A risk factor is anything that increases your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lung, mouth, larynx, bladder, kidney, and several other organs.
Researchers have discovered several specific factors that increase a woman's likelihood of developing epithelial ovarian cancer. These risk factors do not apply to other less common types of ovarian cancer such as germ cell tumors and stromal tumors.
Most women with ovarian cancer do not have any known risk factors. Risk factors increase the odds of getting a disease but do not guarantee it will occur. Only a small number of women who have risk factors will develop ovarian cancer.
Age: Most ovarian cancers develop after menopause. A woman is considered to be menopausal when she has gone a year without a menstrual period. Half of all ovarian cancers are found in women over the age of 63.
Obesity: A study from the American Cancer Society found a higher rate of death from ovarian cancer in obese women. The risk was increased by 50% in the heaviest women.
Reproductive history: Women who started menstruating at an early age (before age 12), had no children or had their first child after age 30, and/or experienced menopause after age 50 may have an increased risk of ovarian cancer. There seems to be a relationship between the number of menstrual cycles in a woman's lifetime and her risk of developing ovarian cancer.
Fertility drugs: In some studies, researchers have found that prolonged use of the fertility drug clomiphene citrate, especially without achieving pregnancy, may increase the risk for developing ovarian tumors, particularly a type known as "tumors of low malignant potential" (LMP tumors). If you are taking this drug, you should discuss its potential risks with your doctor. However, infertility also increases the risk of ovarian cancer, even without use of fertility drugs. More research to clarify these relationships is now underway.
Family history of ovarian cancer, breast cancer, or colorectal cancer:Your ovarian cancer risk is increased if your mother, sister, or daughter has (or have had) ovarian cancer, especially if she developed ovarian cancer at a young age. Two-thirds of women who develop ovarian cancer are over 55 years old. If your relative had ovarian cancer when she was younger than 55, that may be a sign that your risk is even higher. The younger your relative was when she developed ovarian cancer, the higher your risk. You can inherit an increased risk for ovarian cancer from relatives on your mother's side or father's side of the family. About 10% of ovarian cancers result from an inherited tendency to develop the disease. If there is a family history of cancer caused by an inherited mutation (change) of the breast cancer gene BRCA1 or BRCA2, you have a very high risk of ovarian cancer. Also, a mutation leading to inherited colorectal cancer can increase the risk of ovarian cancer. Many cases of familial epithelial ovarian cancer are caused by inherited gene mutations that can be identified by genetic testing.
Women with ovarian cancers caused by these inherited gene mutations tend to have a better prognosis than patients who do not have any family history of ovarian cancer. (See the section on causes of ovarian cancer for information on these gene mutations.)
Genetic counseling, genetic testing, and strategies for preventing ovarian cancer in women with an increased familial risk are discussed in the prevention section of this document.
copyrighted by the American Cancer Society, Inc. All rights reserved.
Wednesday, June 28, 2006
ovarian cancer : How Is Ovarian Cancer Diagnosed?
Ovarian cancer may cause several signs and symptoms. However, most of these may also be caused by benign (non-cancerous) diseases and by cancers of other organs. The most common symptom is back pain, followed by fatigue, bloating, constipation, abdominal pain and urinary urgency. These symptoms tend to occur very frequently and become more severe with time. Most women with ovarian cancer have at least 2 of these symptoms.
Others symptoms, which tend to occur later in the course of the disease, are prolonged swelling of the abdomen, abdominal pain and cramping, a feeling of pelvic pressure, vaginal bleeding, and leg pain.
If there is reason to suspect you may have ovarian cancer, your doctor will use one or more methods to be absolutely certain that the disease is present and to determine the stage of the cancer.
Consultation With a Specialist
If your pelvic examination or other tests suggest that you may have ovarian cancer, you will need a doctor or surgeon who specializes in treating women with this type of cancer. A gynecologic oncologist is an obstetrician/gynecologist who is specially trained in treating cancers of the female reproductive system.
Imaging Studies
Imaging methods such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and ultrasound studies can confirm whether a pelvic mass is present. Although these studies cannot confirm that the mass is a cancer, they are useful if your doctor is looking for spread of ovarian cancer to other tissues and organs.
Ultrasound: Ultrasound (ultrasonography) is the use of sound waves to create an image on a video screen. Sound waves are released from a small probe placed in the woman's vagina or on the surface of her abdomen. The sound waves create echoes as they enter the ovaries and other organs. The same probe detects the echoes that bounce back, and a computer translates the pattern of echoes into a picture. Because ovarian tumors and normal ovarian tissue often reflect sound waves differently, this test may be used to find tumors and determine whether a mass is solid or a fluid-filled cyst.
Computed tomography (CT): The CT scan is an x-ray procedure that produces detailed cross-sectional images of your body. Instead of taking one picture, like a conventional x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body. The machine will take pictures of multiple slices of the part of your body that is being studied.
CT scans are useful in showing how large the tumor is, what other organs it may be invading, whether lymph nodes are enlarged and whether the kidneys or bladder are affected.
This test can help tell if your cancer has spread into your liver or other organs. Often after the first set of pictures is taken you will receive an intravenous injection of a "dye" or contrast agent that helps better outline structures in your body. A second set of pictures is then taken.
CT scans can also be used to precisely guide a biopsy needle into a suspected metastasis. For this procedure, called a CT-guided needle biopsy, the patient remains on the CT scanning table, while a radiologist advances a biopsy needle toward the location of the mass. CT scans are repeated until the doctors are confident that the needle is within the mass. A fine needle biopsy sample (tiny fragment of tissue) or a core needle biopsy sample (a thin cylinder of tissue about ½ inch long and less than 1/8 inch in diameter) is removed and examined under a microscope.
CT scans take longer than regular x-rays and you need to lie still on a table while they are being done. But just like other computerized devices, they are getting faster and the most modern ones only take seconds..
