Ovarian Cancer (Cancer of the Ovaries)


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Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. How to Improve Your Cardiovascular Health. The blood that is returned to the right atrium is deoxygenated poor in oxygen and passed into the right ventricle to be pumped through the pulmonary artery to the lungs for re-oxygenation and removal of carbon dioxide. Urologists also treat the male reproductive organs, while gynecologists often treat urinary diseases or disorders in females, including yeast infections. These branches form the intercostal arteries , arteries of the arms and legs, lumbar arteries and the lateral sacral arteries.

Diseases of the urinary system


The flatworm's dorso-ventrally flattened body shape also restricts the distance of any cell from the digestive system or the exterior of the organism.

Oxygen can diffuse from the surrounding water into the cells, and carbon dioxide can diffuse out. Consequently, every cell is able to obtain nutrients, water and oxygen without the need of a transport system. Some animals, such as jellyfish , have more extensive branching from their gastrovascular cavity which functions as both a place of digestion and a form of circulation , this branching allows for bodily fluids to reach the outer layers, since the digestion begins in the inner layers. The earliest known writings on the circulatory system are found in the Ebers Papyrus 16th century BCE , an ancient Egyptian medical papyrus containing over prescriptions and remedies, both physical and spiritual.

In the papyrus , it acknowledges the connection of the heart to the arteries. The Egyptians thought air came in through the mouth and into the lungs and heart. From the heart, the air travelled to every member through the arteries. Although this concept of the circulatory system is only partially correct, it represents one of the earliest accounts of scientific thought.

In the 6th century BCE, the knowledge of circulation of vital fluids through the body was known to the Ayurvedic physician Sushruta in ancient India. However their function was not properly understood then. Because blood pools in the veins after death, arteries look empty. Ancient anatomists assumed they were filled with air and that they were for transport of air.

The Greek physician , Herophilus , distinguished veins from arteries but thought that the pulse was a property of arteries themselves. Greek anatomist Erasistratus observed that arteries that were cut during life bleed. He ascribed the fact to the phenomenon that air escaping from an artery is replaced with blood that entered by very small vessels between veins and arteries.

Thus he apparently postulated capillaries but with reversed flow of blood. In 2nd century AD Rome , the Greek physician Galen knew that blood vessels carried blood and identified venous dark red and arterial brighter and thinner blood, each with distinct and separate functions.

Growth and energy were derived from venous blood created in the liver from chyle, while arterial blood gave vitality by containing pneuma air and originated in the heart. Blood flowed from both creating organs to all parts of the body where it was consumed and there was no return of blood to the heart or liver.

The heart did not pump blood around, the heart's motion sucked blood in during diastole and the blood moved by the pulsation of the arteries themselves. Galen believed that the arterial blood was created by venous blood passing from the left ventricle to the right by passing through 'pores' in the interventricular septum, air passed from the lungs via the pulmonary artery to the left side of the heart. As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be exhaled.

In , The Canon of Medicine by the Persian physician , Avicenna , "erroneously accepted the Greek notion regarding the existence of a hole in the ventricular septum by which the blood traveled between the ventricles.

In , the Arabian physician , Ibn al-Nafis , became the first person to accurately describe the process of pulmonary circulation , for which he is sometimes considered the father of circulatory physiology. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought.

The blood from the right chamber must flow through the vena arteriosa pulmonary artery to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa pulmonary vein to reach the left chamber of the heart and there form the vital spirit In addition, Ibn al-Nafis had an insight into what would become a larger theory of the capillary circulation. He stated that "there must be small communications or pores manafidh in Arabic between the pulmonary artery and vein," a prediction that preceded the discovery of the capillary system by more than years.

Michael Servetus was the first European to describe the function of pulmonary circulation, although his achievement was not widely recognized at the time, for a few reasons. He firstly described it in the "Manuscript of Paris" [24] [25] near , but this work was never published.

And later he published this description, but in a theological treatise, Christianismi Restitutio , not in a book on medicine. Only three copies of the book survived but these remained hidden for decades, the rest were burned shortly after its publication in because of persecution of Servetus by religious authorities.

Better known discovery of pulmonary circulation was by Vesalius 's successor at Padua , Realdo Colombo , in Finally, William Harvey , a pupil of Hieronymus Fabricius who had earlier described the valves of the veins without recognizing their function , performed a sequence of experiments, and published Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus in , which "demonstrated that there had to be a direct connection between the venous and arterial systems throughout the body, and not just the lungs.

