Ovarian Cancer

Ovarian CancerPeter, Cate, Joanna, Sheema

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712711/ Journal article about pathophysiology of ovarian cancerhttp://www.cancer.ca/en/cancer-information/cancer-type/ovarian/anatomy-and-physiology/?region=on Anatomy and physiology of ovarian cancerhttp://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-staging stages of ovarian cancerhttp://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-signs-and-symptoms Symptoms of ovarian cancer https://books.google.com/books?hl=en&lr=&id=hCVUNHqd0mcC&oi=fnd&pg=PR7&dq=Ovarian+Cancer&ots=sEcT1jHf7c&sig=VLqpMQbazVvwBMp9NSwm4_viocM#v=onepage&q=Ovarian%20Cancer&f=false Overview of Ovarian CancerBenefits and risks of ovarian function and reproduction for cancer development and prevention (Gynecological Endocrinology) look up on depaul database Academic Search Complete

Demographics of Ovarian CancerAbout 22,000 women diagnosed yearly1 in 72 women will get in her lifetime

Older women are more at risk1/2 of women diagnosed are over 63

Survival rate much lower than other types of cancer that affect women (44.3% 5 year survival rating)

a family history of ovarian or breast cancer having had cancernever having been pregnantobesityinfertility

Risk Factors:

Components of Female Reproductive SystemGonads: Ovaries Reproductive Tract: Uterus, Uterine Tubes/Fallopian tubes, VaginaExternal Genitalia (vulva): labia majora, labia minora, clitorus, barthollins glandsGonads: Organism that produces gametes. Ovaries in females / Testes in malesReproductive tract: -Uterus: Organ in womens reproductive tract, where offspring are conceived and where offspring gestate before birth-Uterine Tubes/Fallopian Tubes: Tubes lined with ciliated epithelia leading from ovaries into the uterus. Allows passage of the egg from ovary to uterus.-Vagina: Extends from the vulva to the uterus.External Genitalia (Vulva): -Labia Majora:The labia majora enclose and protect the other external reproductive organs. -Labia minora: Small Lips They lie just inside the labia majora, and surround the openings to the vagina -Barthollins glands: Located beside the vaginal opening, and produce a fluid secretion.-Clitorus:The two labia minora meet at the clitoris, a small, sensitive protrusion that is comparable to the penis in malesComponents of Female Reproductive System

OvariesDefinition: -Ovum-producing reproductive organ. -Females contain two almond shaped ovaries.-Suspended by ligaments from the pelvic girdle-Located in the Ovarian Fossa: alongside the lateral wall of the uterus

OvariesNormal Functioning: Produce ovum, through process called Oogenesis.-Also produce estrogen and progesterone

Ovary: Latin for egg or nutOogenesis: Process by which ova are produced. Oogonia becomes primary oocyte. During Meiosis, each primary oocyte produces a single haploid gamete (secondary oocyte). The secondary oocyte turns into the ootid, which matures into the ovum during fertilization. The diagram show the stages that occur in an ovary during the course of a monthly cycle, arrow indicates changes with time. Estrogen: important for growth of secondary characteristics Progesterone: prepares body for conception by causing buildup of uterine lining (endometrium)Overview of Cancer Cancer can be caused by:Genetic ChangesGenomic AmplificationPoint MutationsTranslocations http://www.news-medical.net/health/Cancer-Pathophysiology.aspxOverview of Cancer Continued...What are Tumors?Carcinogenesis? Metastasis?

http://medical-dictionary.thefreedictionary.com/carcinogenesisTypes of Ovarian Cancer-3 major types of tumorsEpithelial (most common) Germ cell Sex-cord stromal (least common)

Stages of Ovarian Cancer-4 Main Stages:Stage 1- Growth limited to ovariesStage 2- Growth in one or both ovariesStage 3- Growth has spread to pelvic and peritoneal cavityStage 4- Tumor has spread to liver

Pathology of Epithelial Ovarian CancerEpithelial ovarian cancer composed of 2 types of tumorsType IType II

