Ovarian cancer is a malignancy that starts in the ovary, a female reproductive organ that produces eggs. It affects over 22,000 women in the United States each year and causes more than 14,000 deaths annually. Although ovarian cancer is relatively rare, it is the fifth most common cause of cancer death in women. Due to the lack of symptoms in the early stages and the absence of a reliable screening test, most women with ovarian cancer are diagnosed in advanced stages when the cancer has spread to other parts of the body, making it difficult to treat.

There are three main types of ovarian cancer: epithelial, germ cell, and stromal. Epithelial ovarian cancer is the most common type, accounting for 85-90% of cases. It arises from the cells that cover the outer surface of the ovary. Germ cell and stromal ovarian cancers make up the remaining 10-15% of cases. Germ cell ovarian cancer starts in the cells that form the eggs, while stromal ovarian cancer arises from the supporting tissue of the ovary.

Risk factors for ovarian cancer include age, genetics, reproductive history, and hormonal factors. Most cases occur in women over the age of 50, and the risk increases with age. Women with a family history of ovarian cancer or certain inherited gene mutations, such as BRCA1 and BRCA2, are at higher risk. Women who have never had children, who had their first child after age 35, who have never used oral contraceptives, or who have had infertility or hormone replacement therapy are also at increased risk.

Symptoms of ovarian cancer are often vague and nonspecific, making it difficult to diagnose. The most common symptoms include abdominal bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary urgency or frequency. Other symptoms may include fatigue, back pain, menstrual changes, and gastrointestinal disturbances. These symptoms may be present for several months before a diagnosis is made.

Diagnosis of ovarian cancer usually involves a physical exam, imaging tests, and blood tests. A pelvic exam may reveal a swollen ovary or a mass in the pelvis. An ultrasound or CT scan may be used to visualize the ovaries and other organs in the pelvis and abdomen. A blood test called CA-125 may be used to measure a protein that is often elevated in women with ovarian cancer. However, CA-125 levels can also be elevated in other conditions, such as endometriosis, so it is not a reliable screening test.

Treatment of ovarian cancer depends on the stage and grade of the cancer, as well as the woman’s overall health and preferences. Surgery is usually the first step in treatment and may involve removing one or both ovaries, the uterus, and other pelvic or abdominal organs if the cancer has spread. Chemotherapy may be given after surgery to kill any remaining cancer cells. Radiation therapy is rarely used in the treatment of ovarian cancer.

Prognosis for ovarian cancer depends on many factors, including the stage of the cancer at diagnosis, the woman’s age and overall health, and the response to treatment. The five-year survival rate for ovarian cancer is around 45%, but this varies widely depending on the stage of the cancer. Women with early-stage ovarian cancer have a much better prognosis than those with advanced-stage disease.

Prevention of ovarian cancer is difficult since the risk factors are largely out of our control. However, there are some steps that women can take to reduce their risk. These include using oral contraceptives for at least five years, having multiple full-term pregnancies, breastfeeding, avoiding hormone replacement therapy, and maintaining a healthy weight and diet.

In conclusion, ovarian cancer is a devastating disease that often goes undetected until it has spread beyond the ovaries. Early detection and treatment are key to improving outcomes for women with ovarian cancer. Women with a family history of ovarian cancer or certain gene mutations should consider genetic counseling and testing. Additionally, all women should be aware of the symptoms of ovarian cancer and see their healthcare provider if they experience any of these symptoms.

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