testing can provide valuable information about your risk. This information can guide surveillance and prevention strategies.
  6. Be Aware of Symptoms: As mentioned earlier, the symptoms of ovarian cancer can be subtle but persistent. Being aware of common symptoms like bloating, pelvic pain, abdominal swelling, and changes in bowel habits can prompt you to seek medical attention if they persist or worsen.
  7. Clinical Trials and Emerging Tests: Researchers are continually working on improving early detection methods for ovarian cancer. Participating in clinical trials or staying informed about emerging tests and screening techniques may provide additional options for early detection in the future.

It's essential to discuss your individual risk factors and screening options with your healthcare provider. They can help you determine the most appropriate approach to monitor and detect ovarian cancer early, especially if you are at higher risk due to genetic or family history factors. Remember that early detection can significantly improve the chances of successful treatment and better outcomes for ovarian cancer.

What Are The Treatment Options for Ovarian Cancer?

The treatment options for ovarian cancer depend on various factors, including the stage of the cancer, the type of ovarian cancer, the patient's overall health, and individual preferences. Ovarian cancer treatment typically involves a combination of therapies, which may include:

  1. Surgery: Surgical removal of the tumor and affected tissue is a common and critical part of ovarian cancer treatment. The extent of surgery depends on the stage of the cancer and whether it has spread. Options include:
    • Ovarian surgery (oophorectomy): Removal of one or both ovaries.
    • Salpingectomy: Removal of the fallopian tubes.
    • Hysterectomy: Removal of the uterus.
    • Lymph node removal: If the cancer has spread, nearby lymph nodes may also be removed.
  2. Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells or stop their growth. It is typically administered after surgery to eliminate any remaining cancer cells or, in some cases, as the primary treatment for advanced ovarian cancer. Chemotherapy drugs may be given intravenously or directly into the abdominal cavity (intraperitoneal chemotherapy).
  3. Targeted Therapy: Targeted therapies are drugs that target specific molecules or pathways involved in cancer growth.
  4. PARP Inhibitors: Poly (ADP-ribose) polymerase (PARP) inhibitors, such as olaparib (Lynparza) and niraparib (Zejula), are used for the treatment of some types of ovarian cancer, particularly those associated with BRCA gene mutations. These drugs interfere with the ability of cancer cells to repair damaged DNA.
  5. Immunotherapy: Immunotherapy is a relatively new approach to treating ovarian cancer. It involves using drugs to stimulate the body's immune system to target and destroy cancer cells. Immune checkpoint inhibitors like pembrolizumab (Keytruda) and nivolumab (Opdivo) may be used in certain cases.
  6. Radiation Therapy: Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It is less commonly used in ovarian cancer but may be recommended in specific situations, such as to shrink tumors before surgery.
  7. Clinical Trials: Participation in clinical trials may offer access to experimental treatments and therapies that are not yet widely available. Patients should discuss the possibility of participating in clinical trials with their healthcare team.

It's important for patients to work closely with a multidisciplinary team of healthcare professionals, including gynecologic oncologists, medical oncologists, and radiation oncologists, to develop a personalized treatment plan. The choice of treatment will depend on the individual patient's circumstances and the stage and type of ovarian cancer. Ovarian cancer treatment aims to achieve the best possible outcome while minimizing side effects and maintaining the patient's quality of life.


Assoc. Prof. Dr. Ogün Erşen Date of birth 10.11.1987 Education and Expertise Karadeniz Technical University Faculty of Medicine Kocatepe University Ankara University Faculty of Medicine Konya Health Sciences University Professional Interests: Obesity (fatness) surgery and metabolic surgery Laparoscopic reflux surgery Laparoscopic gallbladder surgeries Gastric balloon application ERCP, EMR, ESD (Advanced Endoscopic procedures) Laparoscopic pancreatic cancer surgery Laparoscopic gastric and intestinal cancer surgeries Hemorrhoid surgeries Perianal fistula surgeries Laparoscopic abdominal and inguinal hernia surgeries Oncoplastic Breast cancer surgeries Natural cancer surgery (NOSE) Thyroid cancer and goiter surgeries. Memberships to Scientific Organizations Turkish Surgery Association Turkish Obesity Surgery Association Surgical Oncology Association National Society of Endoscopic Laparoscopic Surgery He is a member of the Bariatric and Metabolic Surgery Association. Courses and Certificates: Turkish surgical association proficiency exam (Board) certificate of achievement in 2018 He has more than 100 papers presented in national and international congresses and more than 50 articles published in international journals. Foreign language English
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