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Ovarian Cancer

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Summer Sutton

on 4 December 2013

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Transcript of Ovarian Cancer

Ovarian Cancer
What is it?
Ovarian cancer is cancer of the ovaries, which, is obviously only found in women.
Ovaries are female reproductive organs that produce eggs (two on each side of the uterus) that are also the main source of female hormones
Cancer, appearing in many forms throughout organisms bodies, is the abnormal and uncontrollable division of cells that invades other tissues, usually traveling through the blood and lymph systems.
Why did it happen?
Ovarian cancer is caused by communication failure throughout cells (from cell to cell)
Type of Cell Communication Breakdown

• Vaginal bleeding or discharge from the vagina that is not normal for the person
• Pain in the pelvic or abdominal area
• Back pain
• Bloating (stomach swelling)
• Feeling full quickly while eating (compared to normal habits)
• A change in normal bathroom habits, such as having to pass urine very badly or very often, constipation, or diarrhea.

Treatment options
Anatomy of Ovaries Diagram
Image adapted from: http://www.bandbacktogether.com/ovarian-cancer-resources/
Epithelial tumors
These tumors begin from the cells that surround the ovaries. Epithelial tumors are the most common type of ovarian tumor.
Benign epithelial tumors are not malignant, do not spread, and usually do not cause serious illness.

This is the best possible kind of tumor to have in the ovaries if any at all.
Benign tumors
LMP ( low malignant potential) tumors
These tumors are not clearly cancerous. They mainly affect younger women and are not as life threatening as full malignant tumors. However, they do have the capability to spread if not treated properly.
Malignant epithelial tumors
These types of tumors are the most common and dangerous. The high malignancy of these tumors cause the most issues.
Germ Cell Tumors
Germ cell tumors are tumors that begin from the cells that produce the eggs (embryos).

The most common type of germ cell tumor is dysgerminoma
Less than 2% of all ovarian cancers originate from germ cell tumors
About 2.4 children in one million will develop one of these tumors in a given year
Stromal tumors
Start from the cells that hold the ovary together (connective tissue cells) and make the hormones.
These tumors account for about 10% of ovarian tumors.
They also account for the most hormonally active tumors
Patients diagnosed with Stromal tumors usually happen to be in stage 1 70% of the time, while epithelial tumors are usually at stage 3 or 4 when encountered 75% of the time.
Each of these types of tumors originate from the main three different kinds of tissue found in the ovaries; connective tissues, cells surrounding the ovaries, and cells that produce eggs.
Hormone Therapy
Targeted Therapy
Risk Factors
Women who have one first-degree relative (mother, daughter, or sister) with ovarian cancer are at an increased risk. This risk is higher in women who have one first-degree relative and one second-degree relative (grandmother or aunt) with ovarian cancer. This risk is even higher in women who have two or more first-degree relatives with ovarian cancer
5 to 10% of ovarian cancer has a familial link
Lowering risks:
Often times women will take the birth control pill to help prevent from ovarian cancer
Having a child also prevents this, although many women have children not simply just to prevent ovarian cancer.
Meet Bre Tipps
Many families are affected by ovarian cancer. This awful disease permanently takes a toll on many families all over the world, whether the cancer is terminal or not.
Her Story
• Symptoms included stomach issues, bloating, and pain with contact

• She has 3 kids (ages 4, 10, 11) and felt these symptoms starting at age 26

• At first she was repeatedly dismissed by the physicians

• Symptoms then worsened and she went to the ER, had a CT scan that revealed a fibroid tumor (about the size of a golf ball).

• A simple surgery was to be done and the chance of cancer was 1%

• After the surgery, she learned that it was unsuccessful and she had stage 4 cancer

• Without treatment she would have 6 months to live, but decided to fight it for her family.

• Chemotherapy was her first move to treatment and her tumors did not respond after a month, they only grew larger.

• Avastin and Sovenifib were two drugs she took over the course of 8 months that shrunk her tumors.

• Months afterward, she had a debulking surgery that removed 90% of the cancer.

• Recently she has been undergoing hormonal therapy (past 2 months), and her recent CT scan shows that tumors are calcifying and dying.

