What is Ovarian Cancer ?

One of the main gynecologic cancers is ovarian cancer, which begins in the ovaries, fallopian tubes, or the lining of the abdomen known as the peritoneum. Ovarian cancer is medically called the "silent killer" because it typically shows nonspecific or minimal symptoms in the early stages, thus often being diagnosed in advanced stages. This is partly the reason for the higher mortality rates compared to other gynecologic cancers, despite the fact that it is less prevalent than other gynecologic cancers like breast or cervical cancer.

Recent statistics on the disease have indicated the challenges and the progress made so far. In the United States, the American Cancer Society has estimated the cases of ovarian cancer for 2026 to be 21,010, with 12,450 deaths. The age-adjusted incidence rate is 10.3 cases of ovarian cancer per 100,000 women. The death rate is 5.9 deaths of women for every 100,000. The risk of a woman developing the disease is 1 in 91, and the risk of death is 1 in 143. The five-year survival rate is about 51.6%, though it varies widely depending on the stage: over 92% when the cancer is confined to the ovaries, 71% when it is regional, and less when it is distant.

Ovarian cancer is a serious and major health problem worldwide. In 2022, the approximate number of new cases worldwide was 324,603. The projection is that the new cases will increase to over 500,000 by 2050. The National Cancer Registry (NCG) Program estimates that there will be 48,984 new cases of cervical cancer among women in India in 2024. 7.1 cases per 100,000 people is the crude incidence rate. After breast and cervical cancer, ovarian cancer is the 3rd most frequent malignancy of the female genital tract. According to projections, the rise will continue through 2025, with the total cancer incidence reaching around 1.57 million at the national level. Uttar Pradesh, including areas like Lucknow and Kanpur, has a significant proportion of the cancer incidence, with a high detection rate of advanced-stage cancer due to access and awareness problems.

As projected, this increase will continue until 2025, and the total incidence of cancer will be around 1.57 million at the national level. Uttar Pradesh has a large proportion of the incidence of cancer, including areas such as Lucknow and Kanpur, where there has been a high rate of detection of cancer in its advanced stage because of access and awareness issues.

At Tender Palm Super Specialty Hospital in Lucknow, we are dedicated to providing our patients with timely, compassionate, and evidence-based care for women with ovarian cancer, helping improve outcomes through expert multidisciplinary management.

What are the Symptoms & Causes of Ovarian Cancer ?

Ovarian cancer symptoms are often vague and easily attributed to common conditions like digestive issues, menopause, or aging. For most women, there are no obvious signs or symptoms until the disease has already progressed; hence, the importance of recognizing the subtle yet constant changes.

The most common signs/symptoms of Ovarian Cancer include:

• Prolonged bloating or swelling of the abdomen
• Pain or pressure in the abdomen or pelvis
• Feeling full after eating small meals
• The frequent urge to urinate
• issues like constipation or diarrhea
• Persistent fatigue despite adequate rest
• Weight gain or reduction due to unidentified causes
• Back pain
• Pain while having sex
• Heartburn or other stomach problems
• Menstrual problems or postmenopausal bleeding

These signs should raise an alarm if they are of recent onset, frequent (more than 12 occurrences per month), sustained (weeks), or worsening. In some instances, the occurrence of neurologic complaints like headaches, vision problems, or seizures can be suggestive of central nervous system involvement.

The exact reasons or causes of ovarian cancer are not fully known, but it begins when cells in the ovaries, fallopian tubes, or peritoneum undergo DNA mutations leading to uncontrolled growth and tumor formation. Many high-grade serous carcinomas (the most common aggressive type) actually originate in the fallopian tubes.

What are the Risk Factors for Ovarian Cancer ?

The risk factors that contribute to the probability of development are:

• Advanced age (diagnoses after age 50, most common diagnosis around age 63)
• Genetic predispositions such as the BRCA1 and BRCA2 genes (highly elevate the risk; also other gene defects causing Lynch syndrome)
• Personal history of breast or colorectal cancer within a family member
• Early menarche age (< 12 years) or late menopausal age (> 52 years)
• No children or few children
• Endometriosis
• Long-term use of menopausal hormone replacement therapy with estrogen or estrogen-progestin
• Obesity
• Previous history of breast cancer

Factors that reduce the risk of getting the disease are:

• Contraceptive pills (five years or more reduce risk by as much as 50% regardless of BRCA mutations)
• Many births
• Breast feeding
• Tubal sterilization/Hysterectomy
• Bilateral Salpingo-Oophorectomy for high-risk subjects (after reproductive age)

No single factor is responsible for most cases, but genetics and hormones are major contributors. Environment is also a focus of research, but no clear links to diet, smoking, and talc use have been seen in recent studies.

