Understanding Ovarian Cancer: Symptoms, Types, and Treatments

Ovarian cancer tends to be found late after very few nonspecific symptoms or no symptoms at all. Early ovarian cancer has no symptoms, while advanced ovarian cancer has variable symptoms.¹

Ovarian cancer is one of the deadliest of all cancers found in women, and is a leading cause of cancer-related deaths. Incidence is higher in developed countries and affects more women nearing menopause and after menopause.

Symptoms of ovarian cancer

Early symptoms (stage I)

Usually asymptomatic

Stage II and II ovarian cancer symptoms

Irregular periods
Vaginal bleeding after menopause
Lower abdominal pain
Polyuria (a lot of urine – over 2.5 litres a day)
Painful sex (dyspareunia)
Constipation
Swollen abdomen
Loss of appetite
Early satiety
Heartburn (dyspepsia)
Backache
Gas pains
Anaemia
Bloating

Stage IV ovarian cancer symptoms

Loss of appetite
Early satiety
Feeling of fullness in the abdomen
Constipation
Fatigue
Shortness of breath
Muscle wasting (cachexia)
Abdominal swelling due to ovarian enlargement
Some women may have severe abdominal pain
Germs cell or stromal tumours may result in hyperthyroidism, feminisation, virilisation

Types of ovarian cancer

Ovarian cancers have diverse roots, with 80 per cent developing from the epithelial cells in the ovary, with 75 per cent of those serous cystadenocarcinoma and around 10 per cent being invasive mucinous carcinoma. Almost 27 per cent of women with stage I epithelial ovarian cancer have some mucinous findings, but less than 10 per cent of those women with stages III or IV do.

Around 20 per cent of ovarian cancer originates in the primary ovarian germ cells or in sex cord and stromal cells, or can be cancer spread from another organ, often the breast or digestive tract. Germ cell cancers are typically found in women under the age of 30.

Types of epithelial ovarian cancers

Brenner tumour
Clear cell carcinoma
Endometrioid carcinoma
Mucinous carcinoma
Serious cystadenocarcinomas (most common)
Transitional cell carcinoma
Unclassified carcinoma

Types of primary germ cell ovarian cancers

Choriocarcinomas dysgerminomas
Embryonal carcinomas
Endodermal sinus tumors
Immature teratomas
Polyembryoma

Types of sex cord and stromal cell ovarian cancers

Granulosa-theca cell tumours
Sertoli-Leydig cell tumours

Diagnosis of ovarian cancer

Ovarian cancer is usually diagnosed via scans and analysis, with staging determined surgically, with markers detected in the blood. If a woman has unexplained masses, abdominal bloating, bowel habit changes, weight loss or abdominal pain, then ovarian cancer must be suspected.^2,3

Treatment of ovarian cancer

Ovarian cancers are typically treated with a hysterectomy, with removal of both ovaries and the removal of as much tissue as possible.⁴ If cancer has spread to other organs, chemotherapy will likely be administered, but if the cancer remains localised to the ovary, just that ovary may be removed.⁵

Risk factors of ovarian cancer

Women who have not carried a pregnancy to term
Women who bear children later
Women who get their periods early (early menarche)
Delayed menopause
Family or personal history of endometrial, breast or colon cancer

Women who use oral contraceptives have a reduced incidence of ovarian cancers.

Causes of ovarian cancer

While the cause of most cancers is not fully understood, up to 10 per cent of ovarian cancers are thought to be related to a gene mutation (autosomal dominant BRCA gene, BRCA1 and BRCA2), which is the gene responsible for gene-related breast cancer.⁶

Women with the BRCA mutation have a 50-85 per cent lifetime risk of developing breast cancer, while those with the BRCA1 mutation have a 20-40 per cent lifetime risk of developing ovarian cancer, while those with the BRCA2 mutations are less at risk.

Ashkenazi Jews have a higher incidence of these mutations than anyone else.⁷ Other mutations that could be linked with hereditary breast and/or ovarian cancer include TP53, PTEN, STK11/LKB1, CDH1, CHEK2, ATM, MLH1, and MSH2.

XY gonadal dysgenesis predisposes one to ovarian germ cell cancer.

