Sunday, July 02, 2006

ovarian cancer : Better Lymph Node Analysis May Improve Colon Cancer Treatment

Examining a colon cancer patient's lymph nodes may help doctors decide on the best treatment while helping them avoid unnecessary therapies, a new study shows.

Doctors routinely remove the nodes during surgery to determine if the cancer has spread to the nodes or not. If the cancer has not yet spread to the lymph nodes, surgery alone may be a sufficient treatment.

"One-third of patients with tumor-free lymph nodes have recurrences, and therefore, adjuvant (supplemental) chemotherapy may be beneficial in these patients," researchers at the John Wayne Cancer Institute and Saint John's Health Center in California explained in a prepared statement. "However, if all node-negative patients are treated, 70 percent will be subjected to unnecessary chemotherapy because surgery alone is curative."

Investigating further, the researchers studied 132 colon cancer patients to see whether analyzing lymph nodes could better predict effective therapy.

The patients in the study had dye injected near their tumors to stain the sentinel (first) lymph nodes. This dye showed the doctors the path by which lymph fluids, which can contain cancer cells, drain from the body's tissues. Then the lymph nodes were removed and studied.

"The sentinel lymph node is the first node to receive lymphatic drainage from a primary anatomical site and is therefore the most likely node to harbor a metastasis," the study authors explained.

Thirty percent of the patients studied had stage I cancer, 41 percent stage II and 29 percent stage III cancer. By analyzing the sentinel nodes, 23.6 percent of the patients had their status changed to a more severe stage. Of the 51 patients whose cancer had metastasized to the lymph nodes, researchers found tumors in the sentinel nodes of 45 patients, and found tumors in a total of 18 percent of the sentinel nodes. Only 6 percent of other lymph nodes were diagnosed with tumors. There was a false-negative rate of only 7.4 percent.

The researchers concluded that "lymphatic mapping and sentinel lymph node techniques are feasible and accurate in colon cancer... avoiding the unnecessary toxic effects and expense for those cured by surgery alone."

By Diana Kohnle

ovarian cancer : Excess pounds may raise ovarian cancer risk

Being overweight in young adulthood or later in life may raise a woman's risk of ovarian cancer, particularly if she's never had children, researchers have found.

In a study of 2,110 women with and without ovarian cancer, researchers found that those who were relatively heavy, either in recent years or at the age of 18, were more likely than thinner women to develop the disease.

But the relationship between weight and ovarian cancer was strongest among women who'd never given birth. For them, cancer risk climbed in tandem with recent body mass index (BMI), a measure of weight in relation to height.

Among childless women, those who were obese in recent years had 2.5 times the risk of ovarian cancer compared with the thinnest women. The same pattern emerged when the researchers looked at the women's weight gain since age 18.

Dr. Julia Greer and her colleagues at the University of Pittsburgh Medical Center report the findings in the journal Cancer.

A number of studies have looked at the relationship between body weight and ovarian cancer risk, with conflicting results. A connection is considered biologically plausible because excess body fat can raise levels of estrogen, as well as male sex hormones called androgens, which may in turn feed ovarian tumor development.

Pregnancy and childbirth are believed to lower the risk of ovarian cancer by reducing the number of times a woman ovulates in her lifetime, and therefore her estrogen exposure.

The new findings suggest that in overweight women who've had no children, the effects of excess body fat and "incessant" ovulation combine to raise the risk of ovarian cancer, according to the study authors.

Along with their greater estrogen exposure, these women may develop chronic inflammation in the ovaries as a result of continuous ovulation, the researchers speculate. This inflammation might then damage cells in a way that leads to cancer.

The findings offer yet another reason to maintain a healthy weight throughout life, Greer told Reuters Health. And that goes for all women, whether they've had children or not, she pointed out.

According to American Cancer Society estimates, Greer noted, at least one third of all cancer deaths in the U.S. each year are attributable to excess weight and obesity.

