Ovarian Tumors



What is Ovarian Tumor?

The ovaries are a fairly common site for the development of tumors. They are most frequently detected in women aged 35 years or more. They tend to grow slowly, and are often not discovered until they have grown to a relatively large size.
Often a lump welling up from the pelvic cavity (sometimes believed to be a pregnancy, even though menstruation may still be occurring) is the first indication. But in an obese woman, it may just appear that she is putting on even more weight in the abdominal region, and may be overlooked for a long time.
Many are discovered in the course of a routine pelvic examination for some other reason. (This is another reason in favour of having regular pelvic checks when returning for a repeat prescription of the contraceptive pill. If this is not carried out routinely by your own doctor, it is well worth asking for.) Many tumors are discovered during a laparoscopic examination of the pelvis.
Fortunately, about 95 per cent of ovarian tumors are benign (ie noncancerous). Benign tumors are usually cystic, so that if a cystic swelling is discovered, it usually means that it is a simple, noncancerous one.
However, the remaining 5 per cent still equals a lot, and malignancy in this area is fraught with problems. For cancer tends to grow at a steady rate, silently, and almost symptom-free in the early stages. Often, by the time adequate symptoms have occurred to make the patient seek medical assistance, the cancer has advanced to an incurable state. Once more this indicates the supreme value of regular medical examinations and pelvic checks throughout life. Discovering these disorders early (before symptoms set in) offers about the only chance of a successful outcome.

Ovarian Tumor Symptoms

Benign tumors never cause pain, unless some sort of complication occurs, and rarely do they affect menstrual function. Symptoms can take place if the tumor is on a lengthy stalk (pedicle), and it becomes twisted on itself. If the cystic swelling suddenly bursts. symptoms may also take place.
Princess Anne of Britain was in the news some years ago when it appeared that she had an ovarian cyst that had suddenly developed this complication. Sometimes a surgical emergency may arise. But with small cysts, a slight discomfort may be all that a woman experiences.
Very large tumors may produce symptoms from pressure on surrounding structures. Abdominal discomfort, lack of appetite and/or nausea may occur when the abdominal contents are squeezed by mechanical pressure. Malignant tumors of the ovaries are often associated with pain, particularly in the later stages when surrounding structures have become involved. Fluid in the pelvic cavity and weight loss are also other ominous signs.
Diagnosis of ovarian tumors may be simple, or they may be extremely difficult. Sometimes radiology and ultrasound aids are needed to help in distinguishing it from other possible diagnoses.



Ovarian Tumor Treatment

The course of action depends on the nature and severity of the symptoms being produced. If severe bleeding is occurring, particularly in an older woman, surgical removal of the uterus is often undertaken. If troublesome pressure symptoms are encountered, a similar approach is frequently made.
In younger women (especially those under the age of 40), and those still desirous of maintaining their reproductive function, myomectomy may be advised. One important flow-on benefit is that a substantial number of women who appeared to be infertile (presumably due to the presence of the tumor) subsequently become pregnant after this operation.
Treatment of most ovarian tumors is surgical. In young women, every effort is made to preserve as much of the normal ovary (if there is any left) as possible. This help ensure continuation of the system’s hormonal supply, and so help maintain a feeling of normality.
As there is a risk of benign cysts turning cancerous, they are usually removed. Smaller ones are either ruptured or removed alone or with the ovary through the operating laparoscope. as seen in full colour by the doctor on a VDU screen, which sits next to the patient. It can sometimes be difficult to know if a tumor is in fact cancerous or not until it has been thoroughly examined by the pathologist under the microscope. Any parts that are removed must always be scrutinised by the experts for a full report.
In older women, frequently a greater amount of tissue is removed, for there is often an increased risk of cancer. Ovarian cancer is a serious disease and follow-up therapy is usually carried out. Development of Taxol, from the yew tree, holds hope for the future. Time will tell.
The main point in this section is the need to recognise that ovarian tumors are relatively common. While most are noncancerous, there is a real risk that malignancy may develop.
The sooner diagnosis is made and treatment undertaken, the better. There is also a case for regular pelvic examinations throughout life in order to detect any such abnormality as early as possible.

Endometrial Ablation

New technology continues to improve the lot of many women undergoing surgery. In many cases, in women with heavy bleeding for no obvious cause, the traditional D and C or hysterectomy (womb removal) is being replaced by endometrial ablation. This is carried out in hospital under a general anaesthetic. A camera looks inside the womb, and this is displayed on a VDU screen nearby, and the surgeon works from this, gently manipulating the instruments. A “rollerball” or laser beam then systematically removes the endometrial lining of the womb. This goes deeply, so that subsequent scar tissue will prevent new tissue lining from growing.
In most cases, bleeding is dramatically reduced. Pregnancy is usually no longer possible. The patient normally recovers quickly. It is a much lesser operation than womb removal, and the patient may return home and back to normal duties fairly quickly.



Laparoscopic Hysterectomy

The laparoscopic method is being used for an increasing range of surgical operations. Many gynaecologists use it for womb removal (hysterectomy) Tubes (one containing a camera and lights) are inserted via tiny 1 cm incisions called portals low down in the pelvis. This is shown up on the VDU screen, and the surgeon gently dissects away the unwanted parts.
Finally, the womb (and other organs if need be) is removed via an incision high up in the vaginal canal. Recovery is claimed to be quicker, although the operation still takes a considerable period of time, and specialised surgical skills and equipment are required.