Ovarian Cancer

Ovarian cancer begins in the ovaries—two small, almond-shaped organs on each side of the uterus that produce eggs and female hormones.

It is often called the 'silent killer' because it is usually detected at an advanced stage, as early symptoms can be vague or mistaken for digestive or urinary issues.

There are different types of ovarian cancer, the most common being epithelial ovarian cancer (starting in the cells covering the ovary). Others include germ cell tumors (in egg-producing cells) and stromal tumors (in hormone-producing cells).

In the early stages, ovarian cancer may not cause noticeable symptoms. However, as it progresses, women may experience:

• Persistent bloating or abdominal swelling
• Pelvic or abdominal pain
• Feeling full quickly while eating
• Loss of appetite or weight loss
• Frequent or urgent need to urinate
• Changes in bowel habits (constipation or diarrhea)
• Fatigue and low energy
• Pain during intercourse

Ovarian cancer is classified into stages based on its spread:

• Stage I: Cancer is limited to one or both ovaries.
• Stage II: Cancer has spread to nearby pelvic structures (uterus, fallopian tubes, bladder, or rectum).
• Stage III: Cancer has spread to the abdominal lining or lymph nodes.
• Stage IV: Cancer has spread to distant organs such as the liver, lungs, or brain.

Treatment may include surgery to remove the ovaries, fallopian tubes, and uterus, followed by chemotherapy, targeted therapy, or immunotherapy depending on the stage.

The exact cause of ovarian cancer is unknown, but certain factors increase the risk:

• Age: Most common in women over 50, especially after menopause.
• Family history: Having close relatives with ovarian, breast, or colorectal cancer.
• Genetic mutations: Inherited BRCA1 and BRCA2 gene mutations significantly raise risk.
• Reproductive history: Never being pregnant or having first pregnancy after age 35.
• Hormonal factors: Long-term use of hormone replacement therapy.
• Endometriosis: A condition where uterine tissue grows outside the uterus.
• Obesity: Linked to higher risk and poorer outcomes.

While ovarian cancer cannot always be prevented, the following steps may reduce risk:

• Get genetic counseling and testing if you have a strong family history.
• Consider oral contraceptives (birth control pills) under medical supervision—they may lower risk.
• Maintain a healthy weight with a balanced diet and exercise.
• Manage conditions like endometriosis promptly.
• For women at very high genetic risk, preventive surgery (removal of ovaries and fallopian tubes) may be advised.
• Schedule regular gynecological check-ups and discuss symptoms early with your doctor.

Ovarian cancer is the 7th most common cancer in women globally.

• Each year, around 300,000 new cases are diagnosed worldwide.
• In India, ovarian cancer is one of the top three gynecological cancers.
• About 1 in 78 women will be diagnosed with ovarian cancer in their lifetime.
• The 5-year survival rate is about 90% when detected early, but since most cases are diagnosed late, overall survival drops to around 45%.