7 Rare Cancers: Symptoms, Diagnosis and Treatment
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Priya.K
11 May, 2023
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Ovarian Cancer: Symptoms, Causes, Diagnosis, and Treatment

Ovarian Cancer, being the third most common cancer in women, typically accounts for 6.7% of observed cancer incidences in India. Ovarian cancer is a sobering reminder of the silent threats that can exist within an intricate tapestry of women's health. It is a silent but deadly disease that frequently goes undetected until it reaches advanced stages, making treatment and survival extremely difficult.

Here’s our guide to ovarian cancer, which includes information on symptoms, causes, diagnosis, and treatment options of ovarian cancer.

What is Ovarian Cancer?

Ovarian cancer is a malignant tumour that develops in the ovaries, the organs that produce eggs in females. The female reproductive system consists of two ovaries, one on either side of the uterus, (which are about the size of an almond) that produce eggs and the hormones oestrogen and progesterone. In the early stages, ovarian cancer has usually no symptoms, but a person may experience lower abdominal pain or pressure, as well as vaginal bleeding.

Symptoms of Ovarian Cancer:

The symptoms of ovarian cancer can vary from person to person. However, it may develop and spread throughout the abdomen before noticing any symptoms, which makes early detection very difficult. Ovarian cancer symptoms can include:

  • Abdominal bloating or swelling
  • Pelvic pain or discomfort
  • Difficulty eating
  • Frequent or urgent urination
  • Changes in bowel habits, such as constipation
  • Unexplained weight loss
  • Fatigue
  • Back pain
  • Vaginal discharge
  • Menstrual irregularities

If you are worried about any of these signs or symptoms, it is vital that you immediately schedule an online consultation with either an oncologist, or a gynaecologist, have all your queries sorted out, and get proper guidance regarding ovarian cancer.

Causes of Ovarian Cancer:

It is uncertain what causes ovarian cancer, but researchers have identified factors that may enhance the risk of the disease. Doctors acknowledge that ovarian cancer develops when cells in or near the ovaries undergo DNA changes (mutations). A cell's DNA contains instructions that teach the cells what to do. The changes cause the cells to grow and multiply rapidly, forming a mass (tumour) of cancer cells. Cancer cells continue to live while healthy cells die, invading neighbouring tissues and breaking off from the original tumour, allowing it to spread to other parts of the body.

However, there are a few risk factors that can increase the likelihood of developing ovarian cancer, which includes:

Age: Ovarian cancer is more common in women over the age of 50.

Family history: Women with a family history of breast, colorectal, or ovarian cancer have an increased risk of the disease.

Endometriosis: Women with endometriosis (a disease in which tissue similar to the lining of the uterus grows outside the uterus) have a higher risk of certain types of ovarian cancer.

Obesity: Obesity is associated with an increased risk of developing ovarian cancer.

Never been pregnant: If you have never been pregnant, you may be at a higher risk of developing ovarian cancer.

Diagnosis of Ovarian Cancer:

Diagnosing ovarian cancer might be challenging due to unclear symptoms and limited screening methods. Healthcare providers may use a variety of diagnostic tools to assess suspicious symptoms, including:

Pelvic examination: A physical exam to look for abnormalities in the ovaries or pelvis.

Imaging tests: Ultrasound, CT scans, and MRI scans can help discover the ovaries and detect abnormalities.

Blood tests: The CA-125 blood test examines a protein that is frequently high in women with ovarian cancer, although it is not conclusive on its own.

Biopsy: A tissue sample can be taken through surgery or minimally invasive techniques and examined under a microscope.

Treatment of Ovarian Cancer:

The goal of cancer treatment is to remove as much of the cancer cells as possible from your body. The most common treatments for ovarian cancer are:

Surgery: This often includes the removal of your reproductive organs as well as any organs that have cancer. Your surgeon may perform laparoscopy (minimally invasive surgery) or laparotomy (open surgery with an abdominal incision).

Chemotherapy: Chemotherapy may be recommended either before or after surgery. Chemotherapy medications are intended to target and kill malignant cells.

Targeted Therapy: Targeted drugs are prescribed to specifically target cancer cells while minimizing damage to healthy tissues.

Hormonal Therapy: Some ovarian tumours use hormones to grow. This sort of therapy inhibits cancer growth by blocking hormones.

Radiation Therapy: In some cases, radiation therapy may be used to target and kill cancer cells.

