Types Of Ovarian Cancer
There are over 30 subtypes of ovarian cancer, which are grouped into 3 major categories depending on the particular kind of ovarian cell that is affected. Ovaries are comprised of:
- Epithelial cells. These make up the outer surface lining of the ovaries.
- Germ cells. Cells inside the ovaries designated to become eggs.
- Stromal cells. These soft tissue cells serve both to provide structure in the ovary and to create / release the sex hormones estrogen, testosterone, and progesterone.
Ovarian carcinomas, cancers that begin in epithelial cells, are most common. Unfortunately, carcinomas are also the deadliest form of ovarian cancer, in large part because they are extremely difficult to diagnose. Current research on the risks of talcum powder use, especially when applied as a dusting to the perineal area, suggests that the product can increase the risk for epithelial-type ovarian cancers.
Germ cell tumors are distinctly rare, occuring most often in young women, including teenagers. Thankfully, around 90% of women with germ cell ovarian cancers can be cured, the National Ovarian Cancer Coalition reports. Stromal cell cancers are probably even less common than germ cell tumors, accounting for just 2% of all ovarian cancers. Most stromal cell tumors are caught early, during the first stage of cancer, leading to good prognoses in most cases.
Treatment Approach Varies By Stage
As with any cancer, early diagnosis is crucial, because the further cancer progresses, the more challenging it is to treat. Stages of ovarian cancer are determined both by the degree that the cancer has spread through the body and by the grade of the malignant tumors, which refers to the appearance and behavior of the tumor cells. Low-grade cancer cells still share significant similarities with normal cells, while high-grade cells may barely resemble their healthy counterparts.
Treatment for ovarian cancer often begins with surgery, the medical experts at Medscape say. “Debulking” procedures are designed to excise, or remove, as much of the malignant tissue as possible. The patient may also be advised to undergo additional surgeries, in an attempt to remove more tissue or entire organs that are particularly susceptible to metastasis, or that may contribute to the progression of cancer through hormonal means. For example, undergoing hysterectomy may help significantly in preventing the spread of ovarian cancer.
After surgery, ovarian cancer patients are often placed on a chemotherapy or hormone therapy regimen to help fight any remaining malignant cells left in the body.
Ovarian Cancer Symptoms & Diagnosis
In its early stages, ovarian cancer rarely displays any symptoms at all. With that being said, women are advised to watch closely for the following signs:
- Abdominal bloating
- Loss of appetite and nausea
- Feeling “full” even though you haven’t eaten much
- Pressure or pain in the pelvis and low back
- Increase in the frequency of urination
- Alterations in the normal appearance of bowel movements
Gastrointestinal symptoms are relatively common, because the ovaries lie close to the bladder and intestines. But again, these symptoms won’t occur in all women with ovarian cancer. To complicate matters, each of these potential signs is more likely to be caused by a benign, or non-cancerous, condition. The key to ovarian cancer symptoms is their persistence, length and abnormality. More often than not, the signs of ovarian cancer tend to persist for longer periods of time, and also tend to be more frequent. The American Cancer Society suggests that women who experience potential symptoms of ovarian cancer more than 12 times in a month seek out the guidance of a gynecologist.
One of the reasons why patients diagnosed with ovarian cancer tend to have a poor prognosis is because many of the disease’s early symptoms are “nonspecific.” This means they can easily be mistaken for signs of other illnesses or conditions, making the cancer difficult to identify until it has reached an advanced stage. Tragically, it’s often only after ovarian cancer has already spread significantly through the body that doctors are able to conclusively diagnose the disease.
Common Risk Factors For Ovarian Cancer
Though the precise causes for ovarian cancer are still poorly understood, medical researchers have established many probable risk factors for the disease by collecting and analyzing statistical data on ovarian cancer patients.
Sadly, most of these risk factors are impossible or difficult to control, including:
- Family history. Having a relative with ovarian, breast, uterine, or colon cancer can indicate a significantly elevated ovarian cancer risk. For example, it’s estimated that women with a first-degree relative (i.e. mother or sister) diagnosed with ovarian cancer have a 5% risk for developing ovarian cancer, which is more than triple the risk for the general population.
- Ethnic background. Statistics show that white, Hispanic, and African American women have a higher incidence of ovarian cancer than women of other races.
- Age. The median age for ovarian cancer diagnosis is 55. Though this is likely due (at least in part) to ovarian cancer’s long latency period, it could also indicate that aging itself increases the risk.
