Ovarian cancer begins in a woman's ovaries. Women have two ovaries, one on each side of the pelvis. The ovaries produce eggs. They are also the main source of the female hormones estrogen and progesterone.
Many types of tumors can start in the ovaries. Some are benign (non-cancerous) and never spread beyond the ovary. Women with these types of tumors can be successfully treated by removing one ovary or the part of the ovary that has the tumor. Other types of tumors are malignant (cancerous) and can spread to other parts of the body.
As a rule, tumors in the ovary are named for the type of cell from which they were initiated and whether the tumor is benign or malignant. There are three main types of tumors:
Germ cell tumors start from the cells that produce the eggs (ova). About one in 20 ovarian cancers are germ cell tumors. Germ cells are those that form the eggs. Most germ cell tumors are not cancer, although some can be. There are several sub-types of germ cell tumors. Most are benign but some are cancerous.
Stromal tumors start from connective tissue cells that hold the ovary together and produce the female hormones. Stromal tumors can be either benign (non-cancerous) or cancerous. More than half are found in women over age 50.
Epithelial tumors start from the cells that cover the outer surface of the ovary. Epithelial ovarian tumors can be further divided into three sub-groups: Benign epithelial tumors do not spread and usually do not lead to serious illness. Tumors of low malignant potential (LMP tumors) do not appear to be clearly cancerous. They are also known as borderline tumors. These tumors affect women at a younger age than other ovarian cancers. They grow slowly and are much less serious than most ovarian cancers. Epithelial ovarian cancers, which account for nearly nine out of 10 ovarian cancers. Cancer cells of this type of tumor have certain features that can be seen under a microscope and that allow doctors to further classify them. These kinds of tumors are also given a grade depending on how closely the cells look like normal cells. Grade 1 means the cells look more normal; grade 3 look less normal, and grade 2 is in between.
Primary peritoneal carcinoma is a cancer much like epithelial ovarian cancer but it starts outside of the ovaries. It grows from the cells that line the pelvis or abdomen. These cells look like the cells along the surface of the ovaries. Women who have had their ovaries removed can still get this type of cancer. Symptoms of this cancer are much like those of ovarian cancer. Treatment is also similar.
An ovarian cyst is fluid that collects inside an ovary. Many of these cysts are normal. The fluid will most often be absorbed and the cyst will go away in time without any treatment. But if the cyst is large or happens in childhood or after menopause, the doctor may suggest further tests or treatment.
Ovarian cancer is the second most common ‘reproductive' cancer, but it kills more women than any other reproductive cancer.
Women younger than 65 are twice as likely to survive the cancer.
When detected early the 5 year survival rate is 94 percent, 50 percent higher than the overall survival rate.
Most women have one of more risk factors for ovarian cancer, but most of the common factors only slightly increase a person's risk. There are things that a woman can do to reduce her risk of ovarian cancer.
Oral contraceptives: The use of oral contraceptives decreases the risk of developing ovarian cancer, especially among women who use them for several years.
Tubal ligation or hysterectomy: Tubal ligation is a surgical procedure to “tie” the fallopian tubes to prevent pregnancy. When performed after childbearing, tubal ligation may reduce the chance of developing ovarian cancer by up to 67 percent.
Pregnancy and breast-feeding: Having one of more children with prolonged breast-feeding, may decrease a woman's risk for ovarian cancer.
Diet: A number of studies have shown a reduced rate of ovarian cancer in women who ate a diet high in vegetables.
Some of the risk factors for the most common (epithelial) type of ovarian cancer are:
Age: Most ovarian cancers happen after menopause. Half of all these cancers are found in women over the age of 65 and the risk peaks in the late 70's.
Women who have never had children are more likely to develop ovarian cancer than those who have had children. Pregnancy, tubal ligation and the use of oral contraceptives appear to reduce the risk of developing ovarian cancer.
Fertility drugs and hormone replacement therapy: Long term use of these drugs increases the risk.
Family history: Ovarian cancer risk is higher among women whose close blood relatives (mother, sister, daughter) have (or had) this disease. The relatives can be from either the mother's or father's side of the family. There is a higher risk if family members were diagnosed with ovarian cancer at an early age.
Breast cancer: Women who have had breast cancer also have a higher risk of ovarian cancer. Recent studies suggested that preventive surgery to remove the ovaries and fallopian tubes can decrease the risk of ovarian cancers and other gynecologic cancers in women with BRCA1 and BRCA2 mutations. Another genetic syndrome, hereditary non-polyposis colon cancer (HNPCC), has also been associated with endometrial and ovarian cancer. Incidence rates are highest in industrialized countries other than
Obesity: Some research indicates that women who were overweight have a higher rate of death from ovarian cancer in. The risk increased by 50 percent in the heaviest women.
- Unusual vaginal bleeding
- Pelvic pressure
- Back or leg pain
- Unexpected weight loss or gain
- Constipation
- Sense of fullness or pressure in the pelvis
- Abdominal bloating or swelling
- Changes in bowel and bladder patterns
- Indigestion or gas
- Frequency or urgency of urination
There is yet no easy, non-invasive tool for diagnosing ovarian cancer. Today, periodic thorough pelvic exams are important to help detect changes in the size or shape of the ovaries and uterus for women at average risk.
For women at higher risk for ovarian cancer, transvaginal ultrasound may be useful. This type of ultrasound uses a small instrument inserted into the vagina that creates sound waves to create images of the ovaries.
A blood test that checks for abnormal levels of a certain protein, CA125, may help in diagnosis and detection for women at high risk. Research is ongoing into improved imaging technology and specific patterns of proteins in the blood that may result in the development of more sensitive screening tests in the future.
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