Type I TumorsIndolent (cause little pain)Present at early stageIncludes low-grade serous, endometrioid, and clear cell mucinous carcinomasInvolves mutations in KRAS, BRAF, and ERBB2 genesType II TumorsDiagnosed as high-grade serous, endometrioid and undifferentiated carcinomasHighly aggressivePresent at advanced stageInvolves mutations in TP53 geneCarcinogenesis3 sites of potential originOvarian surface epitheliumFallopian tube epitheliumMesothelium covering surface of peritoneal cavity

Incessant Ovulation TheoryThis theory postulates that surface epithelium give rise to carcinomaFrequent rupture and repair of ovarian follicle increase likelihood of genetic alterations of surface epitheliumThese genetic alterations contribute to formation of malignant tumorsMetastasisOvarian carcinoma cells undergo epithelial-to-mesenchymal transition (EMT)The molecule E-cadherin loosens the intercellular adhesion between cancer cellsThis causes up-regulation of N and P cadherin, which causes cells to become invasive and proliferate

MetastasisOvarian cancer cells then detach from primary tumor as single cells or clustersCells then spread to peritoneum and omentum through peritoneal fluidCells interact with mesothelial cells covering basement membrane

MetastasisCells then undergo mesenchymal-to-epithelial transition Allows them to respond to paracrine growth factors and rapidly proliferateThis is accomplished through various integrin proteinsUp-regulate MMP-2 gene, which cleaves fibronectin and vitronectin into smaller fragmentsCancer cells adhere more strongly to these smaller fragments

Symptomsbloatingpelvic or abdominal painlow appetiteurinary symptomsmenstrual changespain during sexDiagnosispelvic examImagingultrasound CTBlood testBiopsyPrognosisOvarian Cancer Stage and Corresponding Relative 5-year Survival Rates for Invasive Epithelial Ovarian CancerStageRelative 5-year Survival RateI85-94%II70-78%III39-59%IV17%Treatments Four types:SurgeryRadiationChemotherapyTargetedMay be used together for aggressive cancershttp://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156 source for treatment optionsTreatments are commonly used togetherTreatments-SurgeryHysterectomyPartial: UterusTotal: Uterus and CervixOophorectemyUnilateral or BilateralOmentectomyUseful for early stages and isolated tumorsOophorectemy is the removal of ovariesOmentectemy is removal of the omentem, which houses nerves, blood vessels, lymph tissue and lymph nodesSurgery is also offered as preventative care for women with higher risk of developing ovarian cancerHey Guys, Sorry for not working on this earlier. Have had a hectic week and am at the lake house with the family now. So I will finish my slides by either later tonight or mid tomorrow._Marked as resolved__Re-opened_Happy memorial day everyone. Just finished up on my slides now. Everything looks Great.Good work people:)Treatments-RadiationExternal Radiation TherapyMachineInternal Radiation TherapySealed Radioactive SubstanceIntraperitoneal Radiation TherapyRadioactive liquidDependent on stage and typeExternal Radiation is the most common; least invasiveTreatments-ChemotherapyMechanism: killing cells or inhibiting divisionSystemicOral or injectionRegionalIntraperitonealCombinationDependant on stage and typeTreatments-TargetedMechanism: identification and attack of specific cellsMonoclonal antibodyGiven by infusionCan carry drugs, toxins, or radioactive materialOften used with chemotherapyThe EndAny questions? Source"OVARIAN CANCER: Types of Ovarian Cancer." OVARIAN CANCER: Types of Ovarian Cancer. Johns Hopkins Pathology, 18 Oct. 2001. Web. 20 May 2015.Lengyel, Ernst. "Ovarian Cancer Development and Metastasis." The American Journal of Pathology 177.3 (2010): 1053-064. NCBI. Web. 23 May 2015.Fox, Stuart Ira. Human Physiology. Dubuque, IA: Wm. C. Brown, 1996. Print.http://www.plannedparenthood.org/learn/womens-health/ovarian-cancer#sthash.07mu2Z8I.dpufhttp://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156 http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-survival-rateshttp://www.webmd.com/sex-relationships/guide/your-guide-female-reproductive-systemhttp://www.news-medical.net/health/Cancer-Pathophysiology.aspxhttp://medical-dictionary.thefreedictionary.com/carcinogenesis