Ovarian cancer, often been referred to as a ‘silent killer’, is a cancerous growth that is responsible for 67 deaths each year in Costa Rica.
The signs and symptoms of ovarian cancer are frequently absent early on and when they exist they may be subtle. In most cases, the symptoms persist for several months before being recognized and diagnosed. Most typical symptoms include: bloating, abdominal or pelvic pain, difficulty eating, and possibly urinary symptoms.
Other findings include an abdominal mass, back pain, constipation, tiredness and a range of other non-specific symptoms, as well as more specific symptoms such as abnormal vaginal bleeding or involuntary weight loss. There can be a build-up of fluid (ascites) in the abdominal cavity.
Ovarian cancer is associated with age, family history of ovarian cancer (9.8-fold higher risk), anaemia (2.3-fold higher), abdominal pain (sevenfold higher), abdominal distension (23-fold higher), rectal bleeding (twofold higher), postmenopausal bleeding (6.6-fold higher), appetite loss (5.2-fold higher), and weight loss (twofold higher).
In most cases, the exact cause of ovarian cancer remains unknown. The risk of developing ovarian cancer appears to be affected by several factors:
- Older women who have never given birth, and those who have a first or second degree relative with the disease, have an increased risk.
- Hereditary forms of ovarian cancer can be caused by mutations in specific genes (most notably BRCA1 and BRCA2, but also in genes for hereditary nonpolyposis colorectal cancer).
- Infertile women and those with a condition called endometriosis, and those who use postmenopausal estrogen replacement therapy are at increased risk.
According to statistics, each year 133 Ticas (Costa Rican women) are diagnosed each year. Micheal Liberman, medical manager at the pharmaceutical Roche, says that 80% of the case are detected at later stages, and there is no procedure for early detection.
“In proportion, is a very similar figure to the global statistics. The importance is that it is a deadly disease, then even though the rate of incidence sounds low, is a very high figure (…) would be the second leading cause of death from gynecological cancer after cervical cancer”, said Liberman.
Worldwide, around 140,000 women die of ovarian cancer every year. Even modern screening tests for ovarian cancer, which include a blood test for the CA 125 marker, combined with ultrasound, often result in unnecessary surgery and “..are failing to catch early signs of the disease..”, a study at the University of Alabama at Birmingham Comprehensive Cancer Center revealed.
Main types of ovarian cancers (tumors)
Epithelial ovarian cancer is by far the most common form of ovarian cancer. Germ cell and stromal ovarian cancers are much less common. Ovarian cancer can also result from a cancer somewhere else in the body that has spread:
- Epithelial ovarian cancer (epithelial ovarian tumors) – derived from cells on the surface of the ovary. It occurs mainly in adults.
- Germ cell ovarian cancer (germ cell ovarian tumors) – derived from the egg-producing cells within the body of the ovary. This rare type of cancer more commonly affects children and teenage girls.
- Stromal ovarian cancer (sex cord stromal tumors) – develops within the cells that hold the ovaries together.
- Cancers from other organs in the body can spread to the ovaries – metastatic cancers – a metastatic cancer is one that spreads from where it first arose as a primary tumor to other locations in the body.