You will need to have an IV (intravenous) line through which the contrast "dye" is injected. The injection can also cause some flushing. Some people are allergic and get hives or, rarely, more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have ever had a reaction to any contrast material used for x-rays. You may be asked to drink 1 to 2 pints of a solution of contrast material.
Barium enema x-ray: This is a test to see whether the cancer has invaded the colon (large intestine) or rectum (it is also used to look for colorectal cancer). After taking laxatives the day before, the radiology technician puts barium sulfate, a chalky substance, into the rectum and colon. Because barium is impermeable (impossible for x-rays to go through) to x-rays, it outlines the colon and rectum on x-rays of the abdomen.
Colonoscopy: A colonoscopy is also done after the large intestine has been cleaned with laxatives. A doctor inserts a fiberoptic tube into the rectum and passes it through the entire colon. This allows the doctor to see the inside and detect any cancer. It is also used to look for colorectal cancer. Because this is uncomfortable, the patient will be sedated.
Magnetic resonance imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. Not only does this produce cross sectional slices of the body like a CT scanner, it can also produce slices that are parallel with the length of the body. A contrast material might be injected just as with CT scans, but this is done less often. MRI scans are not used often to look for ovarian cancer.
MRI scans are particularly helpful to examine the brain and spinal cord. MRI scans take longer than CT scans, – often up to 30 minutes or more. Also, you have to be placed inside a tube, which is confining and can upset people with claustrophobia (fear of enclosed spaces). The machine also makes a thumping noise that you may find disturbing. Some places will provide headphones with music to block the sound.
Chest x-ray: This procedure may be done to determine whether ovarian cancer has spread (metastasized) to the lungs. This spread may cause one or more tumors in the lungs and often causes fluid to collect around the lungs. This fluid, called a pleural effusion, can be seen with chest x-rays.
Positron emission tomography: Better known as a PET scan, this test uses radioactive glucose to look for the cancer. Cancers use glucose (sugar) at a higher rate than normal tissues. This means that the radioactivity will tend to concentrate in the cancer. In some instances this test has proved useful in finding ovarian cancer that has spread. It is even more valuable when combined with a CT scan (PET/CT scan).
Other Tests
Laparoscopy: This procedure uses a thin, lighted tube through which a doctor can look at the ovaries and other pelvic organs and tissue in the area around the bile duct. The tube is inserted through a small incision (cut) in the lower abdomen and sends the images of the pelvis or abdomen to a video monitor. Laparoscopy provides a view of organs that can help in planning surgery or other treatments and can help doctors confirm the stage (how far the tumor has spread) of the cancer. Also, doctors can manipulate small instruments through the laparascopic incision(s) to remove small tissue samples to examine under the microscope.
Colonoscopy: A colonoscopy is also done after the large intestine has been cleaned with laxatives. A doctor inserts a fiberoptic tube into the rectum and passes it through the entire colon. The images are sent to a video monitor. This allows the doctor to see the inside and detect any cancer. It is also used to look for colorectal cancer. Because this is uncomfortable, the patient will be sedated.
Tissue sampling:The only way to determine for certain if a growth in the pelvic region is cancer is to remove a sample of the growth from the suspicious area and examine it under a microscope. This procedure is called a biopsy. It can be done during the laparoscopy procedure. Or it can be done with a needle placed directly into the tumor through the abdomen. The skin of the abdomen will be numbed with local anesthetic. Usually the needle will be guided by either ultrasound or CT scanning. This method might be used if the patient cannot have surgery because of advanced cancer or some other serious medical condition. Often, a biopsy is done at the time of surgery.
In patients with ascites (collection of fluid inside the abdomen), samples of fluid can also be used to diagnose the cancer. In this procedure, the skin of the abdomen is numbed and a needle attached to a syringe is passed through the abdomen into the cavity. The fluid is sucked up into the syringe.
In all these procedures, the tissue obtained is sent to the pathology laboratory. There it is examined under the microscope by a pathologist, a doctor skilled in diagnosing cancer.
Blood tests: Your doctor will order blood counts to make sure you have enough red blood cells, white blood cells and platelets (cells that help stop bleeding). There will also be tests to measure your kidney and liver function as well as your general health status. Finally the doctor will order a CA-125 test. If the test is elevated, consultation with a gynecologic oncologist is recommended.
Copyright 2006 © American Cancer Society, Inc.
Others symptoms, which tend to occur later in the course of the disease, are prolonged swelling of the abdomen, abdominal pain and cramping, a feeling of pelvic pressure, vaginal bleeding, and leg pain.
If there is reason to suspect you may have ovarian cancer, your doctor will use one or more methods to be absolutely certain that the disease is present and to determine the stage of the cancer.
Consultation With a Specialist
If your pelvic examination or other tests suggest that you may have ovarian cancer, you will need a doctor or surgeon who specializes in treating women with this type of cancer. A gynecologic oncologist is an obstetrician/gynecologist who is specially trained in treating cancers of the female reproductive system.
Imaging Studies
Imaging methods such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and ultrasound studies can confirm whether a pelvic mass is present. Although these studies cannot confirm that the mass is a cancer, they are useful if your doctor is looking for spread of ovarian cancer to other tissues and organs.
Ultrasound: Ultrasound (ultrasonography) is the use of sound waves to create an image on a video screen. Sound waves are released from a small probe placed in the woman's vagina or on the surface of her abdomen. The sound waves create echoes as they enter the ovaries and other organs. The same probe detects the echoes that bounce back, and a computer translates the pattern of echoes into a picture. Because ovarian tumors and normal ovarian tissue often reflect sound waves differently, this test may be used to find tumors and determine whether a mass is solid or a fluid-filled cyst.
Computed tomography (CT): The CT scan is an x-ray procedure that produces detailed cross-sectional images of your body. Instead of taking one picture, like a conventional x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body. The machine will take pictures of multiple slices of the part of your body that is being studied.
CT scans are useful in showing how large the tumor is, what other organs it may be invading, whether lymph nodes are enlarged and whether the kidneys or bladder are affected.
