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Diagnosing Ovarian Cancer
Ovarian cancer is the fifth leading cause of cancer deaths in women. One out of
40 to 60 women have a lifetime chance of developing ovarian cancer.
There are different types of ovarian cancer:
Surface epithelial-stromal tumour, also known as ovarian epithelial carcinoma,
is the most common type of ovarian cancer. It includes serous tumour,
endometrioid tumor and mucinous cystadenocarcinoma.
Sex cord-stromal tumor, including estrogen-producing granulosa cell tumor and
virilizing Sertoli-Leydig cell tumor or arrhenoblastoma, accounts for 8% of
ovarian cancers.
Germ cell tumor accounts for approximately 30% of ovarian tumors but only 5% of
ovarian cancers.
Mixed tumors (two or more of the above types)
Symptoms
The most common signs are:
Bloating
Pelvic or abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (urgency or frequency)
These rather non-specific signs make early diagnosis difficult to make. When
suspected a doctor should always order a complete blood count (CBC) and serum
electrolyte test. When pregnancy is suspected the serum BHCG level should be
measured. Younger girls and adolescents have a higer risk at developing a
malignant germ cell tumor and should be tested for serum alpha-fetoprotein (AFP)
and lactate dehydrogenase (LDH).
Staging
Here are the stages used to characterize ovarian cancer development:
Stage I - limited to one or both ovaries
IA - involves one ovary; capsule intact; no tumor on ovarian surface; no
malignant cells in ascites or peritoneal washings
IB - involves both ovaries; capsule intact; no tumor on ovarian surface;
negative washings
IC - tumor limited to ovaries with any of the following: capsule ruptured, tumor
on ovarian surface, positive washings
Stage II - pelvic extension or implants
IIA - extension or implants onto uterus or fallopian tube; negative washings
IIB - extension or implants onto other pelvic structures; negative washings
IIC - pelvic extension or implants with positive peritoneal washings
Stage III - microscopic peritoneal implants outside of the pelvis; or limited to
the pelvis with extension to the small bowel or omentum
IIIA - microscopic peritoneal metastases beyond pelvis
IIIB - macroscopic peritoneal metastases beyond pelvis less than 2 cm in size
IIIC - peritoneal metastases beyond pelvis > 2 cm or lymph node metastases
Stage IV - distant metastases to the liver or outside the peritoneal cavity
Para-aortic lymph node metastases are considered regional lymph nodes (Stage
IIIC).
Grading
Description
1 Low grade – slow growing, less likely to spread
2 Moderate grade
3 High grade – tend to grow quickly, more likely to spread
Treatment:
As with many cancers the choice of treatment is usually based on a number of
factors and may include any of the following or combination thereof:
surgery
radiation therapy
chemotherapy
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