According to statistics from the World Health Organization in 2008, cancer is one of the leading causes of death, accounting for as much as 13% of deaths worldwide, exceeding the combined death rates from AIDS, tuberculosis, and malaria. This sounds quite alarming. In Thailand, ovarian cancer ranks as the 6th most common cancer among women, with an incidence rate of approximately 6.8 per 100,000 people per year.
What exactly causes ovarian cancer?
There is no definitive evidence confirming the main cause of ovarian cancer in women. However, based on disease hypotheses, it is believed that repeated injury to the ovaries combined with exposure to stimulants or carcinogens may contribute to its development.
Dr. Thanomsiri Satitthit, a gynecologic oncologist, commented on factors that cause ovarian cancer. One of the triggers causing ovarian injury is menstruation in women. Each ovulation every month causes small wounds on the ovaries that can heal on their own. Frequent ovulation increases the risk of ovarian cancer. Additionally, women who have not had children are considered at higher risk than those who have.
Moreover, the doctor revealed a common cause from using talcum powder on female genital areas, including mothers who apply powder to their children after bathing without realizing that talcum powder can enter the abdominal cavity and stimulate cancer development. Dr. Thanomsiri therefore advises mothers to stop using talcum powder on their children and to avoid consuming high-fat foods, which are considered carcinogenic.
Hidden symptoms of ovarian cancer
There is no clear screening method for ovarian cancer, so most cases are detected when the cancer has reached an advanced stage. Common symptoms include bloating, abdominal fullness, indigestion, and abdominal enlargement. These symptoms are similar to gastritis, causing many patients to seek treatment for suspected gastritis. Diagnosis often occurs only when the disease has progressed significantly. Regular annual pelvic exams should not be neglected because early detection of ovarian masses makes treatment easier and increases the chance of cure.
Important diagnosis of ovarian cancer
To diagnose ovarian cancer, doctors perform a thorough pelvic and physical examination. If a mass is palpated near the uterus, further tests are required to determine the appearance and characteristics of the mass, usually by high-frequency ultrasound. In some cases, more detailed imaging such as CT scans or MRI may be needed to evaluate other abdominal organs.
Additionally, blood tests for tumor markers are performed to assist diagnosis and monitoring. Generally, ovarian cancer is classified into 4 stages, but stage 4 does not necessarily mean the final stage. The Women’s Health Center at Phyathai 2 Hospital classifies ovarian cancer stages as follows:
- Stage 1: Cancer is confined to the ovary.
- Stage 2: Cancer has spread within the pelvic cavity.
- Stage 3: Cancer has spread within the abdominal cavity.
- Stage 4: Cancer has spread to the liver or other organs outside the abdominal cavity.
Statistics from the Women’s Health Center at Phyathai 2 Hospital show that most patients diagnosed with ovarian cancer are at stage 3, reflecting a silent threat that should be prevented rather than treated at an advanced stage.
Treatment approach for ovarian cancer
Often, ovarian cancer treatment occurs over a short period because patients are shocked and unable to accept the diagnosis. The Women’s Health Center at Phyathai 2 Hospital encourages patients to fight the cancer cells. After biopsy to determine the stage, gynecologists will perform the following.
“Perform hysterectomy, removal of both fallopian tubes and ovaries, collect abdominal fluid, remove fat around the intestines, and dissect lymph nodes in the pelvic area and alongside the aorta to check for cancer spread that may not be visible to the naked eye.”
After surgery, most patients stay in the hospital for 4-5 days. Then, the doctor will schedule a follow-up to discuss biopsy results. If it is stage 1 without tumor rupture, treatment usually ends with surgery alone. For more advanced stages, chemotherapy is immediately required because even if the tumor is completely removed, microscopic cancer cells may still be present in the body. Chemotherapy helps eliminate these cells. Medical data shows that 75-80% of patients with advanced ovarian cancer respond well to chemotherapy and can be cured.
Side effects of chemotherapy
Side effects may include anemia, infections due to low white blood cells, and low platelet counts. These are caused by bone marrow suppression, a common side effect of almost all chemotherapy drugs. However, medications have been developed to effectively reduce these side effects, such as anti-nausea drugs to combat chemotherapy-induced vomiting.
Another important issue for all women is hair loss. Most chemotherapy drugs cause hair loss. Dr. Thanomsiri Satitthit, a gynecologic oncologist, revealed, “Some patients find it hard to accept this. After treatment ends and chemotherapy is no longer needed, hair will regrow normally. Meanwhile, this is a good time to try different hairstyles or wigs. Consider this a chance to turn a crisis into an opportunity. Always try to stay positive.”
Approximately 6 cycles of chemotherapy are given, followed by regular monitoring. Follow-up includes pelvic exams, blood tests for tumor markers, and sometimes imaging such as CT scans. In the first 2 years after treatment, follow-ups are every 3 months; in years 3-5, every 4-6 months. After 5 years, the chance of cancer recurrence is very low, so follow-ups are less frequent but still necessary as the disease can still recur.
Finally, Dr. Thanomsiri Satitthit urges all women… ovarian cancer is more dangerous than you think. Therefore, do not neglect annual pelvic exams. Have you taken yourself and your loved ones for a health check-up today?
Dr. Thanomsiri Satitthit
Gynecologic Oncologist
Women’s Health Center, Phyathai 2 Hospital