Copyright © 2006 Reuters Limited. All rights reserved.

Wednesday, June 28, 2006

ovarian cancer ; What Are the Risk Factors for Ovarian Cancer?

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.

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.

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.

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

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

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

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.

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

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

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.

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Wednesday, May 31, 2006

ovarian cancer : When are women most likely to have ovarian cysts?

Functional ovarian cysts usually occur during the childbearing years. Most often, cysts in women of this age group are not cancerous. Women who are past menopause (ages 50-70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, it's important to tell your doctor.

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.

Copyright Hilton Johani - http://www.t-gone.com

ovarian cancer : What are the treatments for ovarian cysts?

If you have not yet gone through menopause, you may not need any treatment, unless the cyst is very big or causing pain. Sometimes, taking birth control pills will make the cyst smaller. Surgery may be needed if the cyst is causing symptoms or is more than 2 inches across.

If surgery is needed, often the cyst can be removed without removing the ovary. Even if one ovary has to be removed, it is still possible to become pregnant as long as one ovary remains.

After menopause, the risk of ovarian cancer increases. Surgery to remove an ovarian cyst is usually recommended in this case. Your doctor will probably want to do a biopsy to see if cancer is present.

If you have gone through menopause and you have an ovarian cyst, talk with your doctor about what will be done during surgery. Make sure you understand whether he or she plans to remove just the cyst, the cyst and the ovary, or to do a hysterectomy. Talk over the options with your doctor and make your own wishes known.

Hilton Johani is a leading expert on period pains,Tinnitus, hyperacusis and Meniere's disease and has been assisting John Currie in running his tinnitus related website since 1999.

His advice and tinnitus treatment plans have helped thousands of people around the world.

by Hilton Johani

ovarian cancer : Was Your Ovarian Cancer Misdiagnosed?

Two Percent of All Female Newborns in the United States Are at Risk of Getting Ovarian Cancer

As many as 30,000 U.S. women will be diagnosed with ovarian cancer this year. In 2006, between 15,000 and 16,000 women are likely to die from this silent killer. Ovarian cancer is the 5th leading cause of death among women, and it is responsible for about five percent of all cancer deaths. Chances are your doctor may have misdiagnosed you. That is often the case. A recent British study found 60 percent of all U.K. general practitioners had misdiagnosed their patients. Three-quarters of British doctors surveyed incorrectly assumed that symptoms only occurred in the late stages of ovarian cancer. Based upon that information, it should be no surprise that Britain has one of the lowest survival rates for ovarian cancer in the Western World – of 6,800 cases diagnosed each year, more than 4,600 die.

A similar discovery was made by University of California researchers, who announced last year, "Four in 10 women with ovarian cancer have symptoms that they tell their doctors about at least four months — and as long as one year — before they are diagnosed." According to their study of nearly 2,000 women with ovarian cancer, the researchers discovered physicians:

• First ordered abdominal imaging or performed gastrointestinal procedures instead of the more appropriate pelvic imaging and/or CA-125 (a blood test that can detect ovarian cancer).

• Only 25 percent of patients, who reported ovarian cancer symptoms four or more months before diagnosis, were given pelvic imaging or had CA-125 blood tests.

Patients with early symptoms are frequently misdiagnosed. Abdominal imaging or diagnostic gastrointestinal studies are less likely to detect ovarian cancer. According to the American Cancer Society's website, "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 two of these symptoms."

By the time a woman reaches the fourth stage of ovarian cancer, her first-line treatment is often Carboplatin, Paclitaxel and Cisplatin as the specific chemotherapy for ovarian cancer. In the first stage, cancer is contained inside one or both ovaries. By stage two, the cancer has spread into the fallopian tubes or other pelvic tissues, such as the bladder or rectum. When the cancer has spread outside the pelvis area into the abdominal cavity, especially when tumor growths are larger than two centimeters on the lining of the abdomen, then ovarian cancer has reached stage three. The fourth and final stage of ovarian cancer is reached when the cancer has spread into other body organs, such as the liver or lungs.

