Ca ovary GROUP D Dr.Tarig Hassan
Introduction .
<ul><li>The incidence of Ca ovary 62/100,000 women. </li></ul><ul><li>Increase in women more than 40 yrs </li></ul><ul><li...
Risk factors <ul><li>1-  Age.   </li></ul><ul><li>2-Family history   </li></ul><ul><li>3-Ethnicity : </li></ul><ul><li>>wh...
<ul><li>-Risk of ovarian cancer associated with HNPCC is lower than is that of ovarian cancer associated with BRCA mutatio...
<ul><li>7- Fertility drugs: </li></ul><ul><li>Ovulation induction: </li></ul><ul><li>-clomiphene citrate </li></ul><ul><li...
Signs&symptoms <ul><li>Clinical presentation.. </li></ul><ul><li>Early stages of disease: </li></ul><ul><li>fatigue </li><...
Screening methods for CA ovary <ul><li>Why screening methods? </li></ul><ul><li>Vague symptoms </li></ul><ul><li>Not easy ...
DIAGNOSIS <ul><li>If the physician suspects ovarian cancer, medical history, physical examination and various tests perfor...
<ul><li>C- Investigations : </li></ul><ul><li>-Routine examination: </li></ul><ul><li>Complete haematogram </li></ul><ul><...
 
<ul><li>-Ovarian Cancer Staging Is Done by laparotomy and Biopsy Taking. The Stages Are: </li></ul><ul><li>1) Stage I: </l...
<ul><li>4) Stage IV: </li></ul><ul><li>Distant Metastases to the Liver or Outside the Peritoneal Cavity. </li></ul><ul><li...
<ul><li>Ic: </li></ul><ul><li>tuomor Limited to the Ovaries With Any of the Following: Capsule Ruptured, Tumor on Ovarian ...
<ul><li>IIc: </li></ul><ul><li>Pelvic Extensions or Implants With Positive Peritoneal Washings. </li></ul><ul><li>* Stage ...
<ul><li>IIIc: </li></ul><ul><li>Peritoneal Metastases Beyond Pelvis More Than 2 Cm or Lymph Node Metastases. </li></ul>
<ul><li>Types of ovarian tumors; </li></ul><ul><li>.Most of these tumors are benign (non cancerous) and never spread beyon...
epithelial tumors <ul><li>1- benign epithelial ovarian tumors. (most common); </li></ul><ul><li>Serious adenomas </li></ul...
Germ cell tumors <ul><li>-life threatening </li></ul><ul><li>-about 5%of ovarian cancers are GCT </li></ul><ul><li>-the mo...
Stromal tumor <ul><li>-about 5-7% </li></ul><ul><li>-most of them are granulosa cell tumor </li></ul><ul><li>->1/2 in olde...
 
Treatment <ul><li>surgery </li></ul><ul><li>laprotomy- needed for diagnosis and staging of cancer. </li></ul><ul><li>fluid...
<ul><li>Chemotherapy </li></ul><ul><li>Very important esp beyond stage 2 </li></ul><ul><li>Chemical debulking- chemo befor...
Prognosis <ul><li>Poor prognosis </li></ul><ul><li>Early detection </li></ul><ul><li>Screening test </li></ul><ul><li>Late...
Complications <ul><li>-Spread of the cancer to other organs </li></ul><ul><li>-Progressive function loss of various organs...
<ul><li>Samih Ahmed Alawi </li></ul><ul><li>Noon Salah Eldin </li></ul><ul><li>Nusaiba Al Tigani </li></ul><ul><li>Ghada B...
<ul><li>Directed by Dr.Tarig Hassan </li></ul><ul><li>Thanks </li></ul>
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Ca Ovary

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Ca Ovary

  1. 1. Ca ovary GROUP D Dr.Tarig Hassan
  2. 2. Introduction .
