Ovarian cancer is often known as the ‘silent killer’ because it is a disease that has few or no symptoms during the earlier stages. It is also difficult to detect and diagnose, and for a majority of case, stage 3 ovarian cancer may be reached before detection is made.
In a majority of cases, symptoms such as abnormal vaginal bleeding, abdominal and back pain, bloating, digestive and urinary disturbances, painful sex, difficult eating or feeling full quickly, breathing problems and so on may first be felt only around stage 3 ovarian cancer. By then prognosis is poor, survival rates are low and treatment options usually limited in terms of efficacy.
It is said to be Stage 3 ovarian cancer when the cancer is present in one or both ovaries, and has also spread to the lining of the abdomen outside the uterus or the peritoneum – the third stage of ovarian cancer has three sub stages –
Stage III A – the tumor is still largely contained in the pelvis, but microscopic cancer cells have started growing on the peritoneum.
Stage III B – The spread of the cancer can now be seen but the size of the tumor is still less than 2 centimeters.
Stage III C – The metastases (spread) of the cancer is now bigger than 2 centimeters or the cancer has spread to the pelvic, para-aortic or groin lymph nodes.
There is only one stage after Stage III ovarian cancer, and Stage IV is the last stage of the cancer when the cancer may have spread to the liver or the lungs and in the fluid that has accumulated in the chest cavity. At this stage the functioning of other organs has begun to be affected and complications such as intestinal obstructions become problematic and even life threatening.
Since there is no effective screening methodology to detect this type of cancer, and it is asymptomatic till it has advanced significantly (60% of detection is done by Stage 3 of ovarian cancer or even later at stage 4), the prognosis for this cancer is usually poor. The overall 5 year survival rate for ovarian cancer is 45%.
Treatment options for Ovarian Cancer – Surgery is the first line of defense against ovarian cancer and depending upon the spread of the cancer, a complete hysterectomy is usually performed to remove the cancers in the ovaries, lymph nodes and the other tissues where they may have spread in a surgical maneuver called tumor debulking.
A procedure known as omentectomy to remove fatty tissue from the abdomen may also be performed. At the same time careful observation of the abdominal surfaces to detect any malignant cells is done.
Following surgery, a full course of chemotherapy is prescribed for the later stages of ovarian cancer. Sometimes women with Stage 2 or Stage 3 ovarian cancer and occasionally with Stage 4 Ovarian cancer, who show persistent cancer even post surgery, may be required to submit to a second look exploratory surgery of the abdomen to confirm being disease free.