If detected early, survival rates can be as high as 90 percent. Detected in the advanced stage, the survival rate falls to between 30 and 40 percent. Various imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and ultrasound studies can confirm whether a pelvic mass is present. A laparoscopy can help a doctor look at the ovaries and other pelvic tissue to in order to plan out a surgical procedure, or to determine the stage of the ovarian cancer. A biopsy, or tissue sampling, would confirm if there is cancer in your pelvic region, and would help determine how advanced it is. An elevated CA-125 blood test typically suggests the cancer has progressed to the advanced stage.

About 50 percent of ovarian cancer patients are already at an advanced stage by the time a correct diagnosis is made. Only 10 to 14 percent of women with advanced cancer are likely to survive more than five years.

by James Finch

Tuesday, May 30, 2006

ovarian cancer : Cancer of the Ovaries

Treatments and Risk Factors
The treatment for ovarian cancer varies according to a number of factors. For most women the first treatment is also a diagnostic procedure which involves surgery to determine the extent to which the disease has spread. As a result of surgery, the cancer will be staged.
Stages range from I to IV, with I being the earliest and IV being the most advanced stage. Treatment of ovarian cancer is based on the stage and grade of the disease. A pathologist will determine the grade (how likely it is to spread) of the malignancy.

Hysterectomy with salpingo- oophorectomy (removal the fallopian tubes and one or both ovaries) will most often follow a diagnosis of ovarian cancer. Young women who still desire children and who have certain types of early ovarian cancer confined to one ovary may be able to have only the diseased ovary removed.

Chemotherapy or radiation will follow the hysterectomy based on individual patient cases.
Are You at Risk?
An immediate (mother, sister, or daughter) family member who has had ovarian cancer increases your risk of developing this disease about three times, giving you a five to seven percent risk of future ovarian cancer.
When the cause is genetic, ovarian cancer usually shows up a decade earlier in each successive generation. Are You at Risk?
An immediate (mother, sister, or daughter) family member who has had ovarian cancer increases your risk of developing this disease about three times, giving you a five to seven percent risk of future ovarian cancer.

When the cause is genetic, ovarian cancer usually shows up a decade earlier in each successive generation. (If your mother had ovarian cancer in her 60's, you stand a good chance that this disease will develop in you in your 50's.)


Genetic counseling is a good idea for women with a family history of breast or ovarian cancers. Women with a family history may opt for oophorectomy, although this procedure does not offer absolute protection it does reduce risk by 75 to 90 percent.


Research has determined that women who use powders to dust their genital areas have a 60 percent higher risk of ovarian cancer. Feminine deodorant sprays can almost double your risk!

Women who use oral contraceptives for at least five years reduce their chance of developing ovarian cancer by half for the short-term following use and possibly for lifetime. The longer you use the pill, the lower your risk.

Having two or three children can cut your risk by as much as 30 percent over women who never conceive or give birth. Having five or more children reduces the risk up to 50 percent, and breast-feeding your children can further reduce your risk.

Tubal ligation reduces a woman's risk up to 70 percent.

From Tracee Cornforth,

ovarian cancer ; Diagnosis

Symptomless ovarian cancer is most often detected during a woman's regular gynecological examination. Your physician will palpitate your ovaries during your pelvic and rectal exam for the presence of ovarian cysts or fibroid tumors. If any abnormalities are noted, he will follow up with further testing which may include an ultrasound and chest X-ray. If further testing is required, a laparoscopy may be performed.

New methods for early screening of ovarian cancer are being investigated including ultrasound in conjunction with a blood test. The blood test may detect an antigen called CA 125 which has been detected in the blood of women with ovarian cancer.

