Ovarian Cancer
Easy Guide To: Understanding Cancer Of The Ovary

Cancer of the Ovaries


Warning Signs
- Bloated tummy
- Feeling full quickly
- Need to urinate more often
- Pelvic or abdominal pain

Ovarian Cancer


What Is Ovarian Cancer?
What Are The Survival Rates?
What Types Are There?
What Are The Symptoms?
What Are The Causes?
Can I Be Screened For It?
How Is It Diagnosed?
How Is It Treated?
What Are The Main Side Effects Of Treatment?
What Is The Follow Up Care?
Will Treatment Leave Me Infertile?
Can It Be Prevented?


Breast Cancer Guide
Cancer Guidelines
Endometrial Cancer
Cancer of the Fallopian Tube
Vaginal Cancer
Vulva Cancer

In This Section:

Types of Ovarian Cancer
Treatment Options
Survival Rates
Cancer Remission
Prevention Advice
Cancer Clinical Trials

Related Articles:

Female Reproductive System

What Is Ovarian Cancer?

It is a cancer which begins in the ovaries. The ovaries are the female reproductive glands which manufacture eggs (ova) for fertilization (image). The egg then travel along the fallopian tubes to the womb (uterus) where, if it is fertilized, it imbeds and develops into a baby. There are 2 ovaries, one on each side of the pelvis. The ovaries are also responsible for producing the body's main source of the hormones estrogen and progesterone. Every year there are about 22,000 new cases of ovary cancer (image) diagnosed in the United States and about 15,000 related deaths. Statistically 1 in every 70 newborn girls will develop the disease at some time in her life, with half of those cases occurring after the age of 65. Fortunately however the incidence rate has been dropping by about 1 percent a year over the past 20 years. This may be because so many women are taking the contraceptive pill which appears to offer some protection.

What Are The Survival Rates?

Cancer of the ovaries is a highly dangerous disease. It responsible for more deaths in women than any other gynecologic cancer. About 75 percent of women will still be alive one year after diagnosis, but this reduces to 46 percent by year 5 after diagnosis. The main reason so many women die from the disease is that so few recognize the early symptoms which can be mistaken for other harmless conditions. Often by the time the cancer is diagnosed the tumor has spread beyond the ovaries and is difficult to control (image). On the other hand, women who are diagnosed early have excellent long-term survival chances, the cure rates are nearly 90 percent. However only 15 percent of ovarian cancers are diagnosed early. Yet, these numbers may cause women undue fear. In reality cancer of the ovary is quite rare, accounting for only 3 percent of all cancers in women. An average gynecologist may only come across one case in their practice every several years. Additionally latest discoveries in cancer cell biology may soon result in new approaches to early detection and treatment breakthroughs from gynecologic oncology researchers are improving long-term ovarian cancer survival rates.

What Types Are There?

Types of ovarian cancer: The ovaries are complex organs and their 2 major functions is egg and hormone production. Each particular function of the cell is carried out by different types of cells. Any of those cell types can turn cancerous with their own unique properties. As a result of this complexity, tumors arising from the different cell types are complex too. That said, the vast majority (90 percent) of ovary cancers occur on the outside surface of the ovary (epithelium). This type of cancer is called ovarian epithelial cancer. Nonepithelial cancers account for 10 percent of cases.

Ovarian Epithelial Cancer
Epithelial tumors are further subdivided into: benign tumors, those with low malignant potential (LMP) and tumors with very clear malignant characteristics. Most epithelial tumors are benign and do not spread or cause illness. LMP is sometimes described as borderline cancer and tends to develop in younger women. It grows slowly and is usually less life threatening. 75 percent are discovered in the early stages. Malignant tumors are more dangerous and found in about 5 percent of women with ovarian cancer.

Nonepithelial Ovarian Cancer
This type of ovary cancer usually occurs during a girl’s childhood or teenage years and accounts for about 10 percent of all ovarian cancers. It is diagnosed and staged in the same way as epithelial types. There are 2 main types of nonepithelial cancer. Germ cell tumors start in the cells that produce the eggs and stromal tumors start in the tissue that holds the ovaries together.

What Are The Symptoms?

The signs and symptoms of ovarian cancer are vague and can be easily attributed to other causes. Yet, we do know from recent studies that it is not a silent disease. It commonly produces the following symptoms:

Bloated stomach.
• Feeling full after a light meal.
• Pain in the pelvic area or abdomen.
• Increased need to urinate more frequently.

The following are also signs, but may also be attributable to lots of other causes:

Irregular periods and menstrual cycles.
• Vaginal bleeding that is not part of a menstrual cycle.
• Excess gas and indigestion, may be mistaken for stomach problems.
• Unexplained weight gain or loss.
Painful intercourse.
• Nausea or vomiting.
Diarrhea or constipation.
• Unexplained back pain which seems to worsen over time.
• Extreme fatigue which may be mistaken as Chronic Fatigue Syndrome.
• A feeling of vague discomfort in the pelvic region.
• Excessive hair growth.

What Are The Causes?

