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Ovarian cancer has become a global problem and it has been highly observed in women. Ovarian cancer is defined as a type of cancer that targets the ovaries of female reproductive system. Ovarian cancer cannot be detected until it reaches to the pelvis and abdomen (Stewart, Ralyea & Lockwood, 2019).During the last stage, ovarian cancer becomes very hard to treat because at the last stage it spreads to other parts of the female reproductive system that results in a fatal stage. Cancer occurs when there is development of new abnormal cells and these extra cells may form a lump of tissue known as tumour. Ovarian cancer can occur due to several risk factors such as older age, late menopause, early menstruation, family background and gene mutations. Sometimes Ovarian cancer cannot be detected until it has spread up-to the pelvis and abdomen. During this stage, treatment for ovarian tumour becomes very limited but if tumour is detected at the early stage in which the ovary is mainly infected then the ovarian tumour can be treated successfully. Advanced stage ovarian cancer has several symptoms but early stage cancer does not show any such symptoms. Ovarian cancer is termed as the fourth most common malignant tumour in Malaysia and it is been observed that there is lack of early diagnostic for this disease that leads to unfavourable outcomes. This paper would focus on the relevant treatment and diagnosis for ovarian cancer that would result in favourable outcomes.
Research reveals that most of the malignant and benign ovarian cancer develops from any one of the cell types which are germ cells, stroma cells and epithelial cells (Reid, Permuth & Sellers, 2017). Most of the ovarian tumours are epithelial in nature. Pathogenesis of ovarian cancer is not properly understood but it is been observed by research studies that most of the ovarian tumours develop from other gynaecological tissues rather than ovary and ovary serves as the secondary organ (Reid, Permuth & Sellers, 2017). Ovarian cancer is divided into five different histological subtypes of epithelial cancer which are high grade serous carcinoma, low grade serous carcinoma, low-grade endometrial carcinoma, clear cell carcinoma and Mucinous carcinoma (Matulonis et al., 2016). Studies suggest that high and serous carcinoma develops from fallopian tube epithelium or tubal epithelium. High grade serous carcinoma is linked with BRCA and TP53 mutations and low grade serous carcinoma is linked with KRAS and BRAF mutations (Matulonis et al., 2016). CCOC and ENOC is found to be associated with endometriosis and MOC is found to be associated with tubal-mesothelium junction. Low grade endometrial carcinoma or ENOC is found to be associated with PTEN, ARID1A and PIK3CA mutations (Matulonis et al., 2016). Some lesions has been observed that are found in fimbriated part of the fallopian tube which shows same morphology and TP53 symbolises High grade serous carcinoma that suggests neoplastic pathway can develop at these lesions which may lead to a rapid growth of carcinogenic cells. Low grade serous carcinoma indicates a clear growth that arises from benign serous tumour to borderline serous carcinoma and then finally to the low grade carcinoma. Clear cell carcinoma has been found to be associated with ARIDA1A and PIK3CA mutations and clinically it is found that it can be associated with parenchymal metastases which is identified in lungs and liver. Low grade serous carcinoma, low grade endometrial carcinoma, clear cell carcinoma and mucinous carcinoma rapidly grows from borderline tumours following certain steps and are grouped as Type I tumours and High grade serous carcinoma is identified as a Type II tumour. Some people may not have any clinical symptoms but few people may have some clinical manifestations of ovarian cancer such as weight loss, abdominal bloating, frequent urination, feeling totally full while eating, and discomfort in the pelvic region, and alterations in bowel habits, lump in the abdomen, fatigue and loss of appetite.
Ovarian cancer has been found to be the eighth most common cancer that is highly observed in women and it comprises of 4% of cancer which mainly occurs in women (Razi et al., 2016). Research studies reveals that every year 225,000 new cases of ovarian cancer has been reported globally and 140,000 people die from this annually. This disease shows high morbidity and mortality rates globally (Razi et al., 2016).It is been observed that Kelantan a state of Malaysia has got a very high rate of diabetes 2 and along with that endometrial carcinoma rates are also having high prevalence (Jalil, Zin, & Othman, 2015). Studies reveals that in this state of Malaysia, total 860 cases of cervical, endometrial, breast and ovarian cancer has been reported (Jalil, Zin, & Othman, 2015). Report says that there were a total 143 cases of ovarian cancer out of 860 cases of carcinoma and it has been confirmed that 26% of them were diabetic (Jalil, Zin, & Othman, 2015). It has been observed that women with diabetes 2 or DM2 has got a relation with ovarian tumour and increase in this tumour in women rises with an increase in diabetes 2. In Malaysian women ovarian cancer has contributed 5% of total cancer and it is been termed as the fourth common cancer that possess an incident rate of 7.4 per 100,000 populations (Elmahdi et al., 2017).Although ovarian cancer has less incidence rate but it is a life threatening cancer amid all other cancers of reproductive system (Elmahdi et al., 2017).