These tests are useful in evaluating tumor growth, however neither of them has been proven as a reliable way to screen for ovarian cancer. Ultrasound can detect changes, but it does not give enough information alone to diagnose ovarian cancer. The CA 125 blood test can return positive results when no cancer is present due to other conditions a woman may experience including fibroid tumors, endometriosis, pelvic infection, pregnancy, or other non-gynecological problems.

Although these methods of screening for ovarian cancer look promising, further study is needed before either of these tests are routinely used to screen for ovarian cancer.

©2006 About, Inc., A part of The New York Times Company. All rights reserved.

Ovarian Cancer: The Silent Killer

Ovarian cancer is often called the "silent" killer because many times there are no symptoms until the disease has progressed to an advanced stage. One-third of American women will get some form of cancer in their lifetime and approximately one and one half percent of those cases will be cancer involving one or both ovaries.

Early symptoms of ovarian cancer are often mild, making this disease difficult to detect. Some early symptoms may include:

An unusual feeling of fullness or discomfort in the pelvic region
Unexplainable indigestion, gas, or bloating that is not relieved with over-the-counter antacids
Pain during sexual intercourse
Abnormal bleeding
Swelling and pain of the abdomen
Most often these symptoms do not indicate ovarian cancer
However, if you experience them you should discuss them with your clinician.
Early detection of ovarian cancer offers a 90 percent cure rate. Sadly, a lack of symptoms from this silent disease means that about 75 percent of ovarian cancer cases will have spread to the abdomen by the time they are detected and, unfortunately, most patients die within five years.

©2006 About, Inc., A part of The New York Times Company. All rights reserved.

Monday, May 29, 2006

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.

http://www.cancersociety.com/ovarian_tp.cfm

ovarian cancer ; Treatment for Ovarian Cancer

Treatment depends on a number of factors, including the stage of the disease and the general health of the patient. Patients are often treated by a team of specialists. The team may include a gynecologist, a gynecologic oncologist, a medical oncologist, and/or a radiation oncologist. Many different treatments and combinations of treatments are used to treat ovarian cancer.



Surgery is the usual initial treatment for women diagnosed with ovarian cancer. The ovaries, the fallopian tubes, the uterus, and the cervix are usually removed. This operation is called a hysterectomy with bilateral salpingo-oophorectomy. Often, the surgeon also removes the omentum (the thin tissue covering the stomach and large intestine) and lymph node (small organs located along the channels of the lymphatic system) in the abdomen.
Staging during surgery (to find out whether the cancer has spread) generally involves removing lymph nodes, samples of tissue from the diaphragm and other organs in the abdomen, and fluid from the abdomen. If the cancer has spread, the surgeon usually removes as much of the cancer as possible in a procedure called tumor debulking. Tumor debulking reduces the amount of cancer that will have to be treated later with chemotherapy or radiation therapy.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control tumor growth, or to relieve symptoms of the disease.
Most drugs used to treat ovarian cancer are given by injection into a vein (intravenous). The drugs can be injected directly into a vein or given through a catheter, a thin tube. The catheter is placed into a large vein and remains there as long as it is needed. Some anticancer drugs are taken by mouth. Whether they are given intravenously or by mouth, the drugs enter the bloodstream and circulate throughout the body.
Another way to give chemotherapy is to put the drug directly into the abdomen through a catheter. With this method, called intraperitoneal chemotherapy, most of the drug remains in the abdomen.
After chemotherapy is completed, second-look surgery may be performed to examine the abdomen directly. The surgeon may remove fluid and tissue samples to see whether the anticancer drugs have been successful.
Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation). Some women receive a treatment called intraperitoneal radiation therapy in which radioactive liquid is put directly into the abdomen through a catheter.

Clinical trial" (research studies) to evaluate new ways to treat cancer are an important treatment option for many women with ovarian cancer. In some studies, all patients receive the new treatment. In others, doctors compare different therapies by giving the promising new treatment to one group of patients and the usual (standard) therapy to another group. Through research, doctors learn new, more effective ways to treat cancer.

http://www.cancersociety.com/ovarian_tp.cfm