This test can help tell if your cancer has spread into your liver or other organs. Often after the first set of pictures is taken you will receive an intravenous injection of a "dye" or contrast agent that helps better outline structures in your body. A second set of pictures is then taken.
CT scans can also be used to precisely guide a biopsy needle into a suspected metastasis. For this procedure, called a CT-guided needle biopsy, the patient remains on the CT scanning table, while a radiologist advances a biopsy needle toward the location of the mass. CT scans are repeated until the doctors are confident that the needle is within the mass. A fine needle biopsy sample (tiny fragment of tissue) or a core needle biopsy sample (a thin cylinder of tissue about ½ inch long and less than 1/8 inch in diameter) is removed and examined under a microscope.
CT scans take longer than regular x-rays and you need to lie still on a table while they are being done. But just like other computerized devices, they are getting faster and the most modern ones only take seconds..
You will need to have an IV (intravenous) line through which the contrast "dye" is injected. The injection can also cause some flushing. Some people are allergic and get hives or, rarely, more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have ever had a reaction to any contrast material used for x-rays. You may be asked to drink 1 to 2 pints of a solution of contrast material.
Barium enema x-ray: This is a test to see whether the cancer has invaded the colon (large intestine) or rectum (it is also used to look for colorectal cancer). After taking laxatives the day before, the radiology technician puts barium sulfate, a chalky substance, into the rectum and colon. Because barium is impermeable (impossible for x-rays to go through) to x-rays, it outlines the colon and rectum on x-rays of the abdomen.
Colonoscopy: A colonoscopy is also done after the large intestine has been cleaned with laxatives. A doctor inserts a fiberoptic tube into the rectum and passes it through the entire colon. This allows the doctor to see the inside and detect any cancer. It is also used to look for colorectal cancer. Because this is uncomfortable, the patient will be sedated.
Magnetic resonance imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. Not only does this produce cross sectional slices of the body like a CT scanner, it can also produce slices that are parallel with the length of the body. A contrast material might be injected just as with CT scans, but this is done less often. MRI scans are not used often to look for ovarian cancer.
MRI scans are particularly helpful to examine the brain and spinal cord. MRI scans take longer than CT scans, – often up to 30 minutes or more. Also, you have to be placed inside a tube, which is confining and can upset people with claustrophobia (fear of enclosed spaces). The machine also makes a thumping noise that you may find disturbing. Some places will provide headphones with music to block the sound.
Chest x-ray: This procedure may be done to determine whether ovarian cancer has spread (metastasized) to the lungs. This spread may cause one or more tumors in the lungs and often causes fluid to collect around the lungs. This fluid, called a pleural effusion, can be seen with chest x-rays.
Positron emission tomography: Better known as a PET scan, this test uses radioactive glucose to look for the cancer. Cancers use glucose (sugar) at a higher rate than normal tissues. This means that the radioactivity will tend to concentrate in the cancer. In some instances this test has proved useful in finding ovarian cancer that has spread. It is even more valuable when combined with a CT scan (PET/CT scan).
Other Tests
Laparoscopy: This procedure uses a thin, lighted tube through which a doctor can look at the ovaries and other pelvic organs and tissue in the area around the bile duct. The tube is inserted through a small incision (cut) in the lower abdomen and sends the images of the pelvis or abdomen to a video monitor. Laparoscopy provides a view of organs that can help in planning surgery or other treatments and can help doctors confirm the stage (how far the tumor has spread) of the cancer. Also, doctors can manipulate small instruments through the laparascopic incision(s) to remove small tissue samples to examine under the microscope.
Colonoscopy: A colonoscopy is also done after the large intestine has been cleaned with laxatives. A doctor inserts a fiberoptic tube into the rectum and passes it through the entire colon. The images are sent to a video monitor. This allows the doctor to see the inside and detect any cancer. It is also used to look for colorectal cancer. Because this is uncomfortable, the patient will be sedated.
Tissue sampling:The only way to determine for certain if a growth in the pelvic region is cancer is to remove a sample of the growth from the suspicious area and examine it under a microscope. This procedure is called a biopsy. It can be done during the laparoscopy procedure. Or it can be done with a needle placed directly into the tumor through the abdomen. The skin of the abdomen will be numbed with local anesthetic. Usually the needle will be guided by either ultrasound or CT scanning. This method might be used if the patient cannot have surgery because of advanced cancer or some other serious medical condition. Often, a biopsy is done at the time of surgery.
In patients with ascites (collection of fluid inside the abdomen), samples of fluid can also be used to diagnose the cancer. In this procedure, the skin of the abdomen is numbed and a needle attached to a syringe is passed through the abdomen into the cavity. The fluid is sucked up into the syringe.
In all these procedures, the tissue obtained is sent to the pathology laboratory. There it is examined under the microscope by a pathologist, a doctor skilled in diagnosing cancer.
Blood tests: Your doctor will order blood counts to make sure you have enough red blood cells, white blood cells and platelets (cells that help stop bleeding). There will also be tests to measure your kidney and liver function as well as your general health status. Finally the doctor will order a CA-125 test. If the test is elevated, consultation with a gynecologic oncologist is recommended.
Copyright 2006 © American Cancer Society, Inc.
Sunday, June 25, 2006
ovarian cancer : Ovarian cancer kills JonBenet's mother
Patsy Ramsey, who was thrust into the international spotlight by the unsolved 1996 slaying of her daughter, six-year-old beauty pageant queen JonBenet, died yesterday following a long battle with ovarian cancer, her lawyer said. She was 49.
Ramsey was diagnosed with the disease in 1993 and suffered a recurrence several years ago, said the lawyer, L. Lin Wood said. She died at her father's home in Roswell, Ga., a suburb of Atlanta, with her husband, John, at her bedside.
"It is not unexpected but it is a sad day," Wood told The Associated Press.
JonBenet was found beaten and strangled in the basement of the family's home in Boulder, Colo., on Dec. 26, 1996.
Patsy Ramsey said she found a ransom note on the back staircase demanding $118,000 for the safe return of JonBenet. John Ramsey said he found his daughter's body in a basement room eight hours later.