Studies reveals that in Malaysia women have very less awareness for ovarian cancer. It is been observed that three fourth of the people are illiterate about the consciousness of the ovarian tumour. Malaysian women have many misconceptions and they lack in awareness for the risk factors of ovarian cancer (Ken et al., 2015). In most of the cases especially in women diagnosis has been done at an advanced stage when the cancer has spread that results in poor treatment for this disease and this serves as a gap between the awareness and attitude of women (Ken et al., 2015).It has been observed that women of Malaysia does not have adequate knowledge about ovarian cancer and that is the reason they cannot understand the importance of the risk factors related to this disease. Immediate awareness about the disease can help to identify the disease at an early stage that would result in proper treatment but women of Malaysia does not have proper knowledge on cancer. Most of the people have not heard about the term ovarian cancer that leads to increased risk factors. Moreover it has been observed that level of education is also a factor for awareness because it has shown that people having higher education level are more aware about this disease than those people who are having lower level of education (Ken et al., 2015). Gynaecologic cancer campaign has been incorporated as a measure to increase awareness among the women (Puckett et al., 2018). Moreover, education programme of women acts as an important measure for developing awareness for ovarian cancer that would help to gain knowledge and information about ovarian cancer. Providing inside knowledge materials also serves as good measure for spreading awareness among women (Puckett et al., 2018). It is been said that risk-stratified screening and genetic testing acts as effective measures or strategies for developing awareness among all the women for ovarian cancer (Elmahdi et al., 2017).
Although there is good advance in combinatorial chemotherapy and intra-peritoneal chemotherapy for the treatment of ovarian tumour but immunotherapy has become a novel therapeutic method for treating ovarian cancer (Chester, et al., 2015). Several modalities of immunotherapy has been formed by following immunogenicity of ovarian cancer Pignata et al., 2017). Cancer vaccine, antibody-based therapies, immune-checkpoint blockade and chimeric antigen receptor modified T – cells have been found to be successful in treatment process (Chester et al., 2015).Studies reveals that advanced ovarian cancer in elderly women has been treated by neoadjuvant chemotherapy and it has become a popular strategy for the treatment process of ovarian tumour (Melamed et al., 2016). Surgery also serves as one of the effective treatment modality for ovarian cancer (Lheureux et al., 2019). It has been observed from studies that salpingectomy reduces the incidence of ovarian cancer (Walker et al., 2015). Apart from these, other treatments such as chemotherapy, intraperitoneal chemotherapy, radiation therapies and some drugs can be used for treating ovarian cancer (Cortez et al., 2018). Nurse plays a big role by providing holistic care to the patients having ovarian cancer. Nurse follows collaborative approach during the treatment process of ovarian cancer as it would help to understand the patient’s problems and needs clearly. Moreover, nurse plays a great role for effective communication between patient and other healthcare professionals such as oncologist, radiologist and doctor to give a proper treatment to the patient suffering from ovarian cancer. During this treatment phase, nurse must provide proper care and understanding towards the patients as this phase of treatment makes the patients very much stressed out (Zamanzadeh et al., 2015). Nurse helps patients by making them learn about the self-care and to perform their daily activities by themselves only as that would help in their treatment process. During this treatment process nurses focus on healing both the mind and body that would assist patients with a fast recovery. Nurse also helps patients to take their decisions on their own and helps to eliminate dependency and it acts as a holistic approach. During the treatment of ovarian cancer spiritual healing is very much needed and nurse helps patients by looking after their spiritual development (Zamanzadeh et al., 2015). This disease is a painful one and during the treatment process for ovarian cancer nurse identifies individual’s needs and treats individual in a different manner to cater all their needs Thus it is evident that nurse plays a great role in providing holistic care towards the patients during the treatment process of ovarian tumour.
Ovarian tumour has been found to be the eighth most common cancer that has been highly observed in women which comprises of 4% of cancer and it has been found that most of the women have diabetes 2 that leads to the risk factors of ovarian cancer. This disease exhibits high morbidity and mortality rates globally. It has been observed that Kelantan a state of Malaysia has got a very high rate of diabetes 2 and along with that endometrial carcinoma rates are also having high prevalence but women in Malaysia lack in proper knowledge about ovarian cancer that leads to less awareness about the ovarian tumour. Several treatment modalities such as chemotherapy, intra-peritoneal chemotherapy, radiation therapies, immunotherapy and some drugs been found to be effective in treatment process of ovarian cancer. Thus ovarian cancer is termed as a global problem as it has high mortality rate and it is also termed as a silent killer because sometimes symptoms which are presented are often mistakenly identified for other conditions that affects the women’s body or gastrointestinal system as she move towards the aging phenomenon.
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