Hi! My mother is suffering from ovarian cancer for 2 years now. She had undergone an operation for more than a year ago. She was able to undergo a chemotherapy for one and a half sessions but decided to discontinue due to pain and the thought of the after effect of the said treatment. She had regained her weight and energy for a year but after that year her bleeding repeated. Her doctor gave her tamoxifen tamoplex but i haven't noticed any good result on her since then. She is agin having a continuos bleeding and abnormal urinating and waste disposal. Could you please give me an advise or a naturapathic form of treatment? Thank you very much.
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General Description:


Ovarian Cancer is a cancer that begins in a woman's ovaries. There is not a single type of this disease. There are actually more than 30 types and subtypes of ovarian malignancies, each with its own histopathologic (diseased tissue) appearance and biologic behavior. Because of this, most experts group ovarian cancers within three major categories, according to the kind of cells from which they were formed:

1. epithelial tumors arise from cells that line or cover the ovaries;
2. germ cell tumors originate from cells that are destined to form eggs within the ovaries; and
3. sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.

Causes & Risk Factors:
One or more of the following characteristics puts you at above average risk:

• Family history of ovarian cancer, breast cancer, colon cancer.
• Personal history of breast cancer, endometrial cancer, colon cancer.
• No pregnancies or birth control use and infertility (uninterrupted ovulation).
• Exposure to talc or asbestos (industrial contamination, frequently used douches, condoms, dusting powder containing talc, used in the gential area.
• Increasing age.
• Breast-Ovarian Cancer Syndrome(s) BRCA, HHNPCC carrier and/or families.
• Ashkenazi Jewish population.
• Fertility drugs taken for more than three cycles has been linked to an increased risk. Discuss their use with your doctor.

Detection & Diagnosis:
Ovarian cancer may not cause many recognizable or alarming symptoms. The most commonly reported is abdominal swelling. If the physician suspects ovarian cancer, a medical history, physical examination, and various tests will be performed to aid in the diagnosis.
1. Medical History that will explore the following:

• Use of oral contraceptives (Women who use birth control pills are less likely to develop ovarian cancer.)
• Pregnancy and breast-feeding history (Women who have been pregnant are less likely to develop ovarian cancer; similarly, women who breast feed their infants are less likely to develop ovarian cancer.)
• Family history of ovarian cancer (Women are more likely to develop ovarian cancer if their immediate female relatives [e.g., mother, sister, daughter] have had ovarian cancer.)
• Previous gynecologic surgery (Women who have had a tubal ligation [surgical procedure in which the fallopian tubes are "tied" to prevent pregnancy] or hysterectomy [surgical removal of the womb without removal of the ovaries] are less likely to develop ovarian cancer.)
• Previous cancer history (Women are more likely to develop ovarian cancer if they already have had cancer of another organ; for example, the risk of ovarian cancer is twice as high among women who have been treated for breast cancer.)

During the medical history, questions also may be asked about smoking habits (some studies have suggested that there may be an association between smoking and ovarian cancer), as well as exposures to harmful occupational or environmental substances. If ovarian cancer is suspected, most physicians recommend consultation with a cancer specialist, such as a gynecologic oncologist (a physician who treats cancers of the female reproductive organs).

2. Pelvic Examination is done to thoroughly explore the abdomen and pelvis. Your physician will feel around for anything unusual.

3. Imaging Studies such as ultrasound, CT Scan or MRI may be used to get a better look at the ovaries and pelvis.

4. Lab work such as a CA - 125 blood level may be used. Though a CA 125 should not be the only determination of a diagnosis, it is a useful marker for many patients. A "normal" level is from 1 - 30, however, numbers can range into the thousands. The problem with this test is that there are many false negative and many false positives, because this level can be affected by many other things aside from cancer.

Prevalence:
One woman out of every fifty-five (approximately 1.8%) will develop ovarian cancer some time in her life time.

In 2003, approximately 25,000 women will be diagnosed with ovarian cancer. Approximately 14,500 women will die of the disease.

Over 70% of all women with ovarian cancer will not be diagnosed until the disease has spread beyond the ovary. This is because the symptoms of early ovarian cancer are often vague and can mimic other common medical problems.

Ovarian cancer is the fifth leading cause of cancer death in women the leading cause of death from gynecologic malignancies and the second most commonly diagnosed gynecologic malignancy.

Older women are at highest risk. More than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age and approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age.