Boulder police said early on that Patsy and John Ramsey were under an "umbrella of suspicion" in JonBenet's death. The Ramseys said an intruder killed their daughter. A grand jury investigation in Boulder ended with no indictments, and no arrests have been made in the case.
In 2003, U.S. District Judge Julie Carnes in Atlanta concluded that the evidence she reviewed suggested an intruder killed JonBenet. That opinion came with the judge's decision to dismiss a libel and slander lawsuit against the Ramseys by a freelance journalist, whom the Ramseys had named as a suspect in their daughter's slaying. The Boulder district attorney at the time said she agreed with Carnes' declaration.
"Hopefully her legacy will not be tied to the false accusation related to the brutal murder of her daughter," Wood said of Patsy Ramsey yesterday.
Copyright © 2006, Canoe Inc. All rights reserved.
Ramsey was diagnosed with the disease in 1993 and suffered a recurrence several years ago, said the lawyer, L. Lin Wood said. She died at her father's home in Roswell, Ga., a suburb of Atlanta, with her husband, John, at her bedside.
"It is not unexpected but it is a sad day," Wood told The Associated Press.
JonBenet was found beaten and strangled in the basement of the family's home in Boulder, Colo., on Dec. 26, 1996.
Patsy Ramsey said she found a ransom note on the back staircase demanding $118,000 for the safe return of JonBenet. John Ramsey said he found his daughter's body in a basement room eight hours later.
Boulder police said early on that Patsy and John Ramsey were under an "umbrella of suspicion" in JonBenet's death. The Ramseys said an intruder killed their daughter. A grand jury investigation in Boulder ended with no indictments, and no arrests have been made in the case.
In 2003, U.S. District Judge Julie Carnes in Atlanta concluded that the evidence she reviewed suggested an intruder killed JonBenet. That opinion came with the judge's decision to dismiss a libel and slander lawsuit against the Ramseys by a freelance journalist, whom the Ramseys had named as a suspect in their daughter's slaying. The Boulder district attorney at the time said she agreed with Carnes' declaration.
"Hopefully her legacy will not be tied to the false accusation related to the brutal murder of her daughter," Wood said of Patsy Ramsey yesterday.
Copyright © 2006, Canoe Inc. All rights reserved.
ovarian cancer : Possible Side Effects of Treatment
The side effects of cancer treatment depend on the type of treatment and may be different for each woman. Doctors and nurses will explain the possible side effects of treatment, and they can suggest ways to help relieve problems that may occur during and after treatment.
Surgery causes short-term pain and tenderness in the area of the operation. Discomfort or pain after surgery can be controlled with medicine. Patients should feel free to discuss pain relief with their doctor. For several days after surgery, the patient may have difficulty emptying her bladder and having bowel movements. When both ovaries are removed, a woman loses her ability to become pregnant. Some women may experience feelings of loss that may make intimacy difficult. Counseling or support for both the patient and her partner may be helpful.
Also, removing the ovaries means that the body's natural source of estrogen and progesterone is lost, and menopause occurs. Symptoms of menopause, such as hot flashes and vaginal dryness, are likely to appear soon after the surgery. Some form of hormone replacement therapy may be used to ease such symptoms. Deciding whether to use it is a personal choice; women with ovarian cancer should discuss with their doctors the possible risks and benefits of using hormone replacement therapy.
Chemotherapy affects normal as well as cancerous cells. Side effects depend largely on the specific drugs and the dose (amount of drug given). Common side effects of chemotherapy include nausea and vomiting, loss of appetite, diarrhea, fatigue, numbness and tingling in hands or feet, headaches, hair loss, and darkening of the skin and fingernails. Certain drugs used in the treatment of ovarian cancer can cause some hearing loss or kidneys damage. To help protect the kidneys while taking these drugs, patients may receive extra fluid intravenously.
Radiation therapy, like chemotherapy, affects normal as well as cancerous cells. Side effects of radiation therapy depend mainly on the treatment dose and the part of the body that is treated. Common side effects of radiation therapy to the abdomen are fatigue, loss of appetite, nausea, vomiting, urinary discomfort, diarrhea, and skin changes on the abdomen. Intraperitoneal radiation therapy may cause abdominal pain and bowel obstruction (a blockage of the intestine).
Doctors and nurses will explain the possible side effects of treatment, and they can suggest ways to help relieve problems that may occur during and after treatment.
The Importance of Followup Care
Followup care after treatment for ovarian cancer is important. Regular checkups generally include a physical exam, as well as a pelvic exam and Pap test. The doctor also may perform additional tests such as a chest x-ray, CT scan, urinalysis, complete blood count, and CA-125 assay.
In addition to having followup exams to check for the return of ovarian cancer, patients may also want to ask their doctor about checking them for other types of cancer. Women who have had ovarian cancer may be at increased risk of developing breast or colon cancer. In addition, treatment with certain anticancer drugs may increase the risk of second cancers, such as leukemia.
American Cancer Society
Surgery causes short-term pain and tenderness in the area of the operation. Discomfort or pain after surgery can be controlled with medicine. Patients should feel free to discuss pain relief with their doctor. For several days after surgery, the patient may have difficulty emptying her bladder and having bowel movements. When both ovaries are removed, a woman loses her ability to become pregnant. Some women may experience feelings of loss that may make intimacy difficult. Counseling or support for both the patient and her partner may be helpful.
Also, removing the ovaries means that the body's natural source of estrogen and progesterone is lost, and menopause occurs. Symptoms of menopause, such as hot flashes and vaginal dryness, are likely to appear soon after the surgery. Some form of hormone replacement therapy may be used to ease such symptoms. Deciding whether to use it is a personal choice; women with ovarian cancer should discuss with their doctors the possible risks and benefits of using hormone replacement therapy.
