01 varian Cancer A leading killer of Cancer in Women- What you should know - PowerPoint Presentation

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varian Cancer

A leading killer of Cancer in Women- What you should know

Women's Health Initiative

About Ovarian Cancer

Cance

r starts when cells in the body begin to grow out of controlOvarian cancer tumors may start in fallopian tubes than in ovariesOvaries are made of 3 kinds of cells, each can develop into a different type of tumor

Epithelial tumors from cells that cover outer surface of the ovaryMost ovarian tumors are epithelial cell tumors

Germ cell tumors - from cells that produce eggs (ova)

Stromal tumors  - from cells that hold ovary together, produce estrogen and progesterone

Tumors can be benign, borderline (low malignant potential) or malignant

Benign tumors never spread beyond the ovaryBorderline or malignant tumors can spread to other parts of the body and can be fatal

Section 1 - About Ovarian Cancer                

American Cancer Society (ACS) 

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Epithelial Ovarian Tumors

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tart in outer surface of ovaries, can be benign, borderline, or malignant

Benign tumors don’t spread and don’t usually lead to serious illness   

Borderline tumors tend to affect younger women than typical ovarian cancer

Grow slowly and are less life-threatening than most ovarian cancers

Don’t grow into supporting tissue of the ovary

Malignant Epithelial Tumors 

85-90% of malignant ovarian cancers are epithelial ovarian carcinomas

Serous type is most common – can include high grade and low grade tumors

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Malignant Epithelial Tumors

Tumor Grades 

Grade 1 look more like normal tissue and tend to have a better prognosis

Grade 3 look less like normal tissue and usually have worse outlook     

Tumor Types

Type I tend to grow slowly and cause fewer symptoms

Do not respond well to chemotherapy

Example of type 1 tumors are serous, clear cell, mucinous, endometrioid

Type II grow fast, tend to spread sooner

Tend to respond better to chemotherapy 

Example of type II tumor is a high grade 3 serous carcinoma

Other traits are how fast cancer cells grow and how well cells respond to chemotherapy

Ovarian Stromal Tumors

About 1% of ova

rian cancers are ovarian stromal tumors

More than 50% of tumors found in women over 50 with 5% occurring in young girls

Abnormal vaginal bleeding most common symptom

Most common type of malignant stromal tumors is granulosa cell tumor

75% of patients survive long term from tumors found at early stage

https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html

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Key Statistics

About

21,750 women will receive diagnosis of ovarian cancer

About 13,940 will die from ovarian cancer

Ovarian Cancer ranks 5th in cancer deaths among women

Mainly develops in older women

Rate of ovarian cancer slowly falling over past 20 years

https://www.cancer.org/cancer/ovarian-cancer/about/

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Ovarian Cancer Diagnosis and Staging – Signs and Symptoms of Ovarian Cancer (ACS)

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ly stage ovarian cancer rarely causes any symptoms

Treatment generally more successful if cancer found and treated early

Symptoms more likely if disease has spread

Cancer symptoms also commonly caused by  benign disease and other cancers

Symptoms may include:

Bloating

Pelvic or abdominal pain

Trouble eating or feeling full quickly

Urinary symptoms such as urgency

Fatigue

Back Pain

Pain during sex

Constipation

Changes in a woman's period, heavy or irregular bleeding

Abdominal swelling with weight loss

Upset Stomach

Section 2 – Symptoms, Causes, Risk Factors and Prevention

https://www.cancer.org/cancer/ovarian-cancer/

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Causes

Cause of ovarian cancer not clear

Factors that can increase risk of disease

Cancer begins when a cell develops errors in its DNA

Cell receives a message to g

row and multiply creating a tumor

Abnormal cells keep living when healthy cells die

Cells can invade nearby tissue, break off from the initial tumor and metastasize

Studies continue on genes responsible for familial ovarian cancer

https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes

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syc-20375941?p=1

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Risk Factors

Older age – most common in women ages 50 to 60 years

Inherited gene mutations – small percentage of ova

rian cancer caused by gene mutations inherited from parents

Genes known to increase risk of disease of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2)

These genes also increase risk of breast cancer

Family history–  people with two or more close relatives with ovarian cancer have increased risk

Estrogen hormone replacement therapy especially with long term use and in large doses

Age when menstruation started and ended – early age or later age or both may increase risk

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Prevention

No sure way to prevent ovarian cancer

Consider use of birth control

pills

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alk with your physician

May have a reduced risk of ovarian cancer

Discuss personal and familial risk factors with your physician

If a gene mutation is

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resent, may need to c

onsider surgical removal of ovaries

Researchers constantly looking for ‘clues’ such as lifestyle, diet and medications that may alter risk

Testing continues on new drugs for ovarian cancer reduction risk

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Early Detection

Regular women’s health exams including pelvic exams

New ways for screening women are being tested

Proteomics (pattern of protein in the blood) being tested to find ovarian cancer early

Imaging Techniques

Functional MRI, PET/CT scans being studied to see where may be best used for ovarian cancer

Two tests used most often to screen for ovarian cancer are CA-125 and TVUS (transvaginal ultrasound)

CA-125 blood test measures amount of a protein called CA-125 in the blood

Test can be useful as a “tumor marker”, but not as useful as screening test for ovarian cancer

TVUS uses sound waves to look at uterus, fallopian tubes and ovaries to help find a mass

