pleno minggu 5 blok

Introduction

It is the most lethal gynecological malignancy >25,000 women in USA annually 14,000 deaths annually Incidence has increased by 30% over the past

decade Deaths from ovarian cancer increased by 18% 60% of patients present with advanced-stage

disease The overall survival rate is 38% at 5 years

Epidemiology The etiologies of epithelial ovarian cancer are

not knownAge The mean age at diagnosis is 59 years 15.7 per 100,000 women at age 40 years 54 per 100,000mwomen at age 79 years One women in 70 in the USA will develop

ovarian cancer Ov ca is a disease of postmenopausal women,

women with a family history of breast ca and ov.ca may be diagnosed with ov.ca up to 10 years earlier than the average women

Family history

The strongest risk factorA women with a single first-degree relative with ov.Ca has a relative risk (RR) of approximately 3.6 for developing ov.ca compared with general populationHer life time risk approx. 5%5-10% of ov.ca are linked to identifiable, inherited mutations in certain genesFamilies in which three or more first-degree relatives have ovarian or ovarian plus breast cancer are likley to have a cancer-susceptibility genetic mutation that is transmitted in an autosomal-dominant inheritance pattern

Family history

Three familial ovarian cancer syndromes: The site specific ovarian ov.ca syndrome # only ov.ca is seen # account for 10-15% of hereditary

ov.ca The hereditary breast/ovarian cancer

syndrome #associated with 65-75% of hereditary

ov.ca

Family history` In the hereditary nonpolyposis colorectal

cancer syndrome (HNPCC), affected individuals may have colon, endometrial, breast, ovarian or other cancers

HNPCC kindred's account for an additional 10-15% of hereditary ovarian cancer

The hereditary breast/ovarian cancer syndrome and perhaps less frequently the site –specific ovarian cancer syndrome are linked to mutations in the BRCA1 and BRCA2 genes

Ethnicity

Higher in white women Higher in north America and northern

Europe than Japan Difference related to genetics, diet, or

environmental exposure or a combination BRCA1 and BRCA2 genes are more

common among white women of Ashkenazi descent

Incidence of ov.ca is higher in countries with higher in countries with higher per capita consumption of animal fat

Reproduction factors

Nulliparous First childbirth after age 35 years Involuntary infertility Late menopause and early menarche RR (2.0-5.0) Pts. With prolonged period or

uninterrupted ovulation

Exogenous hormones

OCP decreased risk of epithelial tumors

RR 0.5 in 5 years or more users HRT

Hysterectomy Decrease the risk

Smoking no relation

Symptoms and Signs

Early stage asymptomatic 10-12 cm Bloating, abdominal discomfort,

pelvic pressure, urinary and rectal symptoms

Ascites , pleural effusion and shortness of breath

cashecsia

Ovarian Cancer

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Ovarian Cancer

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