• There will never be a Cure to Bre’s cancer and she will always live with it. Thankfully she was able to take steps needed to save her life.
Story adapted from Cancerwise Blogger. "Cancer Patient: Don't Ignore Ovarian Cancer Symptoms."
MD Anderson Cancer Center. U of Texas, 3 Sept. 2013. Web. 3 Dec. 2013.
Meet Karen Nugent
Both Karen and Bree were the lucky survivors although they received an awful diagnosis. Not all cases result in such miraculous ways, unfortunately, many are tragic.
Cancer is never cured, but can be restrained and "killed" so that it does not limit the human body. Not all treatments are effective either, some may work and some may not. For the ones that do, cancer may still return.
Many patients undergo invasive or debulking surgeries to remove cancer. Luckily, women can live without their ovaries, but will not be able to reproduce. However, if the cancer has already spread, surgery may not be successful. This is normally the first step taken when cancer is found, no matter how progressed it is.
Granulosa Stromal Cell Tumor
1-2% of ovarian tumors
All types can be malignant
Can be present with abnormal vaginal bleeding
Often can be associated with hyperplasia and carcinoma
Can be displayed in a microscopic view with different patterns
More often found in postmenopausal women
Sertoli-Leydig Stromal Cell Tumors
Accounts for less than 0.5% of ovarian tumors
More often found in younger women
Ranges microscopically
Usually seen in the second and third decades of life
Every woman should undergo a regular rectal and vaginal pelvic examination
If an irregularity of the ovary is found, alternatives to evaluation include transvaginal sonography and/or tumor markers.
The most common tumor marker is a blood test called the CA-125.
There is no prevention of ovarian cancer, but precautionary steps can be taken, especially if you are aware of familial links (risks are higher).
Early action and awareness will not stop cancer or cure it, but will save lives, stopping the horrific disease at it's early stages

Stages of Cancer
Stage 1:
The growth of the cancer is limited to the ovaries
Stage 2:
The growth of the cancer is in one or both ovaries with a pelvic extension
Stage 3:
Growth of the cancer involves one or both ovaries, the cancer has spread beyond the pelvis to the lining of the abdomen and/or the cancer has spread to lymph nodes. The tumor is limited to the true pelvis but with histologically proven malignant extension to the small bowel or omentum.
Stage 4:
This is the most advanced stage of ovarian cancer. Growth of the cancer involves one or both ovaries and the cancer mestastasizes. Finding ovarian cancer cells in pleural fluid (from the cavity which surrounds the lungs) is also evidence of stage IV disease.
*Stages 1, 2, and 3 all have subcategories A-C that are more detailed evaluations of the cancer*
A drug used to treat cancer
Often systemic (the drugs are given in a way that allows them to enter the bloodstream and reach all areas of the body) which helps when cancer is metastasized
Either given orally or through IVs
Can be injected through a catheter directly into the abdominal cavity for ovarian cancer
Although chemo may kill cancer cells, it also damages normal cells leading to nausea and vomiting, sores, skin rashes, loss of hair and appetite
Chemo also affects the blood-producing cells of bone marrow causing low blood counts which can cause the immune system to be weaker resulting in infections, fatigue and bleeding or bruising after minor cuts.

Usually not used for ovarian cancer, surgery and chemo are the main treatments unless it is stage 1 or 2.
Radiation is also used after surgery often times to kill off any remaining cancer cells.
Short term radiation effects: irritable bladder and feeling sick
Long term radiation effects: bowel changes and passing urine more frequently

Use of hormones or hormone blocking drugs to fight cancer.
This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors.
Newer type of cancer treatment that uses drugs or other substances to identify and attack cancer cells while doing little damage to normal cells.
Normal Cell Communication
This entire network of pathways is built with interactive proteins, providing a normal functioning cell. This cell divides and auto destructs when needed.
Cancer cells
The genetic changes in cancer result in altered proteins that disrupt the cell's communication network. These proteins cause signals to altered in some way, if they still exist. Normal communication is then directed towards tumor growth. The cancer cell becomes immortal and does not auto destruct.
What is causing this?
The main trouble with diagnosis is to locate the renegade genes and proteins. The cell then needs to be opened and the biomolecules need to be analyzed after discovered.
In research with different types of cancer cells, some cancer cells do not communicate, whereas others do. Other studies suggest that cancer cells communicate with themselves but not with surrounding normal cells.
There are many theories on the cause of ovarian cancer, but they are still unsure of a reason for the disease.
During the cell communication issues, the signal does not reach it's target after it changes.
Also, too much protein exists causing too much signal within the cell, as well as many other issues.
The normal cell changes when it is cancerous and spreads faster, while it remains immortal.
Information adapted from http://www.cancer.gov/cancertopics/factsheet/detection/staging
Information adapted from http://www.cancer.gov/cancertopics/pdq/treatment/ovarianepithelial/patient/

Information adapted from The National Cancer Society (http://www.cancer.org)

Information adapted from http://www.cdc.gov/cancer/ovarian/basic_info/symptoms.htm

Information adapted from

Information adapted from http://www.cancer.gov/cancertopics/understandingcancer/moleculardiagnostics/MOLEDIAG.PDF
Information adapted from http://www.cancer.gov/cancertopics/understandingcancer/moleculardiagnostics/MOLEDIAG.PDF
Information adapted from http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/oncology/gct.html
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