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(58569) The common risk of having ovarian cancer.

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(58569) The common risk of having ovarian cancer.

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According to Wikipedia, BRCA1 is slightly more common than BRCA2.

BRCA 1 mutation genes has higher risk of cancer (breast & ovarian) than in BRCA 2 because BRCA 1 play important roles in X-inactivation (Science Direct, 21 January 2003).
Besides, BRCA 1 if mutated, it will cause interruption to DNA repair mechanism.

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The origin of high grade carcinomas are :
1) Ovarian surface
2) Fallopian tube
3) Mesothelium

Carcinomas is a cancer arise in epithelial tissues or the lining of internal organ.

"Incessant ovulation" theory holds that frequent cycle of ovulation and surface repair causes the tendency of ovarian epithelium to become trapped in cysts lead to malignant transformation. As explained by Dr Naora, HOX genes (gene that regulate body formation) encodes transcription factors that serve as master regulators of several morphogenesis (formation of morphology). If HOX gene is mutated, it will lead to undifferentiated transformed of ovarian epithelial surface cells, thus lead to tumor. There's are 2 type of stage,

Stage 1 : Low grade tumors of low malignant potential (young age)

Stage 2 : High grade of carcinomas (post-menopausal women).

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The following factors may raise a woman's risk of developing ovarian, fallopian tube, or peritoneal cancer.

Family history. A strong family history of breast or ovarian cancer puts women at higher risk for ovarian, fallopian tube and peritoneal cancer. Doctors believe this is because many of these families have genetic mutations (harmful changes in the gene) that are passed from generation to generation (see Genetics, below). If you are concerned that ovarian cancer may run in your family, it is important to get an accurate family history, including breast cancers in the family. By understanding your family history, you and your doctor can take steps to reduce your risk and be proactive about your health.

Genetics. About 10% to 15% of ovarian, fallopian tube, and peritoneal cancers occur because a genetic mutation (harmful change) has been passed down within a family. A mutation in the BRCA1 or BRCA2 gene is associated with an increased risk of developing ovarian cancer. A woman with a BRCA1 mutation has approximately a 40% lifetime risk of breast cancer and a woman with a BRCA2 mutation has approximately a 10% to 20% lifetime risk of developing ovarian cancer. (A woman with an average risk has only a 1% to 2% lifetime risk of developing ovarian cancer). While less common, it is possible that BRCA-related ovarian cancer can occur in women who do not have a family history of either breast or ovarian cancer. It is recommended that all women with serous ovarian cancer under the age of 70 should consider genetic testing for BRCA1 and BRCA2, the genes related to Lynch Syndrome (see below), and other cancer risk genes even if they don’t have a family history. Read more about the BRCA1 and BRCA2 genes in this website’s section on hereditary breast and ovarian cancer.

Genetic conditions. There are several other genetic conditions that cause ovarian cancer. Some of the most common include:

Lynch syndrome. also known as hereditary non-polyposis colorectal cancer, increases a woman's risk of ovarian cancer and uterine cancer. It is caused by mutations in several different genes. Lynch syndrome increases the risk of colorectal cancer, as well as several other cancers.

Peutz-Jeghers syndrome (PJS). PJS is caused by a specific genetic mutation. The syndrome is associated with multiple polyps in the digestive tract that become noncancerous tumors and increased pigmentation (dark spots on the skin) on the face and hands. PJS raises the risk of ovarian cancer, breast cancer, colorectal cancer, and several other types of cancer.

Nevoid basal cell carcinoma syndrome (NBCCS). Women with NBCCS, also called Gorlin syndrome, have an increased risk of developing fibromas. These are benign fibrous tumors of the ovaries. There is a small risk that these fibromas could develop into a type of ovarian cancer called fibrosarcoma. People with NBCCS often have multiple basal cell carcinomas and jaw cysts and may develop medullablastoma (a type of brain tumor) in childhood.

Li-Fraumeni and Ataxia-Telangiectasia. Women with Li-Fraumeni syndrome or ataxia- telangiectasia may have a slightly increased risk of developing ovarian cancer.

