1. OVARIAN CANCER qpt 20703 STUDENT'S NAMEID AFIQQ AIMAN BIN ABD GHAPOR012015090128 AKMA ASYIRA BINTI ZULKARNAIE012015052385 FATIN NURAFIQAH BINTI MOHD HANAFI012015052370 MURADA BINTI ALI OSMAN012015052382 NURIN AFIQAH BINTI ABDULLAH012015090321 NURBASYIRAH BINTI VYNER012014052264

2. Definition Ovarian cancer refers to any cancerous growth that occurs in the ovary. Ovarian cancer accounts for 3-4% of cancer in women According to the American Cancer Society, it is the 8th most common cancer among women in the United States (excluding non- melanoma skin cancer). It is the 5th most common cause of cancer deaths in women It is a disease of the post menopausal women, with the highest incidence among patients ages 55-64years old

4. Epidemiology & Demographics Incidence 12.9 to 15.1 cases/100,000 persons; ∼ 25,000 new cases annually. Lifetime risk for developing ovarian cancer is 1.4%. It is the leading cause of gynecologic cancer-related deaths. Prevalence It is most commonly diagnosed in those 55 to 64 years of age.

5. Types 1.Epithelial tumors form in the layer of tissue on the outside of the ovaries. About (90%) of ovarian cancers are epithelial tumors 2.Stromal tumors grow in the hormone-producing cells. (5%) of ovarian cancers are stromal tumors. 3. (5%) of germ cell tumors develop in the egg-producing cells. Germ cell tumor are rare.

6. CAUSES OF OVARIAN CANCER The causes of ovarian cancer is still unknown but it is highly related to the risk factors that can lead to ovarian cancer. The causes are : - family history of ovarian cancer - genetic mutations of genes - breast cancer - obesity - no history of pregnancy - endometriosis : the development of uterine-lining tissue outside the uterus.

7. Risk Factors Family History Genetics: Lynch Syndrome Increasing Age Genetics: BRCA1 and BRCA2 Reproduction - nulliparous, first childbirth >35 years old, involuntary infertility Others - Exogenous hormones HRT, Dietary factors (increase in saturated animal fat seem to conser an increased risk by unknown)

8. Signs and Symptoms 1.Early symptoms of ovarian cancer pain in the pelvis pain on the lower side of the body back pain indigestion or heartburn more frequent and urgent urination pain during sexual intercourse 2.As ovarian cancer progresses these symptoms are also possible nausea weight loss breathlessness fatigue (tiredness) loss of appetide

9. Diagnosis The following tests are used to diagnose ovarian cancer. blood test ultrasound laparscopy and possibly endoscopy colonoscopy abdominal fluid aspiration chest x-ray CT scan MRI scan positron emission tomography (PET) scan biopsy

10. Staging 1.Stage 1 i. cancer in one ovary ii. cancer in both ovaries iii. cancer in the ovary and on there surface of one ovary 2.Stage 2 - involved the bowel i. cancer has spread to the bowel or bladder ii. cancer cells also in the fluid of abdomen

11. 3. Stage 3 i. cancer cells are in the lining of the abdomen/only seen under microscope ii. tumours of 2cm or smaller are in the lining of the abdomen iii. cancer is in the lymph nodes 4. Stage 4 i. cancer has spread to other organs

14. Grades GX: The grade cannot be evaluated GB: The tissue is considered borderline cancerous. This is commonly called low malignant potential (LPM). G1: The tissue is well-differentiated (contains many healthy looking cells) G2: The tissue is moderately differentiated (more cells appear abnormal than healthy) G3 to G4: The tissue is poorly differentiated or undifferentiated (more cells appear abnormal, and lack normal tissue structures)

15. Treatment 1.Surgery 2.Chemotheraphy 3.Combination of Surgery with Chemotheraphy 4.Radiotheraphy

16. Chemotheraphy Patients will typically receive a combination of carboplatin (Paraplatin) and paclitaxel (Taxol) intravenously. As it is injected into the bloodstream it can target cancer cells in the reproductive system, as well as any cancer cells that may have reached elsewhere in the body Negative Side Effects  diarrhoea  hair loss  loss of appetite  mouth sores  anaemia

17. Radiotheraphy Negative side effects  bladder infections  diarrhea  constipation  irritation  darkening of skin  nause  frequent urination  abdominal pain

18. Surgery Surgery is the main treatment for ovarian cancer. The goal of surgery is to remove the tumor, but a hysterectomy, or complete removal of the uterus, is often necessary. Removing both ovaries and fallopian tubes, nearby lymph nodes, and other pelvic tissue.

19. Prevention Oral contraceptives (birth control pills) - decreases the risk of developing ovarian cancer, especially among women who use them for several years. Gynaecologic surgery  tubal ligation  hyterectomy

20. REFERENCE Websites : i. https://emedicine.medscape.com/article/255771-overview#a5 ii. https://www.medicalnewstoday.com/articles/159675.php iii. https://ocrfa.org/patients/about-ovarian-cancer/risk-factors/ Articles and Journals : i. Gordon C Jayson, Gordon C Jayson, Elise C Kohn, Henry C Kitchene : Demographic, Clinical and Factors of Ovarian Cancer (2012), International Journal of Gynecological Cancer.

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