  3. 3. <ul><li>The incidence of Ca ovary 62/100,000 women. </li></ul><ul><li>Increase in women more than 40 yrs </li></ul><ul><li>The maximum incidence occur in 80 to 84 yrs old </li></ul><ul><li>Ovarian cancer is the 5 th commonest cancer among Us women </li></ul><ul><li>-about 15,000 women die every year in US from CA ovary. </li></ul><ul><li>white women more than black women. </li></ul><ul><li>.Not the commonest but the most serious gynecological tumor. (silent killer) </li></ul>
  4. 4. Risk factors <ul><li>1- Age. </li></ul><ul><li>2-Family history </li></ul><ul><li>3-Ethnicity : </li></ul><ul><li>>white women </li></ul><ul><li><black women &Asian </li></ul><ul><li>4- Diet </li></ul><ul><li>5- INHERETED GENE MUTATIONS . </li></ul><ul><li>(BRCA1) & (BRCA2). </li></ul><ul><li>5 percent to 10 percent of ovarian cancers </li></ul><ul><li>inherited syndrome called hereditary nonpolyposis colorectal cancer (HNPCC). </li></ul>
  5. 5. <ul><li>-Risk of ovarian cancer associated with HNPCC is lower than is that of ovarian cancer associated with BRCA mutations. </li></ul><ul><li>6- Menstrual history/pregnancy history/infertility : </li></ul><ul><li>-early menstruation&late menopause </li></ul><ul><li>- Nulliparity </li></ul><ul><li>having a first child after age 30 </li></ul><ul><li>Multiple pregnancy↓risk </li></ul><ul><li>Birth control pills40-50% ↓in risk </li></ul>
  6. 6. <ul><li>7- Fertility drugs: </li></ul><ul><li>Ovulation induction: </li></ul><ul><li>-clomiphene citrate </li></ul><ul><li>-menotrpins </li></ul><ul><li>LMP </li></ul><ul><li>8-Androgens </li></ul><ul><li>Danazol increases androgen levels </li></ul><ul><li>9- Estrogen and HRT </li></ul><ul><li>10- Talcum powder </li></ul><ul><li>??carcinogenic </li></ul><ul><li>11- Other cancers </li></ul><ul><li>12- Smoking and alcohol use </li></ul>
  7. 7. Signs&symptoms <ul><li>Clinical presentation.. </li></ul><ul><li>Early stages of disease: </li></ul><ul><li>fatigue </li></ul><ul><li>Bloating </li></ul><ul><li>constipation </li></ul><ul><li>Difficulty eating or feeling full quickly </li></ul><ul><li>indigestion </li></ul><ul><li>back pain </li></ul><ul><li>chronic cough </li></ul><ul><li>menstrual irregularity </li></ul><ul><li>vaginal bleeding or discharge </li></ul><ul><li>Late stages of disease: </li></ul><ul><li>Abdominal mass & ascites </li></ul><ul><li>abdominal pain </li></ul><ul><li>unexplained wt loss </li></ul><ul><li>cachexia </li></ul><ul><li>pleural effusion </li></ul>
  8. 8. Screening methods for CA ovary <ul><li>Why screening methods? </li></ul><ul><li>Vague symptoms </li></ul><ul><li>Not easy to select high risk group </li></ul><ul><li>U/S:not useful as a primary method </li></ul><ul><li>Ca-125 </li></ul>
  9. 9. DIAGNOSIS <ul><li>If the physician suspects ovarian cancer, medical history, physical examination and various tests performed to diagnose it. </li></ul><ul><li>A- History : </li></ul><ul><li>Regularity of menstrual period </li></ul><ul><li>Previous pregnancies </li></ul><ul><li>Contraception </li></ul><ul><li>Breast feeding history </li></ul><ul><li>Previous cancer history </li></ul><ul><li>Family history of ovarian cancer </li></ul><ul><li>B- Examination : </li></ul><ul><li>General examination 2.Abdominal examination: </li></ul><ul><li>- Signs of distention </li></ul><ul><li>- Dilated veins </li></ul><ul><li>-Tenderness </li></ul><ul><li>-Shifting dullness </li></ul>