There may be other hereditary syndromes linked to these types of cancer, and research in this area is ongoing. Only genetic testing can determine whether a woman has a genetic mutation. Most experts strongly recommend that women who are considering genetic testing first talk with a genetic counselor. This expert is trained to explain the risks and benefits of genetic testing.

Age. A woman’srisk of developing ovarian, fallopian tube and peritoneal cancer increases with age. Women of all ages have a risk of these cancers, but women over 50 are more likely to develop the malignancies. The average age of women diagnosed with these cancers is about 60 to 62 years.

Weight and height. Recent studies show that women who were obese in early adulthood are 50% more likely to develop ovarian cancer. Women who are obese are more likely to die from the disease.

Endometriosis. This is when the inside lining of a woman’s uterus grows outside of the uterus, affecting other nearby organs. This condition can cause several problems, but effective treatment is available. Researchers are continuing to study whether endometriosis is a risk factor for ovarian cancer. It may increase the risk of certain types of ovarian cancer, including clear cell and endometrioid ovarian cancers.

Ethnicity. Women of North American, Northern European, or Ashkenazi Jewish heritage have an increased risk of ovarian cancer.

Reproductive history. Women who have never had children, have unexplained infertility (the inability to bear a child), or have not taken birth control pills may have an increased risk of ovarian and fallopian tube cancer.

Hormone replacement therapy. Women who have taken estrogen-only hormone replacement therapy (HRT) after menopause may have a higher risk of ovarian cancer. The risk becomes higher the longer a woman uses the therapy. The risk decreases over time after the therapy ends.

Fertility drugs. Research studies have shown that use of fertility drugs do not increase the risk of ovarian cancer.

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Surgery

1.Salpingo-oophorectomy. This surgery involves removal of the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy. If the woman wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only one ovary and one fallopian tube if the cancer is located in only one ovary. That surgery is called a unilateral salpingo-oophorectomy. For women with a germ cell type of ovarian tumor, surgery often needs to remove only the ovary with the tumor, which preserves the woman’s ability to become pregnant.
2.Hysterectomy. This surgery focuses on the removal of a woman’s uterus and, if necessary, surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when a woman’s uterus and cervix are removed.
3.Lymphadenectomy (lymph node dissection). The surgeon may remove lymph nodes in the pelvis and paraortic areas.
4.Omentectomy. This is surgery to remove the thin tissue that covers the stomach and large intestine.
5.Cytoreductive/debulking surgery. For women with metastatic cancer, the goal of this surgery is to remove as much tumor as is safely possible. This may include removing tissue from nearby organs, such as the spleen, gallbladder, stomach, bladder, or colon. This may involve removing part of each of these organs. This procedure can help reduce a person’s symptoms. It may help increase the effectiveness of other treatment, such as chemotherapy, given after surgery to control the disease that remains. If the disease has spread beyond ovaries, fallopian tubes, or peritoneum, doctors may use chemotherapy to shrink the tumor before cytoreductive or debulking surgery. This is called neoadjuvant chemotherapy.

Side effects of surgery

Surgery causes short-term pain and tenderness. If there is pain, the doctor will prescribe an appropriate medication. For several days after the operation, you may have difficulty emptying your bladder (urinating) and having bowel movements. Talk with your surgeon about what side effects to expect from your specific surgery and how they can be relieved.

Studies have shown that women who have their surgeries performed by a gynecologic oncologist are more likely to be successfully treated with surgery and have fewer side effects.

If the surgeon removes both ovaries, a woman can no longer become pregnant. The loss of both ovaries eliminates the body's source of sex hormones, resulting in premature menopause. Soon after surgery, a woman is likely to have menopausal symptoms, including hot flashes and vaginal dryness.

Talk with your doctor about sexual and reproductive health concerns, including ways to address these concerns before and after cancer treatment.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a gynecological oncologist or a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.
Most of the chemotherapy options described below apply to epithelial ovarian cancer, as well as fallopian tube cancer and peritoneal cancer. The type of the chemotherapy used depends on several factors.