Most importantly, he argued that the beat of the heart produced a continuous circulation of blood through minute connections at the extremities of the body. This is a conceptual leap that was quite different from Ibn al-Nafis' refinement of the anatomy and bloodflow in the heart and lungs.

However, Harvey was not able to identify the capillary system connecting arteries and veins; these were later discovered by Marcello Malpighi in Richards were awarded the Nobel Prize in Medicine "for their discoveries concerning heart catheterization and pathological changes in the circulatory system. In the s, Diana McSherry developed computer-based systems to create images of the circulatory system and heart without the need for surgery.

From Wikipedia, the free encyclopedia. For the song by Ed Sheeran, see Bloodstream song. This article is about the animal circulatory system. For plants, see Vascular tissue. Organ system for circulating blood in animals. The human circulatory system simplified. Red indicates oxygenated blood carried in arteries , blue indicates deoxygenated blood carried in veins. Capillaries , which join the arteries and veins, and the lymphatic vessels are not shown.

Depiction of the heart, major veins and arteries constructed from body scans. This section needs expansion. You can help by adding to it.

Retrieved April 13, From Cells to Systems. Archived from the original on Guyton Textbook of Medical Physiology 10 ed. Archived from the original on February 3, Molecular Biology of the Cell 4th ed. New York and London: Comprehensive Perinatal and Pediatric Respiratory Care.

Agency for Healthcare Research and Quality. Evolutionary origins of the blood vascular system and endothelium. Journal of Thrombosis and Haemostasis 11 s1: The evolutionary origin of cardiac chambers. National Center for Science Education. Retrieved October 3, The first mention of carotid artery hypersensitivity". International Journal of Cardiology. Journal of Applied Physiology.

Life and work of Michael Servetus ]. American women of science since Find more about Circulatory system at Wikipedia's sister projects. Anatomy of the heart. Circulatory system Coronary circulation Coronary arteries. Nutrient artery Arteriole Metarteriole Elastic artery.

Lymphatic vessel Lymph Lymph capillary. Physiology of the cardiovascular system. Central venous Right atrial ventricular pulmonary artery wedge Left atrial ventricular Aortic. Compliance Vascular resistance Pulse Perfusion. Pulse pressure Systolic Diastolic Mean arterial pressure Jugular venous pressure Portal venous pressure.

Baroreflex Kinin—kallikrein system Renin—angiotensin system Vasoconstrictors Vasodilators Autoregulation Myogenic mechanism Tubuloglomerular feedback Cerebral autoregulation Paraganglia Aortic body Carotid body Glomus cell. Development of the circulatory system.

Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atrium Sinus venosus. Atrioventricular Primary interventricular foramen Endocardial cushions Septum intermedium Atrioventricular canal Atrial Septum primum Foramen secundum Primary interatrial foramen Septum secundum Foramen ovale. Aorticopulmonary septum Protein signalling in heart development.

Dorsal aorta Aortic arches Aortic sac. The more a woman ovulates cycles over her lifetime, the higher her risk of ovarian cancer. Thus starting her period menarche at a younger age, ending her periods menopause at a late age, and never getting pregnant nulliparity are all risk factors.

It was once thought that infertility patients who underwent preparation for IVF ovarian stimulation for in vitro fertilization were at increased risk, but this has since been shown not to be the case in a large comprehensive review of the subject.

All patients with ovarian cancer will ideally discuss this topic with their doctor. These gene mutations can affect males as well as females.

If a patient is positive for one of these, then her siblings and her children can be tested as well. Testing involves a simple blood test that can be drawn at many offices and laboratories.

The results of this test can greatly affect how family members are monitored for various cancers, including breast cancer , and family members of both sexes are encouraged to be tested.

When compared with the general population risk 1. Lynch syndrome typically colon and uterine cancer , Li-Fraumeni syndrome, and Cowden's syndrome are also associated with ovarian cancer but are less common.

The less common varieties of ovarian cancer borderline, germ cell, and stromal tumors have few definable risk factors. The germ cell tumors often seen at younger ages and are treated very differently both surgically and chemotherapeutically. What are ovarian cancer symptoms and signs? Screening tests are used to test a healthy population in an attempt to diagnose a disease at an early stage.

