📄 የNCCN የሕሙማን ትምህርት ጽሑፍ

Ovarian Cancer

The 3rd most common cancer in Ethiopian women — listen to your body

📚 በNCCN የሕሙማን መመሪያዎች® ላይ የተመሠረተ · 🌍 ለኢትዮጵያና ለምሥራቅ አፍሪካ ሁኔታ የተዘጋጀ · 👨‍⚕️ የስለ ካንሰር ቡድን

📖 What Is Ovarian Cancer?

The ovaries are two small almond-shaped organs that produce eggs and hormones (oestrogen and progesterone). Ovarian cancer starts in one or both ovaries. The most common type — epithelial ovarian cancer — begins in the outer layer of cells covering the ovary. High-grade serous carcinoma is the most common subtype and is often associated with BRCA1/2 mutations. Other types include endometrioid, clear cell, and mucinous carcinomas. Germ cell tumours arise in the egg-producing cells and are more common in younger women; they are often highly curable. Cancer can also arise in the fallopian tubes (tubal carcinoma), which is now considered part of the same disease spectrum as ovarian cancer.

🔍 Warning Signs & Symptoms

Ovarian cancer symptoms are vague and are often attributed to digestive problems. See a doctor if these symptoms are new, persistent (more than 12 times per month), and unusual for you:

  • Bloating — persistent abdominal swelling or feeling of fullness
  • Pelvic or abdominal pain or pressure
  • Difficulty eating or feeling full quickly (early satiety)
  • Urinary symptoms — urgency or frequency not caused by infection
  • Noticeable increase in abdominal girth (accumulation of fluid — ascites)
  • Unexplained weight loss or fatigue
  • Change in bowel habits
  • Abnormal vaginal bleeding (less common)

🩺 Diagnosis

Pelvic examination may reveal an ovarian mass. Transvaginal ultrasound (TVUS) is the primary imaging tool to characterise an ovarian mass. CA-125 blood test: elevated in 80% of advanced epithelial ovarian cancers. However, CA-125 can be elevated in many benign conditions, so it is used alongside ultrasound, not alone. CT scan of the abdomen and pelvis assesses the extent of disease and helps plan surgery. The definitive diagnosis requires surgery — a tissue biopsy obtained during laparoscopy or laparotomy. BRCA1/2 genetic testing is recommended for all women with high-grade serous ovarian cancer.

📊 Cancer Staging

Ovarian cancer is surgically staged: Stage I: Cancer confined to one or both ovaries. Stage II: Cancer has spread within the pelvis. Stage III: Cancer has spread to the peritoneum (abdominal lining) or retroperitoneal lymph nodes — this is the most common stage at diagnosis. Stage IV: Cancer has spread to distant organs (liver, lungs, pleura). The goal of surgery is to achieve complete cytoreduction (removal of all visible tumour deposits).

💊 Treatment Options

NCCN Guidelines recommend:

  • Primary debulking surgery — Removal of the uterus, ovaries, fallopian tubes, omentum (fatty tissue), and all visible tumour
  • Interval debulking surgery — After 3 cycles of neoadjuvant chemotherapy when primary surgery is not feasible
  • Platinum-based chemotherapy — Carboplatin + paclitaxel every 3 weeks for 6 cycles is the standard
  • Bevacizumab (anti-VEGF) — Added to chemotherapy and then continued as maintenance therapy for advanced disease
  • PARP inhibitors (olaparib, niraparib, rucaparib) — Maintenance therapy after response to chemotherapy, especially for BRCA-mutated ovarian cancer
  • Intraperitoneal chemotherapy — Heated intraperitoneal chemotherapy (HIPEC) for select patients
  • Secondary cytoreduction — For relapsed disease after a treatment-free interval of ≥6 months

💚 Living With Ovarian Cancer

Chemotherapy side effects include nausea, hair loss, peripheral neuropathy (tingling in fingers and feet), and fatigue. Anti-nausea medications significantly help manage nausea. A protein-rich diet and adequate fluid intake support recovery between chemotherapy cycles. Fertility-sparing surgery may be possible for young women with Stage I disease who wish to preserve fertility. Women with BRCA1/2 mutations may consider risk-reducing surgery (removing ovaries and tubes) after completing their family. Follow-up with CA-125 and CT scans every 3–6 months for the first 2 years.

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ይህ ጽሑፍ ለትምህርት ዓላማ ብቻ ነው። በወቅታዊ የNCCN የሕሙማን መመሪያዎች® እና በWHO ምክሮች ላይ የተመሠረተና ለኢትዮጵያና ለምሥራቅ አፍሪካ ሁኔታ የተዘጋጀ ነው። ከብቁ የጤና ባለሙያ የሚሰጥ ምክርን፣ ምርመራን ወይም ሕክምናን አይተካም። የኢትዮጵያ ሕሙማን ለሕክምና በአዲስ አበባ የሚገኘውን የጥቁር አንበሳ ስፔሻላይዝድ ሆስፒታል ኦንኮሎጂ ክፍል ማማከር አለባቸው።

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