Adjuvant chemotherapy. This is done to destroy cancer remaining after surgery. This treatment typically consists of carboplatin (Paraplatin) given with paclitaxel (Taxol) or docetaxel (Docefrez, Taxotere) intravenously (IV), which is through the vein. Most of these drugs are given every 3 weeks.Another approach is called “dose-dense” chemotherapy. This is when the drugs are giving weekly instead of every 3 weeks. Some studies show that using dose-dense paclitaxel with carboplatin may improve survival rates compared to giving the drugs every 3 weeks. Talk with your doctor about which scheduling option is best for your situation.In addition, a third way to give adjuvant chemotherapy is to infuse it directly into the abdomen. This is called intraperitoneal or “IP” chemotherapy. This approach can be considered for women with stage III disease after a successful surgical debulking procedure. In previous studies, IP treatment was more effective when compared to intravenous treatment on the every 3-week schedule.Studies comparing dose-dense (weekly) IV chemotherapy with carboplatin and paclitaxel to IP chemotherapy with the same drugs show similar outcomes. Doctors are discussing whether the more intense IV approach can replace the use of IP chemotherapy.With each of these approaches, doctors consider a variety of factors, such as age, kidney function, and other existing health problems.Research studies are underway to see if additional medications, such as PARP inhibitors, should be used. Several studies have evaluated whether adding bevacizumab (Avastin), which is an anti-vascular or “blood vessel growth blocking” antibody, to standard chemotherapy following initial surgery is helpful. In general, bevacizumab used for ovarian cancer has prolonged the time in some patients before the cancer returns; see Latest Research.

Neoadjuvant chemotherapy. This is done to reduce the size of a tumor before surgery. It will usually follow a biopsy so the doctors can determine where the tumor began. This type of chemotherapy is usually given for 3 to 4 cycles before considering surgery, called interval surgery. Similar to adjuvant chemotherapy (see above), this treatment usually consists of carboplatin (Paraplatin) given with paclitaxel (Taxol) or docetaxel (Docefrez, Taxotere) intravenously, which is through the vein. Typically, the treatment cycle is to give these drugs every 3 weeks. Studies suggest a weekly schedule for the paclitaxel. Talk with your doctor about which scheduling option is best for your treatment plan.

In August 2016, the American Society of Clinical Oncology (ASCO) and the Society of Gynecologic Oncology (SGO) released a joint clinical practice guideline on the use of neoadjuvant chemotherapy, which is chemotherapy given before surgery, for women with newly diagnosed, advanced ovarian cancer. Listen to a podcast about what this treatment guideline means for patients.

Maintenance chemotherapy. This is done to reduce the time to, or risk of, cancer recurrence. Bevacizumab (Avastin) can be used for maintenance chemotherapy for people with ovarian, fallopian tube, and peritoneal cancer.

Recurrence chemotherapy. This is done to treat the cancer if it comes back, called a recurrence. A primary goal of the treatment of recurrent disease is to reduce or prevent symptoms of the disease while keeping the side effects of treatment to a minimum. Treatment for women with recurrent disease is generally categorized based on the time since her last treatment using a platinum chemotherapy drug. Platinum chemotherapy drugs include carboplatin and cisplatin. Researchers are working to see if surgery is an effective option for recurrent disease.

Platinum-sensitive disease: If the cancer returns more than 6 months after platinum chemotherapy, doctors call it “platinum-sensitive.” If it returns to one specific spot, additional surgery may be beneficial. You can discuss this with your doctor. Surgery is usually considered only if the time period following chemotherapy has been at least 12 months. If the cancer comes back to more than one place in the body, chemotherapy is the appropriate next step. For patients with platinum sensitive disease, clinical trials suggest there is benefit to using carboplatin again intravenously and combining it with liposomal doxorubicin (Doxil), paclitaxel (Taxol), or gemcitabine (Gemzar).

A clinical trial evaluated adding bevacizumab to the gemcitabine and carboplatin combination. This extended the time before the disease came back but did not change the overall survival rate. You should discuss the risks and possible benefits of this approach with your doctor.

