Ovarian cancer
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Definition
Epidemiology
Around 2% of women get it at some point in their lives - its the third commonest gynaecological cancer after breast and cervical cancer. Most are diagnosed over the age of 55.
Pathophysiology
Basically, like most cancer, a cell mutates and begins to multiply rapidly. There is a genetic link, in about 10% of cases. The genes involved are called BRCA1 and BRCA2.
Risk Factors
- Family history
- Personal history of cancer-especially breast, uterus, colon or rectum
- Older than 55
- Never been pregnant, or on the pill
- HRT
Clinical Features
- Abdominal pain
- Bladder/rectal pressure
- Weight loss
- Appetite loss
Investigations
- CA-125 blood test can be an indicator
- Ultrasound
- Biopsy
- CT scan
Management
Surgical removal is the mainstay of treatment. If the cancer is inoperable, prognosis plummets. Once this is done, chemotherapy follows, with its accompanying rubbish side effects.
Prognosis
Based on the FIGO staging:
- Growth limited to ovaries - 5 year survival 85%
- 1 or both ovaries with pelvic extension - 60%
- Peritoneal implants outside pelvis - 30%
- Distant metastases - 10%