Prevention:
Several studies have shown the following to be affective in prevention:

• Oral Contraceptives
  The use of oral contraceptives (OCs; birth control pills) can reduce the risk of ovarian cancer by 40% to 50%. Ovarian cancer risk is particularly decreased after five years of use, although the longer that oral contraceptives are used, the greater the protective benefits. OCs may be particularly important in women who are at high risk of this disease and in carriers of genetic mutations; however, some experts caution that OCs may increase breast cancer risk in women with BRCA mutations.
• Dietary Modification and Exercise
  To aid in ovarian cancer prevention, many experts recommend that women eat low-fat, high-fiber diets and reduce their consumption of meat and alcohol. In addition, women are encouraged to exercise three times weekly to maintain a body fat percentage that is within the accepted range. Adults who are 18 years of age or older are considered at risk if the body mass index, or BMI, is greater than 25.
• Pregnancy and Breast Feeding
  Although physicians do not advocate making decisions about child-bearing solely for the purpose of reducing ovarian cancer risk, some pregnancy-related statistics are worth noting. Ovarian cancer risk is 30% to 60% lower among women who have been pregnant versus those who have not. In addition, ovarian cancer risk is lower if the first child is born before a woman reaches 30 years of age, and risk continues to decrease with each successive pregnancy. Breast feeding (which begins when estrogen and progesterone levels drop after childbirth and ovulation is suppressed) also appears to offer protection against ovarian cancer.
• Genetic Counseling
  Genetic counseling may be advisable if a woman's family history suggests that she may have a genetic mutation(s) associated with increased risk of ovarian cancer. In such cases, the individual should discuss the pros and cons of testing with her physician before undergoing genetic analysis. A person may be comforted to learn that she does not have a mutation, but she may be very disturbed to learn that she does. In spite of this, many high-risk women feel that genetic counseling helps them to make informed decisions about prevention strategies.
• Tubal Ligation
  Tubal ligation is a surgical procedure in which the fallopian tubes are ligated, or "tied," to prevent pregnancy. The risk of ovarian cancer is decreased in women who undergo tubal ligation after childbearing, although the mechanism for the protective effect is unknown. Some experts theorize that tubal ligation or hysterectomy -the surgical removal of the womb - may stop carcinogens (cancer-causing agents) from reaching the ovaries after they enter the body through the vagina.
• Ovary Removal
  If a woman is over age 40 and hysterectomy is being performed for a noncancerous condition, such as uterine fibroids, she may decide to have her ovaries removed during this operation to lower her risk of ovarian cancer. This procedure - known as prophylactic oophorectomy - is controversial because it causes early menopause in premenopausal women. Prophylactic oophorectomy usually is recommended only for women who have completed their families and have a strong family history of ovarian cancer. Yet it should be noted that removal of the ovaries does not ensure protection in all high-risk patients. Cancers still may form from lining cells within the pelvic cavity (e.g., intraperitoneal carcinomatosis), despite the removal of normal ovaries.

Staging

Ovarian cancer staging uses information obtained after surgery, which should include a total abdominal hysterectomy, removal of (usually) both ovaries and fallopian tubes, (usually) the omentum, and pelvic (peritoneal) washings for cytology.

• Stage I - limited to one or both ovaries
• • IA - involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
  • IB - involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings
  • IC - tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings
• Stage II - pelvic extension or implants
  • IIA - extension or implants onto uterus or fallopian tube; negative washings
  • IIB - extension or implants onto other pelvic structures; negative washings
  • IIC - pelvic extension or implants with positive peritoneal washings
• Stage III - microscopic peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum
  • IIIA - microscopic peritoneal metastases beyond pelvis
  • IIIB - macroscopic peritoneal metastases beyond pelvis less than 2 cm in size
  • IIIC - peritoneal metastases beyond pelvis > 2 cm or lymph node metastases
• Stage IV - distant metastases

Para-aortic lymph node metastases are considered regional lymph nodes (Stage IIIC).

Prognosis:
The likely course of ovarian cancer is predicted using prognostic factors. The only universally accepted prognostic factors for patients with ovarian cancer are stage and, in advanced stage patients, volume of residual disease. Other factors that may be important but about which there is continued debate include patient age, histopathologic grade, and overall health. For the small number of women who are fortunate enough to have their cancer diagnosed before it has spread beyond the ovary, the chance for cure is 85 to 90%. However, for the majority of women in whom the disease has spread beyond the ovary, the chance of living for five years after the diagnosis is between 20 and 25%. Borderline ovarian cancers and grade one ovarian cancers have a good prognosis, with >90% of women experiencing complete remission without recurrence after standard treatment.


Symptoms:
Many Ovarian Cancer survivors will attest to the idea that their symptoms were very vague and could easily be justified as minor ailments. For this reason, it is important to be aware of any of the following symptoms that you may be experiencing for prolonged periods of time (> three weeks).

• Vague but persistent gastrointestinal complaints such as gas, nausea, indigestion.
• Frequency and/or urgency of urination.
• Any unexplained change in bowel habits.
• Abnormal postmenopausal bleeding.
• Weight gain or loss.
• Abdominal swelling and/or pain; bloating and/or a feeling of fullness.
• Pain during intercourse.
• Back ache or leg ache
• Pelvic pressure

Treatment Options:

1. Surgery (for diagnosis and treatment)
2. Radiation
3. Chemotherapy