Platinum-resistant disease: If the cancer returns in less than 6 months following platinum chemotherapy, doctors call it “platinum resistant.” In general, the choice of chemotherapy at this point is selected from a variety of medications that have all shown similar ability to shrink cancer. Doctors choose them based on possible side effects and preference based on schedule of dosing. These medications may include, but are not limited to:

Liposomal doxorubicin (Doxil)

Paclitaxel (Taxol)

Docetaxel (Taxotere)

Nab-paclitaxel (Abraxane)

Gemcitabine (Gemzar)

Etoposide (Toposar, VePesid)

Pemetrexed (Alimta)

Cyclophosphamide (Cytoxan)

Topotecan (Hycamtin)

Vinorelbine (Navelbine)

Irinotecan (Camptosar)

For platinum-resistant cancer, most doctors recommend single and sequential use (1 drug after another) of these medications, but they are sometimes used in combination.

Bevacizumab can be combined with liposomal doxorubicin, paclitaxel, or topotecan for platinum-resistant cancer. Doctors believe this is best used with patients who have received one or two treatments, have not previously received bevacizumab, and those do not have evidence of significant bowel involvement by a CT scan. By adding bevacizumab to the chemotherapy, the time to disease recurrence may be lengthened when compared to those patients receiving chemotherapy alone. You should discuss the risks and possible benefits of this approach with your doctor.

Clinical trials are always reasonable to consider, if available. Talk with your doctor about available clinical trials open to you.

Ovarian germ cell and stromal tumors

For patients with ovarian germ cell tumors, the first treatment usually is surgery. In some cases, doctors can perform the surgery in a way that preserves fertility. Doctors generally recommend chemotherapy following surgery. The exception is stage IA dysgerminoma or stage I, grade 1 to 2 immature teratoma. Chemotherapy usually consists of a combination of intravenous (IV) bleomycin (Blenoxane), cisplatin (Platinol), and etoposide (Toposar, VePesid). The overall approach and medications given are similar to those used in male germ cell cancer, which is a type of testicular cancer. To learn more about this type of cancer, visit the Cancer.Net guides to testicular cancer and childhood germ cell tumors.

Stromal tumors are a rare form of ovarian cancer. They are found in the connective tissue that holds the ovaries together. For a stage I stromal tumor, treatment usually consists of surgery only. For high-risk, early stage tumors or stage III or stage IV disease, doctors often consider combination chemotherapy. You should discuss the risks and potential benefits with your doctor. For information about staging, visit the Staging section of this guide.

Chemotherapy for a stromal tumor usually involves the combination of bleomycin (Blenoxane), cisplatin (Platinol) and etoposide (Toposar, VePesid). Chemotherapy can be used after surgery or for recurrent tumors. Researchers are looking at chemotherapy with carboplatin (Paraplatin) and paclitaxel (Taxol) as another alternative. For recurrent disease, doctors use the hormonal therapy leuprolide (Eligard, Lupron, Viadur). Clinical trials are evaluating the effectiveness of bevacizumab (Avastin) to block the growth of blood vessels. Studies are being done to test tumors molecularly to find other, more targeted drugs for this type of cancer.

Side effects of chemotherapy

For ovarian, fallopian tube, and peritoneal cancer, the side effects of chemotherapy depend on the individual and the dose used. Side effects can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Possible side effects of chemotherapy include difficulty with cognitive (brain) functions. For example, the patient may have issues with attention span or memory. Other possible side effects include stopping the ability to become pregnant and causing premature or early menopause. Rarely, certain drugs may cause some hearing loss or kidney damage. Patients may be given extra fluid intravenously for kidney protection. Before treatment begins, patients should talk with their health care team about possible short-term and long-term side effects of the specific drugs being given. It is important to note that many side effects can be reduced by adjusting the dose and/or schedule.

Learn more about the basics of chemotherapy and preparing for treatment. Researchers are continually evaluating the medications that treat cancer. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is not used as a first treatment for ovarian, fallopian tube, or peritoneal cancer. Occasionally, it can be an option for treating small, localized recurrent cancer. See the section below for more about treatment options for recurrent ovarian, fallopian tube, and peritoneal cancer.

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external beam radiation therapy. This type of radiation is given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen usually consists of a specific number of treatments given over a set period of time.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy.

For more information on radiation therapy for gynecologic cancers, see the American Society for Therapeutic Radiology and Oncology's pamphlet, Radiation Therapy for Gynecologic Cancers (PDF).