Chemotherapy affects normal as well as cancerous cells. Side effects depend largely on the specific drugs and the dose (amount of drug given). Common side effects of chemotherapy include nausea and vomiting, loss of appetite, diarrhea, fatigue, numbness and tingling in hands or feet, headaches, hair loss, and darkening of the skin and fingernails. Certain drugs used in the treatment of ovarian cancer can cause some hearing loss or kidneys damage. To help protect the kidneys while taking these drugs, patients may receive extra fluid intravenously.
Radiation therapy, like chemotherapy, affects normal as well as cancerous cells. Side effects of radiation therapy depend mainly on the treatment dose and the part of the body that is treated. Common side effects of radiation therapy to the abdomen are fatigue, loss of appetite, nausea, vomiting, urinary discomfort, diarrhea, and skin changes on the abdomen. Intraperitoneal radiation therapy may cause abdominal pain and bowel obstruction (a blockage of the intestine).
Doctors and nurses will explain the possible side effects of treatment, and they can suggest ways to help relieve problems that may occur during and after treatment.
The Importance of Followup Care
Followup care after treatment for ovarian cancer is important. Regular checkups generally include a physical exam, as well as a pelvic exam and Pap test. The doctor also may perform additional tests such as a chest x-ray, CT scan, urinalysis, complete blood count, and CA-125 assay.
In addition to having followup exams to check for the return of ovarian cancer, patients may also want to ask their doctor about checking them for other types of cancer. Women who have had ovarian cancer may be at increased risk of developing breast or colon cancer. In addition, treatment with certain anticancer drugs may increase the risk of second cancers, such as leukemia.
American Cancer Society
Tuesday, June 20, 2006
ovarian cancer : Causes
An ovarian tumor is a growth of abnormal cells that may be either noncancerous (benign) or cancerous (malignant). Although benign tumors are made up of abnormal cells, these cells don't spread to other body tissues (metastasize). Ovarian cancer cells metastasize in one of two ways. Most often, they spread directly to other organs in the pelvis and abdomen. Rarely, they can spread through your bloodstream or lymph nodes to other parts of your body.
The causes of ovarian cancer remain unknown. Some researchers believe it has to do with the tissue-repair process that follows the monthly release of an egg through a tiny tear in an ovarian follicle (ovulation) during a woman's reproductive years. The formation and division of new cells at the rupture site may set up a situation in which genetic errors can occur. Others propose that the increased hormone levels before and during ovulation may stimulate the growth of abnormal cells.
Three basic types of ovarian tumors exist, designated by where they form in the ovary. They include:
Epithelial tumors. About 90 percent of ovarian cancers develop in the epithelium, the thin layer of tissue that covers the ovaries. This form of ovarian cancer generally occurs in postmenopausal women.
Germ cell tumors. These tumors occur in the egg-producing cells of the ovary and generally occur in younger women.
Stromal tumors. These tumors develop in the estrogen- and progesterone-producing tissue that holds the ovary together.
http://www.mayoclinic.com/health/ovarian-cancer/DS00293/DSECTION=3
The causes of ovarian cancer remain unknown. Some researchers believe it has to do with the tissue-repair process that follows the monthly release of an egg through a tiny tear in an ovarian follicle (ovulation) during a woman's reproductive years. The formation and division of new cells at the rupture site may set up a situation in which genetic errors can occur. Others propose that the increased hormone levels before and during ovulation may stimulate the growth of abnormal cells.
Three basic types of ovarian tumors exist, designated by where they form in the ovary. They include:
Epithelial tumors. About 90 percent of ovarian cancers develop in the epithelium, the thin layer of tissue that covers the ovaries. This form of ovarian cancer generally occurs in postmenopausal women.
Germ cell tumors. These tumors occur in the egg-producing cells of the ovary and generally occur in younger women.
Stromal tumors. These tumors develop in the estrogen- and progesterone-producing tissue that holds the ovary together.
http://www.mayoclinic.com/health/ovarian-cancer/DS00293/DSECTION=3
ovarian cancer : Overview
Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the female sex hormones estrogen and progesterone. Ovarian cancer occurs when cells grow in an uncontrolled, abnormal manner and produce tumors in one or both ovaries.
Ovarian cancer is the fifth most common cancer in women. It's diagnosed in more than 25,000 women in the United States each year, and about 16,000 women die of the disease annually.
Your chances of surviving ovarian cancer are better if the cancer is found early. But because the disease is difficult to detect in its early stage, only about 29 percent of ovarian cancers are found before tumor growth has spread into tissues and organs beyond the ovaries. Most of the time, the disease has already advanced before it's diagnosed.
Until recently, doctors thought that early-stage ovarian cancer rarely produced any symptoms. But new evidence has shown that many women do have signs and symptoms before the disease has spread. Being aware of them may lead to earlier detection.
http://www.mayoclinic.com/health/ovarian-cancer/DS00293
Ovarian cancer is the fifth most common cancer in women. It's diagnosed in more than 25,000 women in the United States each year, and about 16,000 women die of the disease annually.
Your chances of surviving ovarian cancer are better if the cancer is found early. But because the disease is difficult to detect in its early stage, only about 29 percent of ovarian cancers are found before tumor growth has spread into tissues and organs beyond the ovaries. Most of the time, the disease has already advanced before it's diagnosed.
Until recently, doctors thought that early-stage ovarian cancer rarely produced any symptoms. But new evidence has shown that many women do have signs and symptoms before the disease has spread. Being aware of them may lead to earlier detection.
http://www.mayoclinic.com/health/ovarian-cancer/DS00293
Friday, June 09, 2006
ovarian cancer : Treatment Options by Stage and Type of Tumor
Stage 1 - Epithelial Cancer
Several options exist for limited, Stage 1 epithelial cancer, which occurs in approximately 15% of women (see also Types of Ovarian Cancer)
Surgery should be performed in women who have finished childbearing. This includes total hysterectomy, complete removal of the uterus; bilateral salpingo-oophorectomy, removal of the fallopian tubes and ovaries; omentectomy, removal of the fatty tissue that covers the bowels; and lymphadenectomy, removal of one or more lymph nodes.