The Ovarian Cancer Statistics:

  • Among the world's population, India has the second largest estimated incidence of ovarian cancer, after China. India accounts for 76.5% of the incidence and 77.5% of the mortality of ovarian cancer patients among the south-central Asian countries.
  • Among gynaecologic cancers, ovarian cancer has the worst prognosis, with roughly 3,14,000 new cases and 2,07,000 deaths each year.
  • According to the WHO classification, 90% of ovarian tumours develop from the epithelium, 3% from germ cells, and 2% from sex-cord stromal.
  • Cases are typically discovered in the late stages III and IV, when the tumour has spread beyond the abdomen. The diagnosis is mostly based on imaging techniques, CA-125 blood tests, and surgical specimens, and is associated with a poor prognosis. In India, Ovarian cancer patients had a 5-year survival rate of approximately 45%.

 
Ovarian cancer poses significant obstacles, but early identification and treatment improvements have led to improved prognosis for many patients. Let us continue to raise awareness by promoting routine screenings, genetic testing, and proactive healthcare practices.



Reference:

1. Frontiersin - Analysis of the Indian Ovarian Cancer Cohort

https://rb.gy/c683et

2. Cleveland Clinic - Ovarian Cancer: Symptoms, Diagnosis & Treatment

https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer



Cancer
15 Mins Read
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World Cancer Day: History, Objectives and Significance

As far back as recorded history goes, cancer has always been the leading cause of death worldwide. Each year on February 4, people throughout the world unite to rid the world of cancer and the fear it inspires just by its name. The annual event is themed around the colors orange and blue to encourage people to band together in the fight against cancer.

World Cancer Day is a global health event that raises awareness of cancer. It is celebrated on February 4th every year since 2000, to educate people about how they can identify cancer, treat it, and prevent it. The annual observance of World Cancer Awareness Day has grown into a major global event for raising public awareness about cancer. More than 900 events were held in 105 countries during the 2017 campaign. On this World Cancer Day, 3,75,000 tweets and posts were made using the trending hashtag #WorldCancerDay. There were over 1,10,000 downloads of campaign materials, and over 50,000 unique posters were made by site visitors.


History

The World Cancer Summit Against Cancer in the New Millennium, which took place on February 4, 2000, in Paris, officially named February 4 as World Cancer Day.  

At the Summit in Paris on 4 February 2000, then-General Director of UNESCO Kichir Matsuura and then-French President Jacques Chirac signed the Charter of Paris Against Cancer, a document designed to encourage cancer research, prevention, and better patient services. The charter also includes an article establishing the anniversary of its official signing as World Cancer Day. 

 
Objective

The purpose of World Cancer Day is to increase public understanding of cancer as a major health problem and to mobilize efforts to provide all cancer patients with timely and effective diagnosis, treatment, and palliative care.

 
Theme

This year's World Cancer Day theme, "Close the Care Gap," is a continuation of the 2022 theme and will run until 2024 (a three-year campaign) with yearly goals. It was hoped that by launching a multi-year campaign, there would be more time to gain traction with target audiences, generate more awareness, and ultimately make a bigger impact on the world.

The objective of this year’s theme is “Uniting our voices and taking action.” The focus of this second year is on mobilizing the support of people, groups, activists, and officials who are all committed to making things better. The Union for International Cancer Control(UICC) plans to investigate in greater depth the role that the consumption of unhealthy items like tobacco, alcohol, and ultra-processed foods play in causing cancer and other preventable deaths. The UICC strives to draw attention to the fact that the sales of these products primarily affect the marginalized groups (such as youth, those from low-income backgrounds, and ethnic minorities).

 
Importance of World Cancer Day

Cancer is a disease in which abnormal cell growth occurs in one part of the body and then spreads to other parts. Over one crore people lost their lives to cancer in 2020, making it the leading cause of death worldwide. Reports indicate that there were between 19 and 20 lakhs (estimated) of cases in India in the year 2022. Cancer risk factors include tobacco use, heavy alcohol use, poor diet, insufficient exercise, and environmental factors including smog and car exhaust.

Various chronic diseases increase the likelihood of developing cancer, and this is a special difficulty for countries with low and moderate incomes. Cancer survival rates were also lower in these countries because of issues like inadequate healthcare infrastructure, late diagnosis, and high costs. Similarly, even in developed countries, a lack of cancer awareness also causes a delay in diagnosis. According to a study from 2020 that was conducted in four main centers, most people with cancer in India identify the disease and seek treatment only in their later stage. Cancer education is significantly impacted by both literacy and economic status. Those in India with higher incomes and levels of education were more likely to be aware of cancer than others.