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Taxol:•	Treat a number of cancers(ovarian cancer, breast cancer, lung cancer, kaposi sarcoma, cervical cancer, pancreatic cancer)•	SE: hair loss, bone marrow suppression, numbness, allergic reactions, muscle pains, diarrheaMOA:•	Targets cytoskeleton(tubulin), cells have defect in mitotic spindle assembly, chromosome segregation and cell division•	Blocks progression of mitosis•	Triggers apoptosis/reversion to G phase of cell cycle without cell division

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Taxol:•	Treat a number of cancers(ovarian cancer, breast cancer, lung cancer, kaposi sarcoma, cervical cancer, pancreatic cancer)•	SE: hair loss, bone marrow suppression, numbness, allergic reactions, muscle pains, diarrheaMOA:•	Targets cytoskeleton(tubulin), cells have defect in mitotic spindle assembly, chromosome segregation and cell division•	Blocks progression of mitosis•	Triggers apoptosis/reversion to G phase of cell cycle without cell division

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The following tests may be used to diagnose ovarian, fallopian tube, and peritoneal cancer:

Abdominal-pelvic examination. Usually, the first exam is the abdominal-pelvic examination. The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for any unusual changes. Some early cancers are very small before they spread and cannot be reliably felt and detected by pelvic examination. A Pap test, usually done with a pelvic examination, is not likely to find or diagnose ovarian, fallopian tube, or peritoneal cancer. However, research advances in DNA testing may help find cells trapped in the cervix that could be studied for changes that indicate cancer elsewhere in a woman’s reproductive system. These findings are considered experimental but are a promising new method for earlier detection of these types of cancers.

Transvaginal ultrasound. An ultrasound wand is inserted in the vagina and aimed at the ovaries and uterus. An ultrasound uses sound waves to create a picture of the ovaries, including healthy tissues, cysts, and tumors. Researchers are studying whether this test can help with early detection of ovarian cancer.

Blood tests/CA-125 assay. There is a blood test that measures a substance called CA-125, a tumor marker. This marker is found in higher levels in women with ovarian cancer, fallopian tube cancer, or peritoneal cancer. Woman younger than 50 with conditions such as endometriosis, pelvic inflammatory disease, and uterine fibroids may also have an increased CA-125 level. This test is more accurate in women who have had menopause. Other tumor marker tests, such as HE4, are available, but neither of these markers have been shown to be effective for the early detection of these cancers.

Computed tomography (CT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. An x-ray is a way to create a picture of the structures inside the body using a small amount of radiation. A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow. A CT scan can be used to measure the tumor’s size. While the technology of CT scanning has continued to evolve, tumors or abnormalities less than about 5 millimeters (1/5th of an inch) are difficult to see.

Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure as just a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to actively use energy, it absorbs more of the radioactive substance. A scanner detects this substance to produce images of the inside of the body.

Lower gastrointestinal (GI) series. This is a series of x-rays of the colon and rectum taken after the patient has a barium enema. This procedure delivers a special dye into the rectum and colon through the anus. The barium highlights the colon and rectum on the x-ray, making it easier to identify a tumor or abnormal area in those organs. This test may be used if the doctor is concerned that the cancer is blocking the large intestine, although a CT scan with contrast (see above) is more commonly used in these circumstances.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

Paracentesis. This is a medical procedure that removes peritoneal fluid that has built up in a person’s abdomen. This fluid build-up may be called ascites. A sample of the fluid is examined under a microscope for signs of cancer (see below, under Biopsy).

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definitive diagnosis. A pathologist analyzes the samples(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

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Those undergoing treatment for cancer may face distress and when the body is exposed to stress for long periods of time, there're some detrimental effects to the body.  The body responds to stressful situations by releasing stress hormones, such as epinephrine or norepinephrine. These hormones causes an increase in blood pressure, heart rate and blood sugar levels. These changes help a person act with greater strength and speed to escape a perceived threat.
However Research has shown that people who experience intense and long-term (i.e., chronic) stress can have digestive problems, urinary problems, and a weakened immune system. People who experience chronic stress are also more prone to viral infections such as the flu or common cold and to have headaches, sleep trouble, depression, and anxiety.