When used for screening, most masses found are not cancer

There are no recommended screening tests for germ cell tumors or stromal tumors

Section 3 – Early Detection

https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/d

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Diagnosis

For women who have an ovarian tumor, the OVA1 test can be used to determine if tumor

is

low risk or high riskTest

measures levels of 5 proteins in the blood that when looked at together can determine risk level

The test is not a screening test and not a test to decide if a woman should have surgery or not

It is intended for women who have a tumor and surgery has been decided, who have not yet been referred to a specialist

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The woman is not likely to have cancer

The woman is more likely to have cancer and

should see a specialist

LOW RISK

HIGH RISK

https://www.cancer.org/cancer/ovarian-cancer/about/new-research.html

Treatment Overview

Treatment research includes testing the value of currently available methods as well as developing new approaches to treatment

Surgery is the main treatment for ovarian cancer

However, treatment may usually involve a combination of surgery and chemotherapy

Other treatments may include hormone therapy and targeted therapy

Section 4 – Treatment for Ovarian Cancer

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Surgery for Ovarian Cancer

First goal is to stage the cancer or determine how far cancer has spread from the ovary

Staging ranges from I to IV - lowest stage I indicating cancer is confined to the

ovariesTo stage IV indicating cancer has spread to distant parts of the body

Next goal

is to remove as much as possible of the tumor as possible

Surgery to remove one ovary and its fallopian tube - very early stage cancer that has not spread

Surgery to remove both ovaries and fallopian tubes – cancer present in both ovaries, but no sign of additional cancerSurgery

to remove both ovaries and uterus – if ca

ncer is more extensive, removal of the ovaries, fallopian tubes, uterus, nearby lymph nodes and a fold of fatty abdominal tissue

Surgery for advanced cancer – if cancer is advanced, doctor may recommend chemotherapy followed by surgery to remove as much of cancer as possible

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A drug treatment that uses chemicals to kill fast-growing cells in the body including cancer cells

Can be injected into a vein (systemic) or taken by mouth

Can also be injected into the abdomen (intraperitoneal chemotherapy)

Often used after surgery to kill any remaining cells

Can also be used before surgery

Chemo for ovarian cancer usually involves giving two drugs together

Combination of drugs seem to work better as initial treatment

Chemotherapy

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For stage III ovarian cancer (cancer has not spread outside the abdomen), IP chemo may be given in addition to systemic chemo

Provides most concentrated dose of drugs directly to cancer cells into abdominal cavity

Also gets absorbed into the bloodstream

IP chemo appears to help women live longer, but side effects more severe

Intraperitoneal

(IP)

Chemotherapy

Uses drugs to identify and attack cancer cells while doing little damage to normal cells

Each type of targeted therapy works differently, but all change the way a cancer cell grows, divides, repairs itself, or interacts with other cells

Usually reserved for treating ovarian cancer that returns after initial treatment or cancer is resistant to other treatments

Targeted therapy is an active area of cancer research

Targeted Therapy

https://www.cancer.org/cancer/ovarian/cancer-treating/ch

emotherapy

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https://www.cancer.org/cancer/ovarian-cancer/treating/targeted-therapy.html

Use of hormones or hormone-blocking drugs to fight cancer

Type of systemic therapy rarely used to treat epithelial ovarian cancer, but more often used to treat ovarian stromal tumors

Hormone Therapy

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https://www.cancer.org/cancer/ovarian-cancer/treating/hor

mone-therapy

.html

https://www.cancer.org/cancer/ovarian-cancer/treating/radiation-therapy.html

Radiation therapy uses high energy x-rays or particles to kill cancer cells

X-rays may be given in a procedure that is much like having a regular x-ray

Aggressive chemotherapy is usually more effective, so radiation therapy is rarely used in this country as the main treatment for ovarian cancer

It

can be useful in treating areas where the cancer has spread, either near the main tumor or in a distant organ, like the brain or spinal cord.

Radiation Therapy

Supportive/Palliative Care

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rovided by team of doctors, nurses, and other specially trained professionalAim is to improve quality of life for the patient and familyFind support person to talk withMaintain communication with your doctor

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https://www.mayoclinic.org/diseases-conditions/ovarian

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cancer/diagnosis-treatment/drc-20375946?p=1

Living as an Ovarian Cancer Survivor

Lif

e after cancer means returning to some normalcy and making new choices

Ask for a “Survivorship Care Plan” from your doctor

Schedule follow-up tests, exams and blood tests for tumor markers

Be aware of possible side effects late and long term

Diet and physical activity suggestions

Follow-up with primary physicianContinue health insurance and keep copies of medical records

Section 5 - Living After Treatment for Ovarian Cancer

After Ovarian Cancer Treatment (ACS)

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Acupuncture

Good Nutrition

Yoga/ Tai ChiMassage Therapy

Naturopathic SupplementsPain Management

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https://www.cancercenter.com/integrative-care

Living as an Ovarian Cancer Survivor

Spiritual Support

Group Therapy

Music Therapy

Physical Therapy

Occupational Therapy

Oncology Rehabilitation

Lower Risk of Cancer Progressing

or Returning

Adopt

healthy behaviors

Don’t smoke

Maintain a healthy weight – eat well

Regular physical activityEmotional support

Family, friends Support groups

Religious Affiliation

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American Cancer Society Medical and Editorial Con

ten

t Team