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3. Ovarian Cancer Treatment in India - A woman's lifetime risk of
dying from ovarian cancer is 1.1 per cent.
It is one of the most common cancers in women after breast
and cervix cancer. It is called a 'silent killer' as it is
asymptomatic in early stages and 75 per cent of cases are
diagnosed in the advanced stage. A woman's lifetime risk of
dying from ovarian cancer is 1.1 percent.

4. What constitutes ovarian cancer?
It largely means tumours of epithelial origin, but it can also
arise from other elements namely germ cells and stroma.
Epithelial ovarian cancers typically occur in
postmenopausal women and are in advanced stage at the
time of diagnosis, whereas germ cell tumours occur at a
young age, are detected in the early stages and are
completely curable.

5. Who Are At Risk?
•The majority of women with ovarian cancer have no known risk factors. Early
menarche, late menopause, being over the age of 30 at first childbirth, and nulliparity
are said to increase the risk.
What are the protective factors?
Childbirth, breast-feeding, oral contraceptives, tubal ligation, bilateral removal of
ovaries (bilateral oophorectomy), and hysterectomy.

6. Symptoms are non-specific like pelvic pain, back pain, abdominal
discomfort, bloating, early satiety, vaginal bleeding, and
frequent urination. Ovarian masses are sometimes detected on
pelvic examination.
What Are The Symptoms?
How is it Diagnosed?
Transvaginal Ultrasound (TVU) is an important diagnostic tool in
evaluation of patients with pelvic mass. Computed Tomography (CT)
and Positron Emission Tomography (PET scan) help in defining the
extent of the disease. MRI is sometimes helpful. Tumour markers
like CA 125 are adjunct to imaging and useful in follow up.

7. All masses in the ovary are not cancers. TVU helps distinguish
benign from malignant ovarian cysts. Complex cysts, defined as
cysts with both solid and cystic components, septations and
echogenicity, are malignant and require exploration. In contrast
simple cysts that are thin walled, less than 5-10 cm and without
septations are usually benign.
Are all ovarian masses cancers?

8. Screening for ovarian cancer has not been successful as natural
history of ovarian cancer is not well understood. There is no well-
defined precursor lesion and the length of time from localised
tumour to dissemination is unknown. Multiple efforts are underway
to develop effective screening methods. Pelvic examination, CA 125,
and TVU with Doppler are studied as screening methods in high-risk
individuals.
Is ovarian cancer genetic?
Around 5-10 per cent of patients carry germline mutation. Breast-
ovarian cancer syndrome accounts for approximately 90 per cent of
hereditary ovarian cancer and is suspected whenever there are
multiple affected family members with , bilateral or early onset
breast cancer, both breast and ovarian cancer in the same
individual, or a male relative with breast cancer.
Can we detect early?

9. Ovarian Cancer Treatment depends on the age, stage, tumour type
and the desire to preserve fertility. Surgery and chemotherapy is
the mainstay of treatment.
What complications can I expect after chemotherapy?
The most common early complications are loss of hair, nausea and
vomiting. There can be reactions during infusion of chemotherapy,
which are prevented with good premedication. Late complications
include tingling and numbness in fingers and toes.
What are the treatment of Ovarian Cancer modalities?

10. Chemoprevention is by oral contraceptives. Surgical prevention is by
bilateral oophorectomy, tubal ligation and hysterectomy. Risk-
reducing bilateral oophorectomy is strongly recommended in
women who carry germline mutation for hereditary ovarian cancer,
because of high mortality of ovarian cancer and lack of effective
screening and preventive approaches. Fortunately, risk of ovarian
cancer does not rise dramatically until the late 30s in women with
germline mutation, so women have the opportunity to complete
their family prior to surgery.
Since ovarian cancer is one of the common cancers in women and
there are no effective population screening methods, high index of
suspicion is necessary for early diagnosis. With the new trends in
chemotherapy, survival is increasing in ovarian cancer patients and
awareness is necessary among the public for seeking early medical
attention.
How do I prevent?

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