- No or few pregnancies and/or live births. Many researchers believe that each act of ovulation presents a risk of malignant mutation. Thus, reducing the number of ovulations over a woman’s life would decrease the cancer risk. Under this theory, it makes sense for pregnancy to decrease ovarian cancer risk, since ovulation is halted during pregnancy and ovarian cancer would have fewer chances to develop. Taking a pregnancy to term and having a live birth has been observed to offer even more protection against ovarian cancer.
- Endometriosis. This condition, in which the lining of the uterus is constantly shedding, often causing excessive bleeding and pain, also elevates ovarian cancer risk.
Unlike with some cancers—such as cervical cancer, which is known to be predominantly caused by human papillomavirus (HPV) and thus can be mostly prevented with the HPV vaccine—ovarian cancer is not yet understood well enough to establish surefire preventative measures.
Reducing Your Risk
Fortunately, there are several practices that patients can perform that may be able to reduce the risk of developing ovarian cancer:
- Use oral contraceptives. Since many birth control pills interrupt ovulation, it’s not surprising that they’ve been shown to be protective against ovarian cancer.
- Maintain a healthy BMI. A high Body Mass Index, or BMI, is a risk factor for many cancers, especially gynecologic cancers like ovarian. Research suggests this may be due to increased inflammation and the hormonal effects of obesity.
- Undergo tubal ligation. Women who have had their “tubes tied” seem to be less likely to develop ovarian cancer. Researchers say this could be due to the fact that tubal ligation closes off the pathway – through the vagina, cervix, uterus, and fallopian tubes – that external contaminants can use to travel to the ovaries.
- Stop genital use of talcum powder.
What Causes Ovarian Cancer?
Scientists are still trying to make sense of known risk factors and identify the precise causes of ovarian cancer. A clear understanding of the mechanisms behind ovarian cancer would help tremendously in prevention efforts as well as the continuing development of effective treatment methods. The cancer’s rarity and difficulty of diagnosis makes it particularly challenging to study.
Still, researchers have made significant headway with 3 major theories on the possible origins of epithelial ovarian cancer:
- Pituitary gonadotropin. According to this theory, when cysts form in the ovarian epithelium and are exposed to high levels of estrogen, the cells within the cysts may mutate into malignant ones. The fact that tubal ligation prevents the entry of particles that may irritate the epithelial lining and cause cyst formation seems to support this theory.
- Incessant ovulation. This theory says that the risk for ovarian cancer formation is a function of the total number and frequency of ovulations over a woman’s lifetime. Every time an egg is released, there’s a possibility of mutagenesis. The protective effect of having pregnancies and live births strongly support this theory.
- Inflammation. This is a relatively new theory in which any kind of inflammation promotes the development of malignant cells. Tubal ligation’s protective effect, as well as the risks that seem to be posed by endometriosis, pelvic inflammatory disease and genital exposure to asbestos and talc particles form strong support for this theory.
Currently, none of these theories seem to adequately explain all of the known risk factors for ovarian cancer. Researchers believe that there could be multiple mechanisms for ovarian carcinogenesis, so it could be that all three of these hold merit. Meanwhile, experts urge women, especially those who already possess multiple risk factors, to carefully consider the few risk factors that can be controlled and to discuss possible preventative measures with their doctors.
Does Talc Powder Cause Ovarian Cancer?
One of the most easily-controlled possible risk factors is genital use of talcum powder. Though doctors point out that this common practice is purely cosmetic, with no medical benefits whatsoever, thousands of women around the world make it part of their daily routine.
Unfortunately, this is likely because most people are simply unaware of the possible risks, even though over 45 years of research suggests that dusting genitals, underwear, or sanitary pads with talc can elevate ovarian cancer risk anywhere from 24% to over 300%.
What Does The Research Say?
Cancer patients who are filing talc lawsuits against Johnson & Johnson for failing to warn consumers of talc risks accuse the manufacturer of ignoring or even concealing decades of research identifying a link between elevated ovarian cancer risk and talcum powder use on the female genitals.
Were Women Warned About Talc & Ovarian Cancer?
Many women express utter shock after being informed that ovarian cancer may be a side effect of talcum powder. Talc products, such as baby and body powders, have been and still are promoted as safe and “gentle” by leading manufacturers such as Johnson & Johnson. Deane Berg, for example, the first woman to file a talc lawsuit against Johnson & Johnson and its talc suppliers, speaks in interviews about the moment she discovered that talc was an ovarian cancer risk factor. Prior to that time, she’d used talc for feminine hygiene as a comforting daily ritual – she’d never imagined that her Johnson’s Baby Powder could possibly harbor serious risks.
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