Unfortunately, there are no good screening tests for ovarian cancer, despite extensive ongoing research. Imaging pelvic or abdominal ultrasound , X-rays , and CT scans , and blood tests should not be used as a screen, as they are inaccurate and lead many women to surgery who do not need it they are false positive tests.

Diagnosis of ovarian cancer is often suspected based on symptoms and physical exam, and these are followed by imaging. The cancer symptoms and signs, when present, are very vague. Ovarian cancer symptoms and signs can include fatigue , getting full quickly early satiety , abdominal swelling, clothes suddenly not fitting, leg swelling , changes in bowel habits, changes in bladder habits, abdominal pain , and shortness of breath.

As mentioned above, these symptoms can be very subtle and vague, as well as very common. This only makes diagnosing the disease that much more difficult. Some studies suggest that the average patient with ovarian cancer sees up to three different doctors prior to obtaining a definitive diagnosis. Often, it is the persistence of the patient that leads to a diagnosis.

OLMPT and some benign tumors can present with similar symptoms. In addition, they are often seen with very large masses in the ovary. Often these masses are large enough to cause bloating , abdominal distension, constipation , and changes in bladder habits. In the more uncommon ovarian types stromal and germ cell tumors , symptoms are similar. Sometimes, granulosa cell tumors can occur with severe pain and blood in the belly from a ruptured tumor. These can often be confused with a ruptured ectopic pregnancy , as they tend to be found in women of reproductive age.

How do health care professionals diagnose ovarian cancer? Often vague symptoms eventually lead to a clinical diagnosis, or one based on suspicion generated by exams for example, a pelvic exam that detects a mass or lump that is abnormal , laboratory tests, and imaging.

However, an accurate diagnosis requires some of the mass or tumor to be removed, either by biopsy less often , or preferably, surgery to verify the diagnosis.

Often a high clinical suspicion can trigger a referral to a gynecologic oncologist. Various types of imaging studies can be used to diagnose this disease and lead to tissue sampling. Pelvic or abdominal ultrasound and CT scans are the most commonly done studies.

These often can give images that show masses in the abdomen and pelvis, fluid in the abdominal cavity ascites , obstructions of the bowels or kidneys, or disease in the chest or liver. Many times this is all that is necessary to trigger a referral to a specialist, as the suspicion for ovarian cancer can be quite high. PET scans can be used but often are not necessary if a CT scan is able to be performed. Blood work can be helpful as well.

The CA is a blood test that is often, but not always, elevated with ovarian cancer. If a postmenopausal woman has a mass and an elevated CA, she has an extremely high risk of having a cancer.

However, in younger women, CA is extraordinarily inaccurate. It is elevated by a large number of disease processes, including but not limited to, diverticulitis , pregnancy , irritable bowel syndrome , appendicitis , liver disease , stomach disease, and more. No one should get this test done unless they actually have a mass, or their doctor has some reason to get it. It should not be drawn just to see the level since it is not a reliable screening test for ovarian cancer.

HE4 is another blood test that is used in the U. Like CA , the HE4 test does not always detect cancer. OVA-1 and Overa are examples of blood tests that are used to help doctors determine the likelihood that an identified mass will be cancerous. These tests aid a doctor in planning for surgery when a mass is found.

How is ovarian cancer staging determined? Staging is the process of classifying a tumor according to the extent to which it has spread in the body at the time of diagnosis. Complete staging of an ovarian cancer includes hysterectomy , removal of the ovaries, tubes, pelvic and aortic lymph node biopsies or dissection, biopsies of the omentum a large fatty structure that provides support for abdominal organs , and peritoneal lining tissue of the abdomen biopsies.

Ovarian cancer staging is determined surgically, unless it is stage 4 metastasis outside of the abdomen, or metastasis to the liver -- not on the surface of the liver.

If it is stage 4, or very advanced stage 3, then often this is proven with biopsy, and chemotherapy may start neoadjuvantly before surgery. If the disease is not obviously stage 4, then aggressive surgical staging and debulking see next section often is considered. This decision is based on the health of the patient, as well as the judgment of the surgeon as to the chance of achieving an optimal debulking see treatment below. What are ovarian cancer treatment options? Epithelial ovarian cancer treatment most often consists of surgery and chemotherapy.