Modified ("conservative") surgery - surgery that leaves tumor-free reproductive organs intact - may be conducted in women who still wish to still have children if (1) the tumor is confined (usually not serous or endometriotic in type, which tend to be bilateral tumors), and (2) wedge biopsy of the opposite ovary shows no evidence for disease involvement. Such a procedure carries an increased risk of relapse; therefore, total hysterectomy and salpingo-oophorectomy should be performed immediately after childbearing is complete.
The role of adjuvant, or additional, treatment in patients with early epithelial ovarian cancer remains controversial. Yet results from a patient's histopathology report may suggest additional care, such as:
radiotherapy plus chemotherapy;
combination chemotherapy; or
participation in a clinical trial that evaluates immediate versus delayed chemotherapy.
Some studies suggest that systemic (whole body) chemotherapy may be less hazardous than radiotherapy, especially after the patient's abdominal lymph nodes have been removed (see also Chemotherapy and Radiotherapy). Although radiotherapy can decrease the rate of cancer relapse in the pelvis, relapse rates are unchanged in intra-abdominal areas and distant sites, and overall survival is unaffected.
Stage 1 - Germ Cell Tumor
Germ cell tumors, which arise from cells that normally form the eggs, usually are benign and tend to occur in women younger than age 30. If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), initial treatment begins with surgery to remove the tumorous ovary and the corresponding fallopian tube on the same side - known as unilateral salpingo-oophorectomy.
Adjuvant therapy for such patients may involve follow-up radiotherapy, or chemotherapy, if the woman wants to bear children in the future.
If the germ cell tumor is a nondysgerminoma (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor), treatment includes surgery (unilateral salpingo-oophorectomy) to remove the tumorous ovary and the corresponding fallopian tube on the same side, with or without follow-up chemotherapy, or participation in a clinical trial of new chemotherapeutic drug combinations.
The only patients who generally do not require systemic therapy are women with Stage 1A, Grade 1 immature teratoma.
Sex-Cord Stromal Tumor (All Stages)
Because of the extreme rarity of sex-cord stromal tumors and because of their variable biologic behavior, no standard therapy exists for these tumors (see also Types of Ovarian Cancer). For example, granulosa cell tumors often respond well to therapy in younger women, whereas the same tumors may be more aggressive and difficult to manage in women over 40. But the cornerstone of most treatments is surgery to remove as much of the tumor as possible.
Many Sertoli-Leydig cell tumors appear on one side only, so if the patient is young and has early-stage disease (e.g., Stage 1A), the physician may recommend modified surgery to remove only the tumorous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy).
By contrast, older patients or those with advanced-stage or bilateral disease may benefit from more extensive surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
If the stromal cell tumor is malignant, metastatic, and/or if the tumor tends to recur (e.g., granulosa cell tumors recur after 5 or 10 years in many patients), combination chemotherapy also may be beneficial, especially platinum-based combinations, such as cisplatin/vinblastine/bleomycin (PVB).
There are few findings concerning the usefulness of radiotherapy for sex-cord stromal tumors. Ongoing studies suggest that hormonal therapy (with progestins, estrogens, gonadotropin-releasing analogs, etc.) may have a future role in the management of sex-cord stromal tumors; however, to date, the findings are inconclusive.
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Stage 2 - Epithelial Cancer
The first form of treatment for Stage 2 epithelial cancer is surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
After surgery, follow-up therapy may include combination chemotherapy with/without radiotherapy, or participation in a clinical trial that evaluates new chemotherapeutic drugs or drug combinations.
Note: In order to evaluate the benefits and disadvantages of chemotherapy, some researchers have divided Stage 1 and Stage 2 epithelial cancer patients into "favorable" and "unfavorable" groups. The favorable group has ovarian cancer with the following characteristics:
growth that is limited to one or both ovaries
an intact ovarian capsule (outer wall)
no evidence of tumor on the outer surface of the ovary
no evidence of tumor cells in pelvic washings
low grade (well-differentiated or moderately well-differentiated) type
The unfavorable group is identified by:
tumors with surface involvement
a ruptured capsule
evidence of tumor cells in pelvic washings
high grade (poorly differentiated) type
Study findings suggest that the favorable group is not helped by the administration of chemotherapy. By contrast, the unfavorable group may benefit from some form of post-operative therapy; however, the exact protocol for such therapy remains to be established. Therefore, systemic chemotherapy should be considered for patients who have a 25% or greater chance of relapse.
Stage 2 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment may start with surgery, including total hysterectomy and bilateral salpingo-oophorectomy, followed by radiotherapy.
However, if the patient's cancer is limited to one ovary and its corresponding fallopian tube, and if she wants to bear children in the future, modified surgery may be performed to remove only the cancerous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy), followed by chemotherapy.
If the germ cell tumor is another, nondysgerminomatous variety, treatment will begin with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, or modified surgery (unilateral salpingo-oophorectomy). Surgery is followed by chemotherapy, and/or follow-up surgery to remove as much remaining cancerous tissue as possible.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
Several options exist for limited, Stage 1 epithelial cancer, which occurs in approximately 15% of women (see also Types of Ovarian Cancer)
Surgery should be performed in women who have finished childbearing. This includes total hysterectomy, complete removal of the uterus; bilateral salpingo-oophorectomy, removal of the fallopian tubes and ovaries; omentectomy, removal of the fatty tissue that covers the bowels; and lymphadenectomy, removal of one or more lymph nodes.
Modified ("conservative") surgery - surgery that leaves tumor-free reproductive organs intact - may be conducted in women who still wish to still have children if (1) the tumor is confined (usually not serous or endometriotic in type, which tend to be bilateral tumors), and (2) wedge biopsy of the opposite ovary shows no evidence for disease involvement. Such a procedure carries an increased risk of relapse; therefore, total hysterectomy and salpingo-oophorectomy should be performed immediately after childbearing is complete.
