About Ovarian Cancer

While it is the ninth most common cancer (other than skin cancer) in women, ovarian cancer ranks fifth in cancer deaths among women. Most women who develop ovarian cancer are over the age of 60, and it is found more often in white women than in African-American women.

Ovarian cancer is a disease in which, depending on the type and stage of the disease, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

Cancer Basics

Cancer develops when abnormal cells in a part of the body (in this case, the ovary) begin to grow uncontrollably. This abnormal cell growth is common among all cancer types.

Normally, cells in your body divide and form new cells to replace worn out or dying cells, and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to create new abnormal cells, forming a tumor. Tumors can put pressure on other organs near the ovaries.

Cancer cells can sometimes travel to other parts of the body, where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells move into the bloodstream or lymph system of the body. Cancer cells that spread from other organ sites (such as breast or colon) to the ovary are not considered ovarian cancer. Cancer type is determined by the original site of the malignancy.

Types of Ovarian Cancer

Some tumors found in the ovaries are benign (not cancer) and do not spread beyond the ovary. Others are malignant (cancer) and can spread to other parts of the body.

There are many types of ovarian cancer. Some types of ovarian cancer are extremely rare and require specialized treatment. The main types, which are listed below, are named for the cells where they start.

  • Epithelial ovarian cancer: About 90% of ovarian cancers start in the epithelium tissue, which is the lining on the outside of the ovary. This type of ovarian cancer is divided into serous, mucinous, endometrioid, clear cell, transitional and undifferentiated types. The risk of epithelial ovarian cancer increases with age, especially after the age of 50.
  • Germ cell ovarian cancer: Germ cell tumors account for about 5% of ovarian cancers. They begin in the egg-producing cells. This type of