 
The main key factors why World Cancer Day is important are,

  • Most common types of cancer can be prevented if detected at an early stage.
  • Talking about cancer and spreading awareness in the rural areas to educate them about the disease.

 
As a result, there is a pressing need to fill the knowledge gaps regarding cancer screening, prevention, and treatment among the Indian and global populations, particularly in low and middle-income countries where literacy rates are low and hence contribute to a rise in cancer prevalence. Some of the prevalent cancer types are
Stomach Cancer, Breast Cancer, Lung cancer, Cervical cancer, etc...On this World Cancer Day, let's all remember how important it is to both detect cancer early and treat it well.

 
World Cancer Day 2023

The Union for International Cancer Control (UICC) is organizing many events in honor of World Cancer Day 2023, including a "5k Challenge" in which people from all walks of life are encouraged to participate in activities including running, cycling, swimming, hiking, or walking to symbolize closing the gap in care. In addition, there will be "21-day challenges" designed to help people form new, healthier habits, increase public understanding of cervical cancer, and learn more about disparities in access to cancer care. 

We all know that some cancers are curable when diagnosed and treated at an early stage. Therefore, it is recommended to see an oncologist as soon as you experience any symptoms.



Cancer
12 Mins Read
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Cervical Cancer: Causes, Symptoms, Diagnosis and Treatment

January is observed as the cervical cancer awareness month, with the aim of raising awareness about causes, diagnosis, prevention, and treatment. As per statistics, India alone is the contributor to almost one third of all cervical cancer fatalities, worldwide. This has been attributed to the lack of awareness, limited or restricted access to healthcare services etc. On the other hand, cervical cancer is also one of the most successfully treated and preventable cancer, if detected and diagnosed early and managed efficiently.  

Cancer is a disease, in which the cells inside the body grow out of control. Cervical cancer is when the cancer starts at cervix. Cervix connects vagina (also known as the birth canal) to the uterus (also known as womb or where a baby grows). This often occurs in people who are aged 30 and above. There exist three diverse types of cervical cancer, namely:  

  • Mixed carcinoma  
  • Adenocarcinoma: forms in the cells producing mucus  
  • Squamous cell carcinoma: most common type and forms in the lining of cervix

What causes cervical cancer?

Cancer develops when healthy cells in the cervix starts to mutate (changes) in DNA. In normal situation, healthy cells multiply, grow and die at a set time. But in mutation the cells multiply, grow and do no die. This leads to the accumulation of the abnormal cells which then forms a mass, also known as tumour. These cancerous cells invade nearby tissues and can very well break and spread from cervix to any other part of the body (metastasize). 

Well, one of the most common causative factors in causing cervical cancer is strains of HPV (human papilloma virus) a sexually transmitted infection. Initially when the body is exposed to HPV, the immune system prevents it from causing harm. But in some cases, the virus survives inside the body for years and contributes to the transition of cervical cells to cancerous cells. The risk factors or  cervical cancer symptoms include:  

  • Sexual activity and sexual partners: Risk of HPV is increased when a person involves in sexual activity at an early age. The higher the number of sexual partners, the higher number of partner’s sexual partners, greater will be the risk of acquiring HPV.  
  • Sexually transmitted infections: Occurrence of other STIs - HIV/AIDS, chlamydia, gonorrhoea, syphilis also increases risk of HPV. 
  • Smoking: raises odds of having cervical cancer and is associated with squamous cell cervical cancer. 
  • Compromised immune system: incidence of HPV and a weak immune system is more likely to attract cervical cancer. 
  • Exposure of fetus to the drug “diethylstilbestrol,” while carrying, has an increased risk in acquiring clear cell adenocarcinoma, a type of cervical cancer stages.
  • Prolonged intake of birth control pills.

How does cervical cancer feel like? 

Usually, the body does not let out any signs during the initial stages of cancer. But a lot of changes can be observed when the cancer progresses to a more advanced stage, the signs and symptoms at this stage includes: 

  • A heavy foul smelling watery and bloody vaginal discharge. 
  • Pelvic pain 
  • Pain during intercourse 
  • Vaginal bleeding after intercourse and after menopause

So, when one experiences these symptoms or notices any sign, it is better to get diagnosed.  