How Ovarian Cancer Diagnosed & Tested?

A history and physical exam to assess for pelvic masses and fluid are the first steps in diagnosing.

Key tests used to diagnose the condition are:

Imaging:

• Transvaginal ultrasound (first test to look at ovaries and masses)
• CT or MRI of the abdomen/pelvis to look at the spread
• PET CT scans, sometimes used

Blood tests:

• CA-125 tumor marker, commonly used but not specific, is more commonly used for follow-up than screening
• Other markers, such as HE4 or the ROMA index, are used.

Biopsy & Surgery:

• Surgical biopsy, used for diagnosis
• A gynecologic oncologist conducts exploratory surgery for staging and cytoreduction.

Genetic testing:

• BRCA1/2, Lynch Syndrome, and other genetic testing for treatment and screening purposes
• Homologous recombination deficiency testing for tumor profiling

Staging according to the FIGO criteria:

• Stage I: Restricted to ovaries/tubes
• Stage II: Restricted to the pelvic area
• Stage III: Abdominal/peritoneal extension or lymph nodes
• Stage IV: Spread to distant organs (liver/lungs/etc.)

A vast majority of cases (70-75%) occur at stages III or IV because symptoms are hard to detect in their early stages. Screening for ovarian cancer is not advised for low-risk women since it does not decrease mortality rates based on CA-125/ultrasound studies.

How is Ovarian Cancer Managed & Treated?

The treatment is tailored to the stage, subtype, genetic makeup, age, health, and fertility wishes. The treatment is provided by a multidisciplinary team of gynecologic oncologists, medical oncologists, and pathologists.

The role of surgery is emphasized in the following ways:

• Primary cytoreductive surgery is done to remove all visible tumor masses, which is optimal if no cancer or <1 cm is left behind.
• This includes hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node removal.
• Fertility-sparing measures, which are unilateral, are also considered for young women with early-stage disease.
• Neoadjuvant chemo or chemo first is an option for advanced or inoperable disease to reduce the tumor volume.

Chemotherapy:

• Platinum + Taxane + 6 cycles of chemo, specifically carboplatin + paclitaxel
• Intraperitoneal chemo for optimally debulked patients for a better prognosis
• Neoadjuvant/adjuvant chemo, depending on presentation

Targeted Therapies (major developments):

• Maintenance therapy with drugs such as olaparib, niraparib, and rucaparib in the PARP inhibitor class is done as a part of therapy after completing the cycle of chemotherapy treatment, especially for patients with mutated BRCA or a high risk of DNA damage repair.
• Angiogenesis inhibitors like bevacizumab may be administered as maintenance or in addition to chemotherapy.

Other Options:

• Hormone therapy can be done for low-grade or stromal tumors.
• Immunotherapy in case studies or in clinical trials
• Radiation therapy is generally not preferred except for symptom control.

Supportive care relieves side effects like nausea, neuropathy, or fatigue. Palliative care relieves symptoms like ascites, bowel obstruction, or pain. Clinical trials provide experimental methods for combination therapy.

Follow-up involves exams, CA-125 tests, and imaging to catch recurrence early.

What is Outlook / Prognosis of Ovarian Cancer ?

The prognosis varies depending on stage, type, and the patient's response to treatment. The five-year survival rate is about 51.6%, but:

• Localized (Stage I): >90-92%
• Regional (Stage II): ~70-75%
• Distant (Stage III/IV): ~30-40%

High-grade serous cancers respond well to platinum-based chemotherapy, although recurrence is common. The addition of PARP inhibitors has revolutionized maintenance therapy. Germ cell/stromal cancers have a good prognosis (>80-90% cure rate).

Good prognostic factors are surgery, mutations in BRCA/HRD genes (high sensitivity to particular drugs), young age, and good general condition. Metastatic malignancies have a high recurrence rate but can be controlled for many years. The survival rate is lower due to outdated oncology methods; with new technologies, the situation will improve drastically.

Emotional, nutritional, and rehabilitative support enhances the quality of life for survivors.

Why choose Tender Palm Super-Speciality Hospital for Ovarian Cancer Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Ovarian Cancer treatment in Lucknow, India, at an affordable cost. We have a team of experienced gynecological oncologists and surgical specialists who provide accurate diagnosis and both non-surgical and surgical treatment options including cytoreductive surgery, chemotherapy, and targeted therapy. Our Gynecological Oncology and Surgical Care team has decades of experience in successfully treating Ovarian Cancer in Lucknow, India.

To seek an Expert consultation for Ovarian Cancer Treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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