Ovarian cancers

MY mother's abdomen has slowly gotten bigger over the past few months. At first, she thought she was getting fat. But when we insisted that she should go to the doctor, the doctor called us in separately and told us that she had ovarian cancer. We are very shocked and we don't know what to tell her.

What is ovarian cancer?

The ovaries are the part of a woman's reproductive organs that generate the ovum (or eggs) that will be released into the uterus (womb) via the Fallopian tubes. The ovaries are also responsible for generating the female hormones - oestrogen and progesterone - which are responsible for a female's menstrual cycle and reproductive function.

The ovaries only stop releasing eggs when a woman hits her menopause. It also manufactures much lower levels of female hormones at this time.

Ovarian cancer occurs when the cells of the ovary mutate and form - collectively - an unusual growth or a tumour. Tumours can be benign or malignant (cancerous). Ovarian cancer is obviously of the malignant variety.

Is this the same as an ovarian cyst? Because my friend also had the same swelling of the abdomen like my mother, only the doctor told her she had an ovarian cyst.

An ovarian cyst is a cyst (fluid-containing sac) that may arise from the surface of the ovary and within its tissue. A cyst usually contains fluid, but may contain solid tissue. A cyst can sometimes grow to very large proportions.

An ovarian cyst can be benign or malignant as well. So ovarian cancer can also arise from an ovarian cyst. Fortunately, most ovarian cysts are benign.

Back to the condition of my mother, the doctor told us that her cancer has spread. What does this mean?

Basically, most cancers can spread. By this spread, it is meant that the cancer can grow bigger and subsequently invade other organs around the ovaries, such as the Fallopian tubes and uterus.

Cancer cells can also shed or break off from the main ovarian tumour mass and attach themselves onto the surface of the organs around the ovary, or even on the abdomen walls.

These are called "seeds" or "implants".

The cancer can also spread via the lymphatic system where the tissue fluids drain into, and then to the lymph nodes. It can also spread via the bloodstream into distant organs like the liver or lungs. This is called "metastasis".

How do you get ovarian cancer?

How did my mother get ovarian cancer? My mother didn't smoke or do anything out of the norm.

Obesity is indeed a risk factor. If you have a mother or sister with ovarian cancer, you are definitely are at increased risk to get it. If you or one of your family members has had breast cancer, or uterine cancer (womb), or colorectal cancer, you are at higher risk for ovarian cancer too.

Older women who have had their menopause, especially those over age 55, are more at risk, as well as women who have never been pregnant. If after your menopause, you have taken more than 10 years of oestrogen replacement therapy (that is, oestrogen alone without the progesterone component), you are also at increased risk.

There have been studies that certain fertility drugs may have a link to ovarian cancer.

Is a distended abdomen the only sign of ovarian cancer?

But when ovarian cancer is very early, it usually does not cause any symptoms at all. But when the cancer grows, you may feel some pain in your abdomen, or back, or pelvic area, or even legs. Then you may have the sign of a distended abdomen.

As a result of tumour pressure on your surrounding organs, you may get nausea, indigestion, diarrhoea, or constipation, especially when the tumour presses on your stomach or guts. Or even the desire to urinate all the time - when the cancer presses on your bladder.

And because it is a cancer, you may feel tired easily.

Sometimes, you may get very heavy periods (if before menopause) or bleeding through the vagina after menopause.

Is there any hope for a cure?

If the ovarian cancer is at early stage without any spread, it can definitely be cured. Surgery is required to remove the tumour and the entire ovary as well as the Fallopian tubes and womb. The lymph nodes in the area are also removed.

Surgery is also done when the ovarian cancer has spread - in this case, it is called a debulking. Once there is spread and/or metastasis, radiotherapy and chemotherapy are required.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only.