OVARIAN CANCER

PRESENTED BY: MARJORIE A. ALVEZA

 The body is made up of trillions of living cells

Normal body cells grow, divide, and die in an orderly
fashion.
Cancer begins when cells in a part of the body start to
grow out of control.
Cancer cell growth is different from normal cell growth.
1. Instead of dying, cancer cells continue to grow and form
new, abnormal cells.
2. Cancer cells can also invade (grow into) other tissues,
something that normal cells cannot do.
Why the Cells become cancerous ???

WHAT IS OVARIAN
CANCER?

OVARIAN CANCER
Ovarian cancer forms in tissues of the ovary.
(An ovary is one of a pair of female
reproductive glands in which the ova, or
eggs, are formed.)
Tumors in the ovaries can be benign, which
means they are not cancer, or they can be
malignant, which means they are cancer.

OVARIAN CANCER
Cancers that start in the ovaries can spread
to other parts of the body. This is called
metastasis. Cancer that starts in the ovaries
and spreads to other parts of the body is still
called ovarian cancer.

SITUATION:
World:
Ovarian cancer is the fifth most common
cause of cancer deaths among women in the
US, according to the American Cancer
Society. However, a new study offers hope
for women diagnosed with the disease; the
10-year survival rate is higher than
previously thought.

SITUATION:
Philippines:
TheDepartment of Healthwebsite
citesovarian cancer as the fifth most
common cancer among Filipino women. It is
considered a silent killer as it is usually
detected when the cancer cells have already
spread to other organs such as the lungs and
the liver.

ANATOMY & PHYSIOLOGY

The ovaries are twin organs that produce
womens eggs and the main source of the
hormones estrogen and progesterone.
size: One ovary is long, 2 cm wide and 1
cm thick
Shape: almond shape.
Location: on each side of the uterus in
pelvis.

SIGNS & SYMPTOMS

Abdominal bloating or swelling

Quickly feeling full when eating
Weight loss
Discomfort in the pelvis area
Changes in bowel habits, such as
constipation
A frequent need to urinate

RISK FACTORS

Heredity
Gender
Age
Obesity
Infertility and drugs
Estrogen hormone replacement
therapy

RISK FACTORS

Age when menstruation started

and ended.
Never being pregnant.
Fertility treatment.
Smoking.
Use of an intrauterine device.
Polycystic ovary syndrome.

CAUSES

cancer begins when a genetic

mutation turns normal cells into
abnormal cancer cells.
Cancer cells quickly multiply,
forming a mass (tumor)

PATHOPHYSIOLOGY

Most theories of the

pathophysiology of ovarian
cancer include the concept that
it begins with the
dedifferentiation of the cells
overlying the ovary. During
ovulation, these cells can be

PATHOPHYSIOLOGY

where they then proliferate. Ovarian

cancer typically spreads to the
peritoneal surfaces and omentum.
Ovarian carcinoma can spread by
local extension, lymphatic invasion,
intraperitoneal implantation,
hematogenous dissemination, and
transdiaphragmatic passage.

PATHOPHYSIOLOGY

Intraperitoneal dissemination is the

most common and recognized
characteristic of ovarian cancer.
Malignant cells can implant anywhere
in the peritoneal cavity but are more
likely to implant in sites of stasis
along the peritoneal fluid circulation.

TYPES OF OVARIAN
CANCER

Epithelial tumors

- thin layer of tissue that covers

the outside of the ovaries
- 90 percent

TYPES OF OVARIAN
CANCER

Stromal tumors

- begin in the ovarian tissue that

contains hormone-producing
cells
- diagnosed at an earlier stage
- 7 percent

TYPES OF OVARIAN
CANCER

Germ cell tumors

- begin in the egg-producing

cells
- occur in younger women

STAGES OF OVARIAN
CANCER

Stage I - Growth of

the cancer
is limited to the ovary or
ovaries.
Stage IA - Growth is limited to
one ovary and the tumor is
confined to the inside of the
ovary. There are no ascites present

STAGES OF OVARIAN
CANCER

Stage I

Stage IB - Growth is limited

to
both ovaries without any
tumor
on their outer
surfaces. There are no ascites
present containing malignant
cells. The capsule is intact.

STAGES OF OVARIAN
CANCER

Stage I

Stage IC - The tumor is classified

as either Stage IA or IB and one or

more of the following are present:

(2) the capsule has ruptured

(3) there are ascites containing
malignant cells or with positive

STAGES OF OVARIAN
CANCER

Stage II Growth

of the cancer
involves one or both ovaries
with pelvic extension.
Stage IIA - The cancer has
extended to and/or involves the
uterus or the fallopian tubes, or
both.

STAGES OF OVARIAN
CANCER

Stage II

Stage IIB - The cancer has

extended to other pelvic organs.

STAGES OF OVARIAN
CANCER

Stage II

Stage IIC - The tumor is

classified as either Stage IIA or
IIB and one or more of the
following are present:
(1) tumor is present on the outer
surface of one or both ovaries;

STAGES OF OVARIAN
CANCER

Stage II

Stage IIC
2)the capsule has ruptured
3)there are ascites containing
malignant cells or with positive
peritoneal washings.

