Primary Peritoneal Cancer Guide

For most sufferers and their families the main question they have is regarding ovarian cancer survival rates. Before we get into this let’s focus on what ovarian cancer is. The ovarian cancer is a disease that affects one or both ovaries, the organs on each side of the uterus. One of the ovaries releases an ovum when a woman ovulates. The ovaries also make hormones for reproduction. Unfortunately, approximately 75% of ovarian cancers are diagnosed at an advanced stage. If it is detected early and treated, the ovarian cancer survival rate is good. Patients increase the ovarian cancer survival rate if it has not spread outside the ovary and have a 90-95% chance of surviving five years or more after treatment.

The type of cancer is based on the cell type where it occurs. The most common is the epithelial cancer. Approximately 85 to 90% of all cancer cases arise from epithelial cancer that occurs in the cells on the surface of the ovary. Most women who develop this cancer are over 40 years of age. Approximately 5% of ovarian cancers are germ cell tumors. Stem cells are cells of the ovaries that become eggs. The cancer cells can also spread other than the abdominal cavity, to the surface of the lungs and chest cavity, resulting in a collection of fluid around the lungs known as a pleural effusion.

Who are at risk? About 3% of all new cancer cases diagnosed each year in women are ovarian cancers. Women of any age can develop ovarian cancer, but the risk increases with age. The most common type occurs more frequently in women between 50 and 75 years of age. Half of all ovarian cancer cases are diagnosed in women over 63 years of age. Ovarian cancer is much less common in women under 40 years of age. The following factors increase a woman’s risk of developing ovarian cancer:

1. Family history of ovarian
2. Personal history of breast cancer
3. Late menopause
4. Use of fertility
5. Women who have never been pregnant, or who became pregnant for the first time at age 30 or older.
6. Approximately 5-10% of all ovarian cancers occur in women who have certain genes (BRCA1 and BRCA2) inherited from their parents. There are blood tests to detect if a woman has one of these genes. Women who have one of these genes should consult a genetic specialist.

The prognosis says that the less a woman ovulates during her lifetime, the lower her risk of developing cancer of the ovary. Therefore, women who have had children have lower odds of developing ovarian cancer because they do not ovulate while pregnant or nursing. Women who use contraceptive pills do not ovulate and, therefore, have lower odds of developing ovarian cancer. Women who have undergone tubal sterilization seem to develop ovarian cancer less frequently, but the reason is unclear. After a doctor gives the diagnosis of ovarian cancer the treatment must start immediately. It’s important to understand that a woman can have some or all of the risk factors and yet never develop ovarian cancer and vice versa. All women should know the symptoms and inform their physicians, allowing the ovarian cancer survival rate to increase.

The symptoms of ovarian cancer are many and varied. Ovarian cancer is a type of cancer that begins in the ovaries, the female reproductive organs that produce an ovum every month and released through the Fallopian Tube. Ovarian cancer, whose cause is unknown, is the fifth most common cancer among women and causes more deaths than any other cancer of the reproductive system.

Often the signs and symptoms of ovarian cancer are confused with other medical problems. In some cases the patient does not experience any symptoms. About 20% of national cases of ovarian cancer are diagnosed early before spreading to any other part of the body. Incipient ovarian cancer may cause symptoms, although they also occur with many other conditions. You should see a doctor if the following symptoms persist on a daily basis for more than a few weeks; bloating, difficulty when eating or feeling full quickly, pelvic or abdominal pain.

Other symptoms are also seen with ovarian cancer, but they can also be common in women without cancer. Warning signs may include:

1. pain or pressure in the pelvic area or back
2. indigestion, gas and bloating without explanation
3. unusual vaginal bleeding
4. pain or swelling in the abdomen
5. increased abdominal size
6. increased feeling of having to urinate or changes in bowel habits
7. feeling tired
8. weight loss

Most women with these symptoms do not have a serious problem. However, they should divulge them with their physicians. The doctor can perform a pelvic laparoscopy or exploratory laparotomy to evaluate symptoms and get a biopsy to help make the diagnosis. No imaging or laboratory test has ever shown that it can diagnose ovarian cancer at an early stage (screening).

Surgery is a treatment for all stages of ovarian cancer. It’s important to note that for the initial stages it may be the only treatment. The surgery involves:

1. Removing the uterus (hysterectomy)
2. Removal of ovaries and fallopian tubes
3. Partial or complete excision of the omentum. (A sheet of fat that is covered by peritoneum. The greater omentum is attached to the bottom edge of the stomach, and hangs down in front of the intestines. Its other edge is attached to the transverse colon. The lesser omentum is attached to the top edge of the stomach, and extends to the undersurface of the liver.)
4. Review, biopsy or removal of lymph nodes and other tissues in the pelvis and abdomen just as chemotherapy and radiotherapy.

Some possible complications may be: when cancer spreads to other organs, loss of organ function, fluid in the abdomen and intestinal obstruction. You should make an appointment with your doctor if you are a woman over 40 years of age who have not recently had a pelvic examination. You should see your doctor periodically and remember that Pap tests and pelvic examinations are routinely recommended for all women over 20 years of age. Call your doctor if you display any regular symptoms of ovarian cancer so he can get you tested.

Ovarian cancer metastasis is a process that involves local tumor invasion followed by dissemination and then re-establishment at distant sites. It usually occurs through blood or lymphatic system, a network of conduits that carry a clear fluid. Approximately 98% of deaths from undetected cancers are due to ovarian cancer metastasis.

Cancers spread through the body by two mechanisms: invasion and metastasis. The invasion is the direct migration and penetration by cancer cells in nearby tissues. Metastasis is the ability of cancer cells to penetrate the blood and lymphatic vessels, circulate through the bloodstream and then grow into a new focus, ovarian metastasis in normal tissues elsewhere in the body. Ovarian cancer is the seventh most common cancer among women in the United States followed by the primary cancers, breast cancer and gastrointestinal cancer.

There are several different types of cancer that can arise in the ovary, including epithelial ovarian cancer that occurs in the cells on the surface of the ovary. Epithelial cancer is another term for ovarian cancer.

Studies make a special reference to Krukenberg tumor which refers to an ovarian cancer metastasis whose primary site arose in the gastrointestinal tract or breast. These tumors are often found in both ovaries. Patients with Krukenberg tumor often come to the attention of the doctor when they’re suffering from abdominal or pelvic pain, bloating, vaginal bleeding, a change in their menstrual habits or pain during intercourse. These symptoms are not specific, pointing to a number of other problems that the cancer and the diagnosis of the disease can only be made following computed tomography (CT), laparotomy and/or a biopsy of the ovary. A laparotomy is a surgical procedure involving an incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy. When treating a secondary metastatic tumor its origin, the primary tumor, should also be treated. On early staging ovarian cancer is associated with abdominal distension. Depending on the stage you can figure out the size of the tumor and how deeply it has penetrated.

The ovary is a common site of metastasis of certain primary carcinomas. Today science advances rapidly with new research that helps to prevent many diseases. Scientists have created a vaccine to prevent ovarian cancer metastasis. The results thus far show promise, both for their safety and for their effectiveness. Ovarian tumors are “stealthy murderers” because they are notoriously difficult to detect in their early stages. About 10% of ovarian tumors are of primary origin. Thus far, nobody has convincingly described the procedure normally followed to ovarian with metastases from gastric cancer. It is known that the lymphatic channels that drain the upper gastrointestinal tract end up joining the lumbar chain of lymph nodes. The only hope for improvement is the removal as soon as possible of the primary tumor. In terms of treatments adjuvant chemotherapy is effective to minimize the effects of ovarian cancer metastasis depending on the stage reached.