The order is best determined by a gynecologic oncologist. Surgery is used for both staging and debulking. Staging is the determination of the extent to which as cancer has spread in the body. Debulking is removing as much of the tumor as possible. If one imagines a handful of wet sand thrown on the ground, you will see small piles and bigger piles. This is often how the abdomen looks when in surgery. It is the job of the surgeon to remove, also known as debulking as many of these masses as possible.

This surgery usually results in removal of both tubes and ovaries, the uterus hysterectomy , removal of the omentum omentectomy -- a large fat pad that hangs off of the colon , lymph node biopsies, and any other organ involved in the disease. This can mean a portion of the small bowel, large bowel, liver, the spleen, the gallbladder, a portion of the stomach, a portion of the diaphragm , and removal of a portion of the peritoneum a thin lining in the abdomen that covers many of the organs and the inside of the abdominal wall.

Done properly, this can be a very extensive surgery. The patients who live the longest have all of the visible nodules taken out at time of surgery.

To accomplish an "optimal debulking," at minimum, no individual nodule greater than 1 cm should be left behind. If this cannot be done, the patient is brought back to the operating room for a second surgery after a few rounds of chemotherapy neoadjuvant chemotherapy and interval debulking surgery. It should be noted that now many gynecologic oncologists believe that optimal debulking should mean that there is no visible disease left at the time of surgery.

This has been a shift over the last years. Historically, the goal was to leave no individual nodule greater than 2 cm behind. This has steadily progressed to the point where the term optimal debulking is now accepted by many to mean that there is no disease left to remove.

As we have progressed to this point, surgery has become more involved, on a more routine basis. This has led to a concern about undertreatment of elderly patients due to a fear that they cannot survive the surgical risks.

Any patient healthy enough to tolerate chemotherapy will often benefit greatly from its use. The drugs used in ovarian cancer tend to have fewer side effects, and thus are easier to tolerate than many other chemotherapy drugs.

Currently, there are two ways to give chemotherapy in ovarian cancer. Traditionally, it is given into the vein intravenously IV. When initially diagnosed, the usual first-line approach is to give a combination of a platinum drug typically carboplatin and a taxane drug, such as paclitaxel Taxol or docetaxel Taxotere. Another way of giving the chemotherapy is to place it directly into the abdomen intraperitoneal or IP.

In many studies, intraperitoneal administration has been shown to significantly increase survival. This is most often used after optimal surgical debulking. Currently, the drugs used are cisplatin and paclitaxel.

Targeted therapy is a type of treatment that uses drugs or other treatments to identify and attack target specific cancer cells without harming normal cells. The drug bevacizumab is an example of targeted therapy that has been used in the treatment of advanced ovarian cancer. Bevacizumab Avastin is a monocolonal monoclonal antibody that targets the development of blood vessels by a tumor. These drugs block an enzyme necessary for DNA repair and may cause cancer cells to die.

Stromal and germ cell ovarian tumors are most often treated with a combination of chemotherapy drugs. There is much less research on these as they are more curable and much less common than epithelial tumors. Because of their rarity, it will be very difficult to find effective new treatments. The Gynecologic Oncology Group is a national organization that sponsors clinical trials in gynecologic cancers.

Patients can ask their physician if they are eligible for a clinical trial that may help them, as this is how new drugs are discovered. If a doctor or hospital does not participate in the GOG trials, a doctor can often contact a regional center that does. Research also suggests that eating less sugar can help lower blood pressure, a major risk factor for heart disease.

When you eat, your pancreas pumps out insulin. Eventually, your overworked pancreas will break down and your blood sugar levels will rise, setting you up for type 2 diabetes and heart disease.

If you have diabetes , too much sugar can lead to kidney damage. The kidneys play an important role in filtering your blood sugar. Once blood sugar levels reach a certain amount, the kidneys start to let excess sugar into your urine.

If left uncontrolled, diabetes can damage the kidneys, which prevents them from doing their job in filtering out waste in your blood. This can lead to kidney failure.

One study even found that people who increased their sugar intake gained about 1. You may want to skip the dessert on date night: Sugar may impact the chain of events needed for an erection. This is because it affects your circulatory system, which controls the blood flow throughout your body and needs to be working properly to get and keep an erection.

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