Epithelial ovarian cancer (EOC) is the most common form of ovarian malignancy, accounting for over 90% of ovarian cancer cases. This cancer originates from the epithelial cells covering the ovaries and is often diagnosed in later stages due to its asymptomatic nature in early development.
What is Epithelial Ovarian Cancer?
Epithelial ovarian cancer develops in the outermost layer of cells surrounding the ovary. It is a highly aggressive malignancy often associated with late-stage diagnosis and poor prognosis.
Risk Factors and Causes
Understanding the risk factors for EOC is crucial for early detection and prevention. Key risk factors include:
- Age: Most common in postmenopausal women, especially over 50.
- Genetics: BRCA1 and BRCA2 mutations increase the risk significantly.
- Family History: A history of ovarian, breast, or colorectal cancer raises susceptibility.
- Hormonal Factors: Early menstruation, late menopause, and hormone replacement therapy (HRT) contribute to risk.
- Lifestyle Factors: Obesity, smoking, and a diet high in processed foods can elevate risk levels.
Symptoms of Epithelial Ovarian Cancer
EOC is known as a “silent killer” due to its subtle and non-specific symptoms. Common signs include:
- Abdominal bloating or swelling
- Pelvic pain or pressure
- Frequent urination
- Changes in bowel habits
- Loss of appetite or feeling full quickly
- Unexplained weight loss
Diagnosis and Staging
Diagnostic Tests
Diagnosing EOC requires a combination of clinical evaluation, imaging, and laboratory tests:
- Pelvic Exam: Initial assessment for abnormalities.
- Ultrasound: Detects ovarian masses and cysts.
- CA-125 Blood Test: Measures tumor marker levels.
- CT/MRI Scan: Determines tumor size and spread.
- Biopsy: Confirms malignancy through histological examination.
Staging of EOC
Epithelial ovarian cancer is classified into four stages:
graph TD;
StageI[Stage I: Confined to ovaries] --> StageII[Stage II: Spread to pelvis]
StageII --> StageIII[Stage III: Spread to abdomen/lymph nodes]
StageIII --> StageIV[Stage IV: Distant metastasis (liver, lungs, etc.)]Treatment Options
Surgery
- Debulking Surgery: Removal of visible tumor tissue.
- Hysterectomy: Often includes the removal of ovaries, fallopian tubes, and uterus.
Chemotherapy
- Neoadjuvant Chemotherapy: Administered before surgery to shrink tumors.
- Adjuvant Chemotherapy: Given post-surgery to eliminate residual cancer cells.
Targeted Therapy
- PARP Inhibitors: Effective for patients with BRCA mutations.
- Anti-angiogenic Therapy: Blocks blood supply to the tumor.
Immunotherapy
Although still under research, immunotherapy drugs are showing promise in treating advanced EOC.
Prognosis and Survival Rates
The prognosis for epithelial ovarian cancer depends on the stage at diagnosis:
- Stage I: 90% 5-year survival rate
- Stage II: 70% 5-year survival rate
- Stage III: 39% 5-year survival rate
- Stage IV: 17% 5-year survival rate
Prevention and Early Detection
- Genetic Testing: Recommended for high-risk individuals with family history.
- Regular Screenings: CA-125 and transvaginal ultrasound for at-risk groups.
- Healthy Lifestyle: Regular exercise, balanced diet, and avoiding smoking reduce risk.
- Oral Contraceptives: Long-term use can lower risk by up to 50%.