The role of adjuvant, or additional, treatment in patients with early epithelial ovarian cancer remains controversial. Yet results from a patient's histopathology report may suggest additional care, such as:
radiotherapy plus chemotherapy;
combination chemotherapy; or
participation in a clinical trial that evaluates immediate versus delayed chemotherapy.
Some studies suggest that systemic (whole body) chemotherapy may be less hazardous than radiotherapy, especially after the patient's abdominal lymph nodes have been removed (see also Chemotherapy and Radiotherapy). Although radiotherapy can decrease the rate of cancer relapse in the pelvis, relapse rates are unchanged in intra-abdominal areas and distant sites, and overall survival is unaffected.
Stage 1 - Germ Cell Tumor
Germ cell tumors, which arise from cells that normally form the eggs, usually are benign and tend to occur in women younger than age 30. If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), initial treatment begins with surgery to remove the tumorous ovary and the corresponding fallopian tube on the same side - known as unilateral salpingo-oophorectomy.
Adjuvant therapy for such patients may involve follow-up radiotherapy, or chemotherapy, if the woman wants to bear children in the future.
If the germ cell tumor is a nondysgerminoma (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor), treatment includes surgery (unilateral salpingo-oophorectomy) to remove the tumorous ovary and the corresponding fallopian tube on the same side, with or without follow-up chemotherapy, or participation in a clinical trial of new chemotherapeutic drug combinations.
The only patients who generally do not require systemic therapy are women with Stage 1A, Grade 1 immature teratoma.
Sex-Cord Stromal Tumor (All Stages)
Because of the extreme rarity of sex-cord stromal tumors and because of their variable biologic behavior, no standard therapy exists for these tumors (see also Types of Ovarian Cancer). For example, granulosa cell tumors often respond well to therapy in younger women, whereas the same tumors may be more aggressive and difficult to manage in women over 40. But the cornerstone of most treatments is surgery to remove as much of the tumor as possible.
Many Sertoli-Leydig cell tumors appear on one side only, so if the patient is young and has early-stage disease (e.g., Stage 1A), the physician may recommend modified surgery to remove only the tumorous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy).
By contrast, older patients or those with advanced-stage or bilateral disease may benefit from more extensive surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
If the stromal cell tumor is malignant, metastatic, and/or if the tumor tends to recur (e.g., granulosa cell tumors recur after 5 or 10 years in many patients), combination chemotherapy also may be beneficial, especially platinum-based combinations, such as cisplatin/vinblastine/bleomycin (PVB).
There are few findings concerning the usefulness of radiotherapy for sex-cord stromal tumors. Ongoing studies suggest that hormonal therapy (with progestins, estrogens, gonadotropin-releasing analogs, etc.) may have a future role in the management of sex-cord stromal tumors; however, to date, the findings are inconclusive.
Back to Top
Stage 2 - Epithelial Cancer
The first form of treatment for Stage 2 epithelial cancer is surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
After surgery, follow-up therapy may include combination chemotherapy with/without radiotherapy, or participation in a clinical trial that evaluates new chemotherapeutic drugs or drug combinations.
Note: In order to evaluate the benefits and disadvantages of chemotherapy, some researchers have divided Stage 1 and Stage 2 epithelial cancer patients into "favorable" and "unfavorable" groups. The favorable group has ovarian cancer with the following characteristics:
growth that is limited to one or both ovaries
an intact ovarian capsule (outer wall)
no evidence of tumor on the outer surface of the ovary
no evidence of tumor cells in pelvic washings
low grade (well-differentiated or moderately well-differentiated) type
The unfavorable group is identified by:
tumors with surface involvement
a ruptured capsule
evidence of tumor cells in pelvic washings
high grade (poorly differentiated) type
Study findings suggest that the favorable group is not helped by the administration of chemotherapy. By contrast, the unfavorable group may benefit from some form of post-operative therapy; however, the exact protocol for such therapy remains to be established. Therefore, systemic chemotherapy should be considered for patients who have a 25% or greater chance of relapse.
Stage 2 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment may start with surgery, including total hysterectomy and bilateral salpingo-oophorectomy, followed by radiotherapy.
However, if the patient's cancer is limited to one ovary and its corresponding fallopian tube, and if she wants to bear children in the future, modified surgery may be performed to remove only the cancerous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy), followed by chemotherapy.
If the germ cell tumor is another, nondysgerminomatous variety, treatment will begin with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, or modified surgery (unilateral salpingo-oophorectomy). Surgery is followed by chemotherapy, and/or follow-up surgery to remove as much remaining cancerous tissue as possible.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
ovarian cancer : Treatment
There are three main forms of treatment for ovarian cancer:
Surgery to remove cancerous tissue.
Chemotherapy to destroy cancer cells using strong anti-cancer drugs.
Radiotherapy to destroy cancer cells by high-energy radiation exposure.
There are also many combinations of these treatment methods and it is usually worthwhile to get a second opinion about treatment before entering into a specific program. Treatment depends upon a number of factors (e.g., stage and grade of the disease, the histopathologic type, and the patient's age and overall health).
Surgery
Surgery usually is required to treat ovarian cancer. Most patients undergo surgery in addition to another form of treatment (e.g., chemotherapy and/or radiotherapy). Surgery helps the physician to accurately stage the tumor, make a diagnosis, and perform debulking (removal of as much tumor mass as possible). Debulking surgery is especially important in ovarian cancer because aggressive removal of cancerous tissue is associated with improved survival. Patients with no residual tumor mass, or tumor masses that measure less than 1 cm, have the best opportunity for cure.
The surgeon usually performs a laparotomy (through an abdominal incision) or laparoscopy (using a tube containing a light and camera that is inserted into the pelvic cavity through a small incision). A sample of the tumor (called a frozen section) is examined immediately under a microscope to confirm ovarian cancer and rule out metastasis from another site. If the cancer is a metastasis from another organ, the surgeon searches for the primary tumor within the abdominal cavity.
