Ovarian cancer the silent killer

THE OVARIES are the primary female reproductive organs. These glands have three important functions: they secrete hormones, they protect the eggs a female is born with, and they release eggs for possible fertilisation.

Women are typically born with two ovaries stemming from the uterus. However, before puberty, ovaries are just long bundles of tissue. As the female matures, so do her ovaries. When mature, ovaries are about the size of a large grape, and they lie on either side of the uterus against the pelvic wall in a region called the ovarian fossa. They are held in place by ligaments attached to the uterus.

Our bodies are made up of billions of cells that can only be seen under a microscope. The cells group together to make up the tissues and organs of our bodies. Normally, cells only divide to replace old and worn-out cells. Cancer develops when something inside a single cell goes wrong, making the cell carry on dividing until it forms a lump or a tumour.

Ovarian cancer is when abnormal cells in the ovary begin to grow and divide in an uncontrolled way and eventually form a growth or tumour. If not caught early, cancer cells gradually grow into the surrounding tissues and may spread to other areas of the body.

There are different types of ovarian cancer, and the type of ovarian cancer you have depends on the type of cell it starts in.

According to Dr Ian Bambury, consultant gynaecologic oncologist and acting head of the Department of Radiation Oncology at the Kingston Public Hospital, one in 70 women will develop ovarian cancer in their lifetime. Ovarian cancer is also the fifth most common female cancer, and ranked three to four per cent of cancers among women.

Every ovarian cancer patient is different, and each deserves a treatment plan tailored to her needs and specific diagnosis. That starts with identifying the type of ovarian cancer.

Dr Bambury, who was a guest presenter at the Jamaica Cancer Society Dr Jospeh St Elmo Hall Memorial Lecture on Cervical Cancer, said most epithelial ovarian carcinomas or epithelial ovarian tumours are benign. However, cancerous epithelial tumours are the most common types of ovarian cancer.

According to the American Cancer Society, about 85 to 90 per cent of ovarian cancers originate from epithelial cells, which cover the outer surface of the ovary. They commonly spread to the lining and organs of the pelvis and abdomen first before spreading to other parts of the body, such as the lungs and liver. They also may spread to the brain, bones and skin.

“Two other types of cancer are similar to epithelial ovarian cancer: primary peritoneal carcinoma and fallopian tube cancer. Because they closely resemble epithelial ovarian cancer, they’re often treated with the same approaches and techniques. Primary peritoneal carcinoma develops in the lining of the pelvis and abdomen. Fallopian tube cancer starts in the fallopian tubes. Both are rare,” Dr Bambury said.

There are also germ cell tumours that begin in the reproductive cells, which are in the eggs for women and sperm for men. Germ cell tumours make up less than two per cent of all ovarian cancers, and have a high survival rate, with nine out of 10 patients surviving five years after diagnosis.

There is no way to know for sure if you will get ovarian cancer. Some women get it without being at high risk. However, several factors may increase a woman’s risk for ovarian cancer, including:

RISK FACTORS

• If you are middle-agd or older.

• Have close family members (such as your mother, sister, aunt, or grandmother) on either your mother’s or your father’s side, who have had ovarian cancer.

• Have a genetic mutation (change) that raises your risk, including BRCA1 or BRCA2, or one associated with Lynch syndrome.

• Have had breast, uterine, or colorectal (colon) cancer.

• Have endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body).

• Have never given birth or have had trouble getting pregnant.

In addition, some studies suggest that women who take estrogen by itself (without progesterone) for 10 or more years may have an increased risk of ovarian cancer.

If one or more of these factors is true for you, it does not mean you will get ovarian cancer. However, you should speak with your doctor about your risk.

According to Dr Bambury, despite surgery and chemotherapy, most patients may have a recurrence of ovarian cancer. There are a few preventative strategies that can be employed. However, constant monitoring when diagnosed with the illness is strongly advocated.

keisha.hill@gleanerjm.com

SOURCES:

Jamaica Cancer Society, American Cancer Society, Centers for Disease Control and Prevention.