  10. 10. <ul><li>C- Investigations : </li></ul><ul><li>-Routine examination: </li></ul><ul><li>Complete haematogram </li></ul><ul><li>RFT </li></ul><ul><li>LFT </li></ul><ul><li>Random blood sugar </li></ul><ul><li>Chest X ray </li></ul><ul><li>Echo may be needed </li></ul><ul><li>-imaging: </li></ul><ul><li>U/S </li></ul><ul><li>CT-scan </li></ul><ul><li>MRI </li></ul>
  11. 12. <ul><li>-Ovarian Cancer Staging Is Done by laparotomy and Biopsy Taking. The Stages Are: </li></ul><ul><li>1) Stage I: </li></ul><ul><li>Limited to One or Both Ovaries. </li></ul><ul><li>2) Stage II: </li></ul><ul><li>Pelvic Extensions or Implants. </li></ul><ul><li>3) Stage III: </li></ul><ul><li>Microscopic Peritoneal Implants Outside of the Pelvis, or Limited to the Pelvis With Extension to the Small Bowl or omentum. </li></ul>
  12. 13. <ul><li>4) Stage IV: </li></ul><ul><li>Distant Metastases to the Liver or Outside the Peritoneal Cavity. </li></ul><ul><li>* Stages I,II, and III Are Further Divided Into: </li></ul><ul><li>Stage I: </li></ul><ul><li>Ia: </li></ul><ul><li>Involves One Ovary, Capsule Is Intact, No Tumor on the Ovarian Surface and No Malignant Cells in the ascitis or in the Peritoneal Washing. </li></ul><ul><li>Ib: </li></ul><ul><li>Involves Both Ovaries, No Tumor on Ovarian Surface, and Negative Washings. </li></ul>
  13. 14. <ul><li>Ic: </li></ul><ul><li>tuomor Limited to the Ovaries With Any of the Following: Capsule Ruptured, Tumor on Ovarian Surface, and Positive Washing. </li></ul><ul><li>* Stage II: </li></ul><ul><li>IIa: </li></ul><ul><li>Extension or Implants Onto Uterus or Fallopian Tubes With Negative Washings. </li></ul><ul><li>IIb: </li></ul><ul><li>Extension or Implants Onto Other Pelvic Structures With Negative Washings. </li></ul>
  14. 15. <ul><li>IIc: </li></ul><ul><li>Pelvic Extensions or Implants With Positive Peritoneal Washings. </li></ul><ul><li>* Stage III: </li></ul><ul><li>IIIa: </li></ul><ul><li>Microscopic Peritoneal Metastases Beyond Pelvis. </li></ul><ul><li>IIIb: </li></ul><ul><li>Macroscopic Peritoneal Metastases Beyond Pelvis Less Than 2 Cm in Size. </li></ul>
  15. 16. <ul><li>IIIc: </li></ul><ul><li>Peritoneal Metastases Beyond Pelvis More Than 2 Cm or Lymph Node Metastases. </li></ul>
  16. 17. <ul><li>Types of ovarian tumors; </li></ul><ul><li>.Most of these tumors are benign (non cancerous) and never spread beyond the ovaries </li></ul><ul><li>.the others are malignant, which can metastasize. </li></ul><ul><li>.ovarian tumors are named according to the kind of cells the tumor started from. </li></ul><ul><li>.types; </li></ul><ul><li>1-epithelial tumors ( most common) </li></ul><ul><li>2-germ cell tumors </li></ul><ul><li>3-stromal tumors </li></ul>classification
  17. 18. epithelial tumors <ul><li>1- benign epithelial ovarian tumors. (most common); </li></ul><ul><li>Serious adenomas </li></ul><ul><li>Mucinous adenomas </li></ul><ul><li>Brenner tumors </li></ul><ul><li>2-tumors of low malignant potential (LMP) </li></ul><ul><li>.(affect women at young ages) </li></ul><ul><li>.it grows slowly and are less life threatening. </li></ul><ul><li>3-malignant epithelial ovarian tumors; </li></ul><ul><li>.about 85% to 90% of ovarian cancer are epithelial ovarian carcinoma </li></ul><ul><li>Mucinous </li></ul><ul><li>Endometrioid </li></ul><ul><li>Clear cell </li></ul><ul><li>Undeffrentiated </li></ul><ul><li>.it tend to grow and spread more quickly than others. </li></ul>