Once ovarian cancer is confirmed, a total hysterectomy (removal of the uterus [womb]), bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries on both sides), omentectomy (removal of the fatty tissue that covers the bowels), lymphadenectomy (removal of one or more lymph nodes) may be performed. Tissue removed during debulking is sent for histopathological examination.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved
Surgery to remove cancerous tissue.
Chemotherapy to destroy cancer cells using strong anti-cancer drugs.
Radiotherapy to destroy cancer cells by high-energy radiation exposure.
There are also many combinations of these treatment methods and it is usually worthwhile to get a second opinion about treatment before entering into a specific program. Treatment depends upon a number of factors (e.g., stage and grade of the disease, the histopathologic type, and the patient's age and overall health).
Surgery
Surgery usually is required to treat ovarian cancer. Most patients undergo surgery in addition to another form of treatment (e.g., chemotherapy and/or radiotherapy). Surgery helps the physician to accurately stage the tumor, make a diagnosis, and perform debulking (removal of as much tumor mass as possible). Debulking surgery is especially important in ovarian cancer because aggressive removal of cancerous tissue is associated with improved survival. Patients with no residual tumor mass, or tumor masses that measure less than 1 cm, have the best opportunity for cure.
The surgeon usually performs a laparotomy (through an abdominal incision) or laparoscopy (using a tube containing a light and camera that is inserted into the pelvic cavity through a small incision). A sample of the tumor (called a frozen section) is examined immediately under a microscope to confirm ovarian cancer and rule out metastasis from another site. If the cancer is a metastasis from another organ, the surgeon searches for the primary tumor within the abdominal cavity.
Once ovarian cancer is confirmed, a total hysterectomy (removal of the uterus [womb]), bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries on both sides), omentectomy (removal of the fatty tissue that covers the bowels), lymphadenectomy (removal of one or more lymph nodes) may be performed. Tissue removed during debulking is sent for histopathological examination.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved
Thursday, June 01, 2006
ovarian cancer : Few women know ovarian-cancer risk factors
Only 15 percent of U.S. women are familiar with ovarian-cancer symptoms, and 82 percent have never discussed it with their doctors, a survey finds.
The national survey sponsored by the National Ovarian Cancer Coalition finds 54 percent of the women who have not spoken to their doctors about ovarian cancer do not think it's an issue because the doctor never initiated the discussion.
Fifty-nine percent of women have talked to their doctor about breast cancer, compared to only 18 percent of women who have talked to their doctor about ovarian cancer.
Forty percent of the women are not sure of the risk factors, and many incorrectly identified the use of high-dose estrogen without progesterone and extended use of the birth-control pill as risk factors.
In fact, women who have used oral contraceptives for three or more years have about a 30-percent to 50-percent lower risk of developing ovarian cancer.
Sixty-seven percent of women incorrectly believe that a yearly Pap test is effective in the diagnosis of ovarian cancer.
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© Copyright 2006 United Press International, Inc. All Rights Reserved
The national survey sponsored by the National Ovarian Cancer Coalition finds 54 percent of the women who have not spoken to their doctors about ovarian cancer do not think it's an issue because the doctor never initiated the discussion.
Fifty-nine percent of women have talked to their doctor about breast cancer, compared to only 18 percent of women who have talked to their doctor about ovarian cancer.
Forty percent of the women are not sure of the risk factors, and many incorrectly identified the use of high-dose estrogen without progesterone and extended use of the birth-control pill as risk factors.
In fact, women who have used oral contraceptives for three or more years have about a 30-percent to 50-percent lower risk of developing ovarian cancer.
Sixty-seven percent of women incorrectly believe that a yearly Pap test is effective in the diagnosis of ovarian cancer.
E-MAIL | PRINT | SAVE | LICENSE
© Copyright 2006 United Press International, Inc. All Rights Reserved
ovarian cancer : How are ovarian cysts found?
Since ovarian cysts may not cause symptoms, they are usually found during a routine pelvic exam. During this exam, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, which uses sound waves to create images of the body.
With an ultrasound, the doctor can see how the cyst is shaped; its size and location; and whether it's fluid-filled, solid, or mixed. A pregnancy test is also done. Hormone levels (such as LH, FSH, estradiol, and testosterone) may also be checked. Your doctor may want to do other tests as well.
To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test.
There are also non-cancerous diseases that increase the levels of CA-125, like uterine fibroids and endometriosis. These non-cancerous causes of increased CA-125 are more common in women under 35, while ovarian cancer is very uncommon in this age group. For this reason, the CA-125 test is recommended mostly for women over age 35, who are at high risk for the disease and have a cyst that is partially solid.
Hilton Johani is a leading expert on period pains,Tinnitus, hyperacusis and Meniere's disease and has been running his tinnitus related website since 1999.
His advice and tinnitus treatment plans have helped thousands of people around the world.
Click to view his Tinnitus website.
Hilton's latest websites can be found at Herpes
Organic Health And Beauty Products
Affordabale Dental Plan Information
Period Pains
Copyright Hilton Johani - http://www.t-gone.com
With an ultrasound, the doctor can see how the cyst is shaped; its size and location; and whether it's fluid-filled, solid, or mixed. A pregnancy test is also done. Hormone levels (such as LH, FSH, estradiol, and testosterone) may also be checked. Your doctor may want to do other tests as well.
To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test.
There are also non-cancerous diseases that increase the levels of CA-125, like uterine fibroids and endometriosis. These non-cancerous causes of increased CA-125 are more common in women under 35, while ovarian cancer is very uncommon in this age group. For this reason, the CA-125 test is recommended mostly for women over age 35, who are at high risk for the disease and have a cyst that is partially solid.
Hilton Johani is a leading expert on period pains,Tinnitus, hyperacusis and Meniere's disease and has been running his tinnitus related website since 1999.
His advice and tinnitus treatment plans have helped thousands of people around the world.
Click to view his Tinnitus website.
Hilton's latest websites can be found at Herpes
Organic Health And Beauty Products
Affordabale Dental Plan Information
Period Pains
Copyright Hilton Johani - http://www.t-gone.com
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