However, there is no evidence that successful management of psychological stress improves cancer survival. Evidence from experimental studies does suggest that psychological stress can affect a tumor’s ability to grow and spread. For example, some studies have shown that when mice bearing human tumors were kept confined or isolated from other mice—conditions that increase stress—their tumors were more likely to grow and spread (metastasize). In one set of experiments, tumors transplanted into the mammary fat pads of mice had much higher rates of spread to the lungs and lymph nodes if the mice were chronically stressed than if the mice were not stressed. Studies in mice and in human cancer cells grown in the laboratory have found that the stress hormone norepinephrine, part of the body’s fight-or-flight response system, may promote angiogenesis and metastasis.

Although there is still no strong evidence that stress directly affects cancer outcomes, some data do suggest that patients can develop a sense of helplessness or hopelessness when stress becomes overwhelming. This response is associated with higher rates of death, although the mechanism for this outcome is unclear. It may be that people who feel helpless or hopeless do not seek treatment when they become ill, give up prematurely on or fail to adhere to potentially helpful therapy, engage in risky behaviors such as drug use, or do not maintain a healthy lifestyle, resulting in premature death.

To Cope With Psychological Stress
Approaches can include the following:

Training in relaxation, meditation, or stress management

Counseling or talk therapy

Cancer education sessions

Social support in a group setting

Medications for depression or anxiety

Exercise

Some Cancer Support Groups

National Cancer Society Malaysia(NCSM) http://www.cancer.org.my/about/what-we-do/support/support-groups/

MAKNA - National Cancer Council Malaysia http://makna.org.my/

Infertility
*CASE1* - Removal of Single Ovary -

Identify and share your feelings

Don't blame yourself

Work with your partner as a team

Decide how much you're willing to pay

Get support from professionals and other people with fertility problems

Balance optimism and realism

Take care of yourself by pursuing other interests

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Ovarian, fallopian tube, and peritoneal cancer can be hard to find in their earliest stages. That’s because the symptoms are often vague until these diseases are advanced. These diseases have the same symptoms.

It’s possible for women with ovarian, fallopian tube and peritoneal cancer to not show any symptoms. It’s also important to note that symptoms are non-specific and may be caused by a medical condition that is not cancer.

Cancer symptoms for ovarian, fallopian tube, and peritoneal cancer may include:
-Abdominal bloating
-Pelvic or abdominal pain
-Difficulty eating or feeling full quickly
-Urinary symptoms such as urgency or frequency
-Fatigue
-Upset stomach
-Indigestion
-Back pain
-Pain with intercourse
-Constipation
-Menstrual irregularities
-Pelvic mass or lump

Another symptom for fallopian tube cancer may be a watery vaginal discharge, which may be clear, white, or tinged with blood.

For many women, these symptoms occur often and are different from what is normal for their bodies. Women who have any of the symptoms listed in this section almost daily for more than a few weeks should see either a primary care doctor or a gynecologist. A gynecologist is a doctor who specializes in treating diseases of the female reproductive organs. Early medical evaluation may help find cancer at the earliest possible stage of the disease when it is easier to treat.

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(58569) Differences between malignant and benign tumors.

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(58569) Differences between malignant and benign tumors.

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Benign tumors.

It is a tumor that don't invade its surrounding tissues and spread around the body. Benign tumors is consider as primary tumor. It's not cancerous and what made it's easier to be remove is, benign tumors is surrounded by protective sacs.  This involves the mechanism  of e-cadherin switch. It is a glycoprotein that function as to anchor epithelial cells to each other.  At this stage, e-cadherin is loosen up and the expression is higher for this stage compare to malignant tumor.

Malignant.

This type of tumor may invade its surrounding tissues or spread around the body. The ability to multiple uncontrollably is abnormal forming abnormal growth cells (unstable) and travel via blood stream, lymphatic and circulatory system. There's no e-cadherin to anchor the tumor cells to original growth site. This is why malignant cells is cancerous and it can be divided into 2. First is sarcomas (connective tissues) and carcinomas (organs & gland tissues).