Cervical Cancer Diagnosis: The most common and important cervical cancer screening is the broader use of Pap smear (also known as Papanicolaou test) and high-risk HPV test. Pap smear test is a part of women’s regular check-up test as well, where the cells from cervix surface is collected and viewed under microscope. Any abnormality in this will lead to the next step, which is biopsy, where a part of the cervical tissue is taken for testing and confirming.  

A pelvic exam, aka colposcopy, also carried out if there is any unusual findings in Pap smear.  

Conization is a removal process (a part of the cervix), using a LEEP (loop electrosurgical excision procedure), or a scalpel, or laser. A simple procedure, usually done for minimally invasive tissues, under anaesthesia, where the patient can leave home in the same day.   

Treatment: The course of treatment can be internal, external or both.  If cancer is present only on the surface, then process like conization will be carried out by doctors to destroy or remove the cancerous cell.   Surgery is recommended and needed of the cells have passed beyond the surface through a layer called the basement membrane, and if the disease has invaded into the deeper layers of the cervix.  

A hysterectomy is carried out if the tumor is found to be spread across the uterus. 

Radiation therapy, use of high energy rays is employed to damage cancer cells and to prevent them from growing further. This therapy, just like with surgery, affects the cancer cells only in the treated area. The course of treatment spans over a period of 5-6 weeks, wherein a beam of radiation is targeted over the pelvic area.  

Chemotherapy- use of powerful drugs to kill the cancerous cells. Used in cases where it is locally spread or advancing/spreading to other parts of the body. This treatment takes place in cycles of treatment with recovery period in between, as it is very intensive. 

Immunotherapy/Biological therapy: An advanced and recently emerging technique, which targets checkpoints in immune cells to alter the immune response, to block proteins on the cells which will cause shrinkage or slows down the growth of the cell.  “Prevention” plays a vital role!!! 

As said, earlier, cervical cancer prevention is vast and can be successfully treated if detected earlier. So, what must be done?? 

  • Visit your medical expert and as a primary step, get yourself vaccinated with cervical cancer vaccines against HPV. The FDA approved HPV vaccine provides protection against two strains that causes 70% of cervical cancers and against 50% of precancerous lesions occurring in the vulva, vagina, and cervix.  
  • Getting a Pap smear test at least once in a year, if 21 year or older.  
  • Using a barrier while indulging in sexual activity.  
  • Quitting smoking.



Cancer
12 Mins Read
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Stomach Cancer: Causes, Symptoms, Diagnosis And Treatment

Cancer is one of the deadliest chronic diseases that human beings have been fighting for years. It is a universal plague that can affect any part of the body. Cancer is competent to rapidly create abnormal cells that can grow beyond their usual boundaries, invade adjoining body parts, and spread to other organs. 


Gastric Cancer, also known as stomach cancer, is a cellular abnormality that begins in the stomach (the stomach is located Just behind the ribs in the top middle of the belly  which helps with food digestion and breakdown) and it begins in any part of the stomach.


In 2020, stomach cancer accounted for approximately 1.1 million new cases worldwide and was the third leading cause of cancer mortality, accounting for nearly 800,000 deaths. Men are about twice as likely as women to have stomach cancer. About 90% to 95% of stomach malignancies are adenocarcinomas. The gland cells in the deepest layer of the stomach are where these tumours start to grow (the mucosa).

 

There are two main types of stomach adenocarcinomas. They are intestinal and diffuse types.


  • The prognosis for intestinal types is marginally better (outlook). Certain gene modifications that might make it possible to treat cancer cells with targeted medication therapy are more likely to occur in cancer cells.
  • The diffused form typically spreads more rapidly. It is less common than the intestinal type and is frequently more difficult to treat.

Gastrointestinal Stromal tumors (GISTs), neuroendocrine tumors, lymphomas, squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas can also start in the stomach, but these cancers are rare. 

 

Symptoms of Stomach Cancer 

 

Stomach cancer can be hard to find, and there are no symptoms in the early stage.