Staging of ovarian cancer

Stage I – Tumour limited to the ovaries
Stage IA – Tumour limited to one ovary, with no tumour present on the external surface, and the capsule intact
Stage IB – Tumour in both ovaries, but no tumour on the external surface and capsules intact
Stage IC – Stage 1A or 1B, but with tumours on the surface of one or both ovaries, with capsule ruptured, or with malignant cells in ascites or peritoneal washings.
Stage II – Tumour involving one or both ovaries with pelvic extension or metastases
Stage IIA – Extension and/or metastases to the uterus, fallopian tubes, or both
Stage IIB – Extension to other pelvic tissues
Stage IIIC – Stage IIA or IIB, but with malignant cells in ascites or in peritoneal washings
Stage III – Tumour involving one or both ovaries with confirmed peritoneal metastases outside the pelvis
Stage IIIA – Microscopic peritoneal metastases outside the pelvis and negative lymph nodes
Stage IIIB – Macroscopic peritoneal metastases outside the pelvis that are two or less than two centimetres in diameter and negative lymph nodes
Stage IIIC – Abdominal peritoneal metastases extending beyond the pelvis and are over two centimetres in diameter and/or regional lymph node metastases
Stage IV – Distant metastases, including parenchymal liver metastases. If pleural effusion present, positive cytologic tests results must be obtained to signal stage IV.

Outcomes and prognosis of ovarian cancers

The five-year survival rates with treatment are:

Stage I – 70-100 per cent
Stage II – 50-70 per cent
Stage III – 20-50 per cent
Stage IV – 10-20 per cent

Recurrence is possible in some patients.

Is it possible to treat ovarian cancer with natural medicine?

The short answer is maybe, but probably not in our lifetime. So, no.

While My Vagina advocates for having as many conventional and unconventional options available to both treat and support treatments, natural medical practitioners are not qualified to treat cancer.

However, natural medicine has a very valuable place in supporting a person going through cancer treatments. This support can range from antioxidant treatments to combat the effects of chemotherapy on healthy tissue, or boost immunity with herbal medicines or specific supplements.⁸

Supportive treatment for cancers can be hugely important for patients going through cancer treatments, and we recommend seeking out a qualified, experienced natural medicine practitioner who can evaluate your diet and lifestyle, working alongside your conventional treatments in an integrative fashion. Qualified, experienced natural medicine practitioners can provide safe, effective options to boost your body and mind during a difficult time.⁹

If you are interested in supportive treatments while you undergo conventional cancer treatments, seek out an integrative clinic. Integrative cancer clinics provide the very best of both worlds: a fantastic doctor who can effectively treat your cancer, and a support team of other qualified, experienced practitioners to cover all your bases.

Supportive cancer therapies may include:

Naturopaths
Acupuncturists
Herbalists
Body workers – osteopaths, pelvic physiotherapists
Counsellors and psychologists

References

1.
Lawson-Michod KA, Watt MH, Grieshober L, et al. Pathways to ovarian cancer diagnosis: a qualitative study. BMC Women’s Health. Published online November 4, 2022. doi:10.1186/s12905-022-02016-1
2.
Liberto JM, Chen SY, Shih IM, Wang TH, Wang TL, Pisanic TR II. Current and Emerging Methods for Ovarian Cancer Screening and Diagnostics: A Comprehensive Review. Cancers. Published online June 11, 2022:2885. doi:10.3390/cancers14122885
3.
Rauh-Hain J, Krivak T, Del C, Olawaiye A. Ovarian cancer screening and early detection in the general population. Rev Obstet Gynecol. 2011;4(1):15-21. https://www.ncbi.nlm.nih.gov/pubmed/21629494
4.
Minig L, Guadalupe M, Alvarez R, de Bernabe JV, Diaz-Padill I. Surgical Treatment of Ovarian Cancer. Ovarian Cancer – A Clinical and Translational Update. Published online February 27, 2013. doi:10.5772/53972
5.
Akter S, Rahman MdA, Hasan MN, et al. Recent Advances in Ovarian Cancer: Therapeutic Strategies, Potential Biomarkers, and Technological Improvements. Cells. Published online February 13, 2022:650. doi:10.3390/cells11040650
6.
Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. <p>Ovarian cancer in the world: epidemiology and risk factors</p> IJWH. Published online April 2019:287-299. doi:10.2147/ijwh.s197604
7.
Robles-d�az L, Goldfrank DJ, Kauff ND, Robson M, Offit K. Hereditary ovarian cancer in Ashkenazi Jews. Familial Cancer. Published online 2004:259-264. doi:10.1007/s10689-004-9552-0
8.
Wu J, Zhou T, Wang Y, Jiang Y, Wang Y. Mechanisms and Advances in Anti-Ovarian Cancer with Natural Plants Component. Molecules. Published online September 30, 2021:5949. doi:10.3390/molecules26195949
9.
Chang CYY, Yang PY, Tsai FJ, et al. Integrated Chinese Herbal Medicine Therapy Improves the Survival of Patients With Ovarian Cancer. Integr Cancer Ther. Published online January 2019:153473541988149. doi:10.1177/1534735419881497