Ovarian cancer is the most lethal gynae cancer. The tragedy with ovarian cancer is that only 20% of ovarian cancer are found at an early stage. It usually does not cause any symptoms, also some types of ovarian cancers grow very fast and spread to nearby organs by the time it is diagnosed. Efforts at devising an early detection test are hindered by our limited knowledge of the origin of ovarian cancer.
Regarding the causation of ovarian cancer, one of the hypotheses is the possible relationship between the process of ovulation and development of the most common form of Ovarian cancer that is Epithelial ovarian cancer. Humans have a higher incidence of ovarian cancer as compared to any other mammal, possibly due to their ovulation not being limited to the breeding season alone. Also, in the modern world with reduction in family size, there are fewer rest periods to ovulation as a result of pregnancy and breast feeding. The ovulatory process causes hormone-induced injury involving trauma and repair which can result in DNA damage causing cancer.
The causative effect of ovulation on ovarian cancer is further supported by the fact that suppression of ovulation by oral contraceptive pills reduces the risk of ovarian cancer. Various studies of analysis of data for incidence of ovarian cancer in the users of oral contraceptive pills have shown a lower incidence of ovarian cancer in them. This protective effect of the pills continues for years after stopping usage of pills.
The same theory raises concern about the possible long-term effect of development of ovarian cancer in women who are given ovulation stimulating drugs to induce multiple ovulations for infertility treatment. There is no convincing evidence for increase in risk of invasive ovarian cancer with fertility drug treatment. However, most medical bodies advise to limit the usage of the ovulation stimulating drugs to the minimum dose and duration.
Ovarian cancer lifetime risk in general population is less than two percent. The risk factors for ovarian cancer are age, obesity, parity, and genetic factors. Incidence of ovarian cancer increases with age and most cases happen after menopause. Obesity has been linked to increased risk of many cancers including ovarian cancer. Not having pregnancy or having pregnancy after 35 years of age increases the risk for ovarian cancer. Inherited mutations in genes BRCA-1 and BRCA-2 are linked to high-risk of breast, ovarian, fallopian tube, and primary peritoneal cancer.
Despite a lot of research, there is no good and effective screening tool for ovarian cancer. The two tests that are recommended are transvaginal ultrasound and blood test for a tumour marker, namely, CA-125.
The mainstay of management of ovarian cancer is surgery for removal of cancerous tissue, followed by chemotherapy. Timely detection of the cancer at an early stage helps in improving the chances of survival.