Ovarian Cancer

Presented by:

Vidya dhonde

M.Pharm sem-1

2014-2015

Guided by :

Dr. S.S.Mahajan.

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Contents Introduction

Types of ovarian tumors

Symptoms

Causes

Diagnosis

Stages

Treatment

Side effects

Prevention

Conclusion

reference

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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.

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Anatomy and physiology4

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.

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

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Epithelial ovarian tumours

Benign epithelial ovarian tumours

Tumours of low malignant potential

Malignant epithelial ovarian tumor

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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).

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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.

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SymptomsEarly 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

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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.

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Stagesstage:111

Stage:212

Stage: 313

Stage:414

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

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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.

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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.

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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®)

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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.

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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

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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.

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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 !!!

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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.

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Thank you

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