ovarian cancer

1. Ovarian Cancer
Presented by:
Vidya dhonde
M.Pharm sem-1
2014-2015
Guided by :
Dr. S.S.Mahajan.
1

2. Contents
 Introduction
 Types of ovarian tumors
 Symptoms
 Causes
 Diagnosis
 Stages
 Treatment
 Side effects
 Prevention
 Conclusion
 reference
2

3. Introduction
 The body is made up of trillions of living cells
 Normal body cells grow, divide, and die in an orderly fashion.
 Cancer begins when cells in a part of the body start to grow out of control.
 Cancer cell growth is different from normal cell growth.
1. Instead of dying, cancer cells continue to grow and form new, abnormal cells.
2. Cancer cells can also invade (grow into) other tissues, something that normal cells
cannot do.
Why the Cells become cancerous ???
Due to damage to DNA.
3

4. Anatomy and physiology
4
female organs (glands producing sex hormones and the
ova)
size: One ovary is long, 2 cm wide and 1 cm thick
Shape: almond shape.
Location: on each side of the uterus in pelvice.

5. Types of ovarian cancer
The ovaries contain 3 main kinds of cells:
1. Epithelial
2. Germ cells
3. Stromal cells
Each of these cells can develop into different
type of tumors.
Subsequently there are 3 main types of ovarian tumours:
1. Epithelial tumours
2. Germ cell tumours
3. Stromal tumours
5

6. Epithelial ovarian tumours
 Benign epithelial ovarian tumours
 Tumours of low malignant potential
 Malignant epithelial ovarian tumor
6

7. Germ cell tumors
 Less than 2% of Ovarian Cancers are germ cell tumors.
 9 out of 10 patients surviving at least 5 years after diagnosis.
Types of Germ Cell Tumors
 Teratoma
 Dysgerminoma
 Endodermal sinus tumor (yolk sac tumor).
7

8. Stromal tumours
 About 1% of ovarian cancers are ovarian stromal cell tumors.
 More than half of stromal tumors are found in women older than 50, but
about 5% of stromal tumors occur in young girls.
 The most common symptom of these tumors is abnormal vaginal bleeding.
 sudden, severe, abdominal pain. This occurs if the tumor starts to bleed.
8

9. Symptoms
Early symptoms of ovarian cancer:
•Pain in the pelvis
•Pain on the lower side of the body
•Back pain
•Indigestion or heartburn
•More frequent and urgent urination
•Pain during sexual intercourse
As ovarian cancer progresses these symptoms are also possible:
•Nausea, Weight loss, Breathlessness, Fatigue (tiredness)
•Loss of appetite
9

10. Causes
 Family history
 - Age
 - High number of total lifetime ovulations.
- Never having been pregnant .
 - Early start of menstruation and Late start of menopause .
 - Breast cancer.
- HRT (Hormone replacement therapy) .
- Obesity/overweight.
- Endometriosis.
- Inherited genetic syndromes.
 - Cowden's disease.
10

11. Stages
stage:1 11

12. 12 Stage:2

13. 13 Stage: 3

14. 14 Stage:4

15. Diagnosis of ovarian cancer
The following tests are used to diagnose ovarian cancer:
 Blood test
 Ultrasound
 Laparoscopy and possibly Endoscopy
 Colonoscopy
 Abdominal fluid aspiration
 Chest X-ray
 CT (computerized tomography) scan
 MRI (magnetic resonance imaging) scan
 Positron emission tomography (PET scan)
 Biopsy
15

16. Treatment
Treatment for ovarian cancer consists of
1. surgery
2. chemotherapy
3. combination of surgery with chemotherapy
4. radiotherapy
 Surgery
 Chemotherapy: Patients will typically receive a combination of carboplatin
(Paraplatin) and paclitaxel (Taxol) intravenously. As it is injected into the
bloodstream it can target cancer cells in the reproductive system, as well as
any cancer cells that may have reached elsewhere in the body.
16

17. Side effects of chemotherapy
Nausea, vomiting - medication for this may be given
intravenously during chemotherapy sessions.
 Diarrhoea.
 Hair loss.
 Loss of appetite.
 Mouth sores.
 Anaemia.
17

18. Drugs used in chemotherapy:
 Topotecan
 Liposomal doxorubicin (Doxil®)
 Gemcitabine (Gemzar®)
 Cyclophosphamide (Cytoxan®)
 Vinorelbine (Navelbine®)
 Ifosfamide (Ifex®)
 Etoposide (VP-16)
 Altretamine (Hexalen®)
 Capecitabine (Xeloda®)
 Irinotecan (CPT-11, Camptosar®)
 Melphalan
 Pemetrexed (Alimta®)
 Albumin bound paclitaxel (nab-paclitaxel, Abraxane®)
18

19. COMBINATION CHEMOTHERAPY
For Germ Cell Cancer:
The combination mainly used most often is called PEB
P - cisplatin (Platinol), E -etoposide, B - bleomycin.
Other combination includes -
· TIP: paclitaxel (Taxol), ifosfamide, and cisplatin
· VeIP: vinblastine, ifosfamide, and cisplatin
· VIP: etoposide (VP-16), ifosfamide, and cisplatin
For stromal tumors:
carboplatin plus paclitaxel or PEB
Side effects: Nausea, vomiting, hair loss and low blood count.
19

20. RADIOTHERAPY
Side effects -
•Bladder infections.
•Diarrhea, Constipation.
•Irritation, darkening of your skin that the radiation
beams hit.
•Nausea, Frequent urination, Abdominal pain
PREVENTION:
Oral contraceptives
Gynaecologic surgery
tubal ligation
hysterectomy
20

21. EARLY DETECTION
If a woman shows ovarian cancer symptoms, doctors may monitor her with one
of three tests or a combination of them:
1. Blood Test
2. Transvaginal Ultrasound
3. Pelvic Exam
Screening test for ovarian cancer:
1. Transvaginal ultrasound
2. CA – 125 blood test.
21

22. Conclusion
 Remember that although ovarian cancer is less common cancer
it is not silent and early diagnosis may save lives.
 Ovarian cancer has always been thought of as a symptomless
disease, but research has shown this to be untrue . There are
symptoms , unfortunately they may be so subtle that they are
attributed to other benign conditions.
 However 81% of the respondents realize in observation that
symptoms existed before diagnosis, with these symptoms being
confused with irritable bowel syndrome, pre-menopause, stress
acid-reflex, endometriosis, gall bladder issues or other ailments.
 It is the time to BREAK THE SILENCE….. educate yourself and
the women you love !!!
22

23. References
 American joint committee on cancer. Ovary. In: AJCC cancer
staging manual. 6th ed. New york: springer; 2002: 275-279.
 Murthy ns1, shalini s, suman g, pruthvish s, mathew changing
trends in incidence of ovarian cancer - the indian scenario. Asian
pac. J cancer prevention. 2009;10(6):1025-30.
 World cancer research fund/american institute for cancer research,
food, nutrition, physical activity, and the prevention of cancer,
ovarian cancer 2014 report :1-39.
23

24. Thank you
24