 

  • Indigestion or burning sensation (heart burning)
  • Discomfort or pain in the abdomen
  • Nausea and vomiting
  • Diarrhea  or Constipation 
  • Bloating of the stomach after meals
  • Loss of appetite 
  • Weakness and fatigue 
  • Bleeding (vomiting blood or having blood in the stool)

Causes of Stomach Cancer


Stomach cancer is found most often in people over the age of fifty five, Scientists worldwide are trying to learn more about what causes this disease and prevention  but they could not find the exact reason for stomach cancer and the researchers speculate that genetic, environmental, infection and immunologic factors may contribute to the development of gastric cancer. They include:


  • Family history of stomach cancer
  • Helicobacter pylori (H. pylori) infection
  • Gastroesophageal reflux disease (GERD)
  • Gastritis
  • Epstein-Barr virus infection
  • History of stomach ulcers or stomach polyps
  • A diet high in fatty, salty, smoked, or pickled foods
  • A diet that does not include certain fruits and vegetables
  • Frequent exposure to substances like coal, metal, and rubber
  • Smoking, vaping, or chewing tobacco
  • Drinking too much alcohol
  • Obesity
  • Autoimmune atrophic gastritis

There are considerable amounts of hereditary disorders linked to an increased risk of stomach cancer, including


  • Lynch syndrome.
  • Peutz-Jeghers syndrome.
  • Li-Fraumeni syndrome.
  • Familial adenomatous polyposis.
  • Hereditary diffuse gastric cancer.
  • Common variable immunodeficiency (CVID).

People with Type A blood have a higher risk of developing stomach cancer, though it is unclear why.


Diagnosis of Stomach Cancer


The diagnosis of stomach cancer is based on a thorough clinical examination, a detailed patient and family history, and a variety of specialized testing.


Imaging procedures, including CT scans, MRIs, and positron emission tomography, are just the amount of the tests that doctors can perform to identify stomach cancer (PET). When it comes to stomach problems, barium is frequently used. During a barium swallow test, you ingest the barium liquid, which travels down your food pipe and into your stomach. After that, X-rays are performed to check for any anomalies.


A tiny, flexible, and thin tube with a camera is inserted into the stomach by a doctor to perform an upper endoscopy. During the endoscopic operation of a gastric patient, the doctor can take a biopsy (sample), and malignant cells can be detected in the lab.


An endoscopic ultrasound test might be performed if a person is diagnosed with stomach cancer. The examination, which uses an ultrasound probe, aids in staging the tumors or determining how much of the stomach is impacted by the cancer.


Gastric Cancer Treatment


Treatment options for stomach cancer vary from person to person. According to the tumor's stage, different treatments are used. The principal treatment is surgery, chemotherapy, and radiation therapy.


Surgery is the typical treatment for stomach cancer. The operation is known as gastroplasty. During the surgery, the surgeon removes subtotal or total gastrectomy of the stomach and specific tissues around the abdomen.

Chemotherapy is the use of drugs to kill cancer cells. In this treatment, the drugs enter the bloodstream and travel through the body. Chemotherapy can be used before surgery for stomach cancer. (The dual form of chemotherapy and radiation therapy is referred to as "chemoradiation.”) Neoadjuvant treatment frequently results in tumour shrinkage and may facilitate surgery.

Additionally, it might prolong patients' lives and prevent cancer from returning. Neoadjuvant chemotherapy is one of the standard therapeutic options for specific stages of stomach cancer. Chemotherapy is regularly administered again after surgery.

After surgery, radiation therapy and chemotherapy can be used to try to eliminate any cancer cells that the surgery did not manage to remove. As a result, cancer may spread more.

Stomach Cancer Treatment in India 

According to a study from Karnataka, stomach cancer is one of the top five cancers among young Indian men and women (aged 15 to 44). In India, 50,000 cases of stomach cancer are estimated to occur annually.


Diagnosis of gastric cancer is made by taking various tests. They are blood tests, imaging tests (endoscopy, ultrasound, CT, PET-CT, biopsy, or diagnostic laparoscopy), and diagnostic laparoscopy, which are all available in India and are highly accurate in their diagnosis. India has improved healthcare facilities like surgery, laparoscopy, and robotic surgery, as well as the top oncologists specializing in treating complicated illnesses like stomach cancer are in India. They are adopting robotic or laparoscopic surgeries to ensure fast, safe alternatives to conservative open surgery. Using this technology, stomach cancer patients have decreased postoperative pain, shorter hospital stays and quicker recovery.

India is one of the most popular locations for stomach cancer treatment since it boasts modern facilities, innovative technology, sophisticated infrastructure, and access to highly qualified medical professionals at reasonable costs. So, people receive treatment in India each year for stomach cancer. 




Cancer
15 Mins Read