OVARIAN CANCER

 OVARIAN CANCER 

WHAT IS OVARIAN CANCER?

Ovarian cancer is a collection of diseases that initiates in the ovaries or in areas of fallopian tubes and peritoneum. It belongs to cancer epithelial stromal tumors that are the most common types among ovarian neoplasm. They arise in variety of different tumors types. Most common type is high grade serous carcinoma occurring in 70% of ovarian cancer. Serous cancer divided into low and high grade subtypes; Low grade is characterized of mutations of BRCA1 and BRCA 2. High grade is characterized with TP53

According to Centre of Disease control and prevention, ovarian cancer is the second most common gynecologic cancer and accounts for more death than any other cancers of woman’s reproductive system

According to American cancer society, the risk of getting ovarian cancer is 1 in 78 women and chance of a women dying in her lifetime from ovarian cancer is about 1 in 108

RISK FACTORS

Increased incidence of this cancer is more prominent in women over 65 years of age and is primarily considered as postmenopausal disease

Lack of ovulation due to pregnancy or use of oral contraceptives lack of ovulation caused by menstrual disorders is related with increased risk of ovarian cancer

Women who have a family history of ovarian cancer and certain inherited gene changes such as BRCA2 gene changes have a greater risk than women who do not have a family history

CLINICAL PRESENTATION

It is often stated as a silent killer, as it is challenging to identify easily as there are no screening tests. Patients are usually asymptomatic until disease become very aggressive

Symptoms of advanced stage incudes bloating, belly pain, frequency, need to urinate quickly, feeling full after eating, abnormal vaginal bleeding, tiredness, pelvic pain.

Ovarian cancer is diagnosed using transvaginal ultrasound and blood test to detect a protein called Ca 125, CT guided needle biopsy form pathology testing

WHAT ARE THE TREATMENT OPTIONS FOR OVARIAN CANCER?

The standard care for ovarian cancer is surgery and platinum based chemotherapy 

1. Antiangiogenic drugs: These drugs bind to VEGF molecules, which prohibits them from activating receptors on endothelial cells inside blood vessels.

Example: Bevacizumab

2. PARP (poly adenosine diphosphate ribose polymerase) inhibitors: kill cancer cells that have impaired DNA receptor capabilities

 Examples: olaparib., niraparib, bucapurib

3. Mirvetuximab sravtansine: is a first in class ADC comprising a folate receptor (FR alpha) binding antibody, cleavable linker to kill the targeted cancer cells 

4. AVB S6 500 protein therapy: it is a therapeutic recombinant fusion protein that has been shown to neutralize GAS6 activity  by binding to GAS6 with very high affinity, it selectively inhibits the GAS6 AXL signaling pathway

HOW TO PREVENT?

 Using oral contraceptives declines the risk of emerging ovarian cancer

 Tubal ligation and hysterectomy may lessen the chance of developing certain types of ovarian cancer

 Genetic counselling

Written By:

Rajeshwari Boda

CSRPL_INT_ONL_WKD_156/0721

REFERENCES:

1. https://rarediseases.info.nih.gov/diseases/7295/ovarian-cancer

2. https://cancercommons.org/latest-insights/new-treatments-for-ovarian-cancer-in-2020/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500433/#!po=12.0536