  18. 19. Germ cell tumors <ul><li>-life threatening </li></ul><ul><li>-about 5%of ovarian cancers are GCT </li></ul><ul><li>-the most common GC, Teratoma, Dysgerminoma, endodermal sinus tumors and choriocarcinoma </li></ul><ul><li>-Teratoma; </li></ul><ul><li>*Benign form called mature teratoma, but the malignant one called immature teratoma </li></ul><ul><li>*The mature teratuma is the most common and Affects women of reproductive age </li></ul><ul><li>can contain different kined of benign tissues including bone ,hair and teeth </li></ul><ul><li>*the immature teratoma occur in girls and young women<18 </li></ul><ul><li>-dysgerminoma: </li></ul><ul><li>*These are rare affect teens and 20s </li></ul><ul><li>*its malignant ,not grow or spread very rapidly </li></ul><ul><li>endodermal sinus tumors and choriocarcinoma </li></ul><ul><li>*very rare,affect girls and young women </li></ul><ul><li>*grow and spread rapidly </li></ul>
  19. 20. Stromal tumor <ul><li>-about 5-7% </li></ul><ul><li>-most of them are granulosa cell tumor </li></ul><ul><li>->1/2 in older than 50 yrs old,but 5% occur in young </li></ul><ul><li>Types of malignant: </li></ul><ul><li>-granulosa cell tumor </li></ul><ul><li>-granulosa theca tumor. </li></ul><ul><li>- Sertoli -Leydig cell tumors </li></ul>
  20. 22. Treatment <ul><li>surgery </li></ul><ul><li>laprotomy- needed for diagnosis and staging of cancer. </li></ul><ul><li>fluid aspiration for cytology-in chronic cases </li></ul><ul><li>Types of surgery, </li></ul><ul><li>Oopherectomy </li></ul><ul><li>Salpingectomy </li></ul><ul><li>Hysterectomy </li></ul><ul><li>Cystectomy </li></ul><ul><li>Omemtectomy </li></ul><ul><li>Debulking- in metastatic cases </li></ul><ul><li>Is patient able to withstand the surgery? </li></ul>
  21. 23. <ul><li>Chemotherapy </li></ul><ul><li>Very important esp beyond stage 2 </li></ul><ul><li>Chemical debulking- chemo before surgery. </li></ul><ul><li>Chemo drugs </li></ul><ul><li>Cisplatin, paditaxel, carboplatin. </li></ul><ul><li>Side effects </li></ul><ul><li>Nausea, vomiting, diarrhoea, alopecia </li></ul><ul><li>Anaemia,thrombocytopenia, leukopenia </li></ul><ul><li>Nephrotoxicity, neurotoxicity, ototoxicity </li></ul><ul><li>Peripheral neuropathy </li></ul><ul><li>Radiotherapy </li></ul><ul><li>Usually ineffective, however is sometimes used in recurrent cases. </li></ul>
  22. 24. Prognosis <ul><li>Poor prognosis </li></ul><ul><li>Early detection </li></ul><ul><li>Screening test </li></ul><ul><li>Late presentation </li></ul><ul><li>Probably germ cell tumor has better prognosis </li></ul>
  23. 25. Complications <ul><li>-Spread of the cancer to other organs </li></ul><ul><li>-Progressive function loss of various organs </li></ul><ul><li>- Ascites </li></ul><ul><li>-Intestinal obstructions </li></ul><ul><li>► </li></ul>
  24. 26. <ul><li>Samih Ahmed Alawi </li></ul><ul><li>Noon Salah Eldin </li></ul><ul><li>Nusaiba Al Tigani </li></ul><ul><li>Ghada Babikir </li></ul><ul><li>Sara Abbas </li></ul><ul><li>Nihal Hanafi Abdallah </li></ul><ul><li>Noha Salah Eldin </li></ul><ul><li>Aula Muntasir Mostafa </li></ul><ul><li>Khalid ElSadig </li></ul><ul><li>Alaa Eldin Abdelbadee </li></ul><ul><li>Rouaa Shouayeb </li></ul><ul><li>Dalia Amin Osman </li></ul><ul><li>Nadeen Magdi Faried </li></ul><ul><li>Mohammad Ahmed Sayid </li></ul><ul><li>► </li></ul>
  25. 27. <ul><li>Directed by Dr.Tarig Hassan </li></ul><ul><li>Thanks </li></ul>
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