The causes of ovarian cancer are unknown, but several risk factors appear to play a role. Genetic predisposition is a key factor. Up to 10 percent of women with epithelial type cancers will have the BRCA1 or 2 genetic mutations associated with breast cancer. Other risks include:

• Women who take estrogen replacement therapy (without progesterone) for 5 years.
• Age, postmenopause women over 65 are more prone to the disease.
• Not having children (nulliparity) or having children later in life.
• History of other cancers such as endometrial cancer, colon or breast cancer.
• Risks may be higher among lesbian women, although this has not been scientifically proven.
• Studies into a link between fertility drugs and ovarian cancer leave this question unanswered. Although recent research suggests there is no risk, even if you take fertility medications for more than a year.

Birth control pills and breastfeeding on the other hand seem to lower the overall risk.

Can I Be Screened For It?

Testing for a disease when a person has no symptoms is called screening. Currently there is no general screening process for ovarian cancer and it is probably not necessary for most women. Cervical cancer screening (Pap test) will not identify ovary cancer. If you feel you are at risk (because of a strong family history of ovarian, breast, uterine or even prostate or colon cancer) talk to your doctor about genetic testing. He may recommend you speak to a genetic counselor.

How Is It Diagnosed?

A doctor will carry out an extensive pelvic examination. If the doctor suspects abnormalities the woman will be referred to a specialist, usually a gynecologic oncologist. This is a doctor who specializes in cancers of the female reproductive system. The gynecologist will take a full medical history; carry out another physical examination and Pap smear test to rule out other female cancers. The rest of the diagnostic procedure (work-up) will depend on the woman's age, symptoms and condition of health. Tests may include:

• CA125 tumor marker blood test.
• hCG blood tests.
• Chest and abdominal X-rays.
Ultrasound of abdomen.
Transvaginal ultrasound.
Colonoscopy or barium enema to rule out colon cancer.
Mammogram to rule out breast cancer.
Laparoscopy to view the internal organs.
• Laparotomy to determine the exact location of the tumor and ovarian cancer staging.
Special Tests: Imaging tests such as MRI scan, CT scan or PET scan. The tests will also be used to rule out other possible causes of symptoms such as:
Ovarian cysts
• Inflammatory bowel disease (see bowel disorders)
• Diverticulitis

A full and complete ovarian cancer diagnosis can only be given once a biopsy has been performed.

How Is It Treated?

Ovarian cancer treatment is improving rapidly on an almost yearly basis. Women with the disease are encouraged to find out about the most up-to-date options. Those new techniques may be of particular interest to younger women who wish to preserve fertility if treatment requires the removal of their ovaries. For example, one possibility is to preserve fertilized embryos if they have a partner. New assisted reproductive technology also helps to preserve sections of ovarian tissue for later use. All this will need to be discussed and performed before treatment for the cancer begins. The main ovarian cancer treatment options are surgery, systemic chemotherapy and radiation therapy. Surgery is usually the main choice, and according to the stage of the disease chemotherapy may also be offered. If the pathologist and surgeon think cancer may have remained behind after surgery, radiation therapy might be recommended, although it is rarely recommended in the United States.

What Are The Main Side Effects Of Treatment?

If you are a younger woman and have had your ovaries removed you may enter premature menopause. This means you will be prone to menopause symptoms such as hot flashes and night sweats. The side effects of chemotherapy can include vomiting, diarrhea, and nausea and hair loss. Your treatment team should fully advise you before starting therapy.

What Is The Follow Up Care?

Once the treatment course has finished, your doctor will want to see you for regular checkups. This is known as follow-up. Every 2 to 4 months the doctor should perform a complete physical examination for the first 2 years. This cuts to every 6 months for the next 3 years and annually thereafter. The doctor may also order CT scans of the chest, abdomen and pelvic region. Read also about ovarian cancer recurrence.

Will Treatment Leave Me Infertile?

This depends on how far the cancer has spread. For women of childbearing age with certain type of tumors, or ovarian cancer in the early stages, it may still be possible to treat the disease without removing both ovaries and the womb. In fact a new study of young women with early stages of the cancer found that those who kept their uterus and at least part of one ovary did not reduce their overall survival rate. In many instances however the disease will result in hysterectomy and the loss of fertility. This is why it is important for women who still wish to become pregnant to discuss fertility preservation technologies with their doctor before beginning treatment.

Can It Be Prevented?

Women who take contraceptive pills for more than 5 years have their risk factor reduced by 50 percent. However the side effects of birth control pills must also be taken into account.

A genetic counselor can help predict if you are likely to have a BRCA gene mutation associated with ovarian cancer. If you are high risk they may recommend genetic testing. If you test positive, you may consider taking the birth control pill to lower your risks. Research shows that premenopausal women with BRCA mutations who have their ovaries removed cut their risk of ovarian cancer by 85 to 95 percent. They also reduce their breast cancer risk factor by 50 to 60 percent. For more read about ovarian cancer prevention.

  Other Useful Guides

Recommended Health Screenings For Women: List for all ages.
The Female Body: How it works, visual guide with pictures.
Reproductive System Disorders: Vaginal discharges, bleeding, pain compared.

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