STAGES OF OVARIAN

CANCER
Stage III - Growth of the cancer
involves one or both ovaries, and one
or both of the following are present:
(1) the cancer has spread beyond the
pelvis to the lining of the abdomen;
and
(2) the cancer has spread to lymph
nodes. The tumor is limited to the true
pelvis but with histologically proven

STAGES OF OVARIAN
CANCER

Stage III Stage IIIA - During the staging operation,

the practitioner can see cancer involving
one or both of the ovaries, but no cancer
is grossly visible in the abdomen and it
has not spread to lymph nodes. However,
when biopsies are checked under a
microscope, very small deposits of cancer
are found in the abdominal peritoneal

STAGES OF OVARIAN
CANCER

Stage III

Stage IIIB - The tumor is in one or

both ovaries, and deposits of cancer
are present in the abdomen that are
large enough for the surgeon to see
but not exceeding 2 cm in diameter.
The cancer has not spread to the

STAGES OF OVARIAN

CANCER
Stage III

Stage IIIC - The tumor is in one or

both ovaries, and one or both of the
following is present:
(1)the cancer has spread to lymph
nodes; and/or
(2) the deposits of cancer exceed 2
cm in diameter and are found in the

STAGES OF OVARIAN
CANCER

Stage IV - This is the most advanced

stage of ovarian cancer. Growth of the
cancer involves one or both ovaries
and distant metastases (spread of the
cancer to organs located outside of the
peritoneal cavity) have occurred.
Finding ovarian cancer cells in pleural
fluid (from the cavity which surrounds
the lungs) is also evidence of stage IV

TREATMENT OVARIAN
Treatment
CANCER for ovarian cancer consists of
1.surgery
2.chemotherapy
3.combination of surgery with
chemotherapy
4.radiotherapy

TREATMENT OVARIAN
CANCER
Surgery
Chemotherapy: Patients will typically
receive a combination of carboplatin
(Paraplatin) and paclitaxel (Taxol)
intravenously. As it is injected into the
bloodstream it can target cancer cells in
the reproductive system, as well as any
cancer cells that may have reached

TREATMENT OVARIAN
CANCER

Side Effects of Chemotherapy

Nausea, vomiting - medication for this may be
given intravenously during chemotherapy
sessions.
Diarrhoea.
Hair loss.
Loss of appetite.
Mouth sores.

TREATMENT OVARIAN
CANCER

Drugs used in Chemotherapy

Topotecan
Liposomal doxorubicin (Doxil)
Gemcitabine (Gemzar)
Cyclophosphamide (Cytoxan)
Vinorelbine (Navelbine)
Ifosfamide (Ifex)
Etoposide (VP-16)
Altretamine (Hexalen)

TREATMENT OVARIAN
CANCER

Drugs used in Chemotherapy

Capecitabine (Xeloda)
Irinotecan (CPT-11, Camptosar)
Melphalan
Pemetrexed (Alimta)
Albumin bound paclitaxel (nab-paclitaxel, Abraxane)

TREATMENT OVARIAN
COMBINATION
CANCER CHEMOTHERAPY

For Germ Cell Cancer:

The combination mainly used most often is called PEB
P - cisplatin (Platinol), E -etoposide, B - bleomycin.
Other combination includes TIP: paclitaxel (Taxol), ifosfamide, and cisplatin
VeIP: vinblastine, ifosfamide, and cisplatin
VIP: etoposide (VP-16), ifosfamide, and cisplatin

TREATMENT OVARIAN
COMBINATION
CANCER CHEMOTHERAPY
For stromal tumors:
carboplatin plus paclitaxel or PEB
Side effects: Nausea, vomiting, hair loss and low blood count.

TREATMENT OVARIAN
RADIOTHERAPY
CANCER

Side effects Bladder infections.

Diarrhea, Constipation.
Irritation, darkening of your skin that the
radiation
beams hit.
Nausea, Frequent urination, Abdominal pain

PREVENTION:

TREATMENT OVARIAN
RADIOTHERAPY
CANCER
Gynaecologic surgery
tubal ligation
hysterectomy

TREATMENT OVARIAN
EARLY
DETECTION
CANCER

If a woman shows ovarian cancer symptoms, doctors may

monitor her with one of three tests or a combination of them:
1.Blood Test
2.Transvaginal Ultrasound
3.Pelvic Exam

TREATMENT OVARIAN
EARLY
DETECTION
CANCER
Screening test for ovarian cancer:
1.Transvaginal ultrasound
2.CA 125 blood test.

PROGNOSIS OVARIAN
CANCER

About 75 percent (3 out of 4) of ovarian cancer

patients live for at least one year after diagnosis.
Forty-six percent are still alive at least after 5
year. If diagnosed and treated before the cancer
has spread outside the ovary, the five-year
survival rate is 94 percent.