Ovarian Cancer

Question 1

Why does ovarian cancer have such a poor prognosis?

Answer 1

• it is difficult to diagnose
• by the time it is diagnosed, it is metastasized
• progresses silently

Question 2

What causes ovarian cancer?

Answer 2

gene mutation

Question 3

What are risk factors for ovarian cancer? (4)

Answer 3

1) ageing (due to cumulative exposure to carcinogens, also ovulatory age)
2) autosomal dominant, hereditary in some cases
3) familial history of cancers (not just ovarian cancer, breast cancer too)
4) others: nulliparity, infertility, dysmenorrhea

Question 4

Ovarian cancer can be a few different types originating from different cells - which cells are these? Which type is more common?

Answer 4

• epithelial (90%)
• germ cell
• stromal tumours

Question 5

What is the pathology of ovarian cancer?

Answer 5

• usually originates in epithelial cells
• grows and spreads silently, extends to tubes, uterus, ligaments and the other ovary, may seed to bowel surfaces, liver
• metastasis via lymph and blood
• may be uniform tumour or papillary

Question 6

What are manifestations of ovarian cancer?

Answer 6

• early on, non-specific GI disturbances (flatulence, bloating)
• abdominal distension
• pain
• urinary and bowel obstruction
• complications = inflammation, ascites and dyspnea
• pelvic mass usually the first finding

Question 7

How is ovarian cancer treated?

Answer 7

1) determine stage using exploratory surgery with laparoscopy
2) likely need aggressive treatment - remove uterus, tubes, ovaries, omentum
3) chemo after surgery in intermediate and advanced cancers
4) repeat the exploratory surgery after 6-24 months to see if more treatment is needed
5) some women may recover fully (sometimes it is detected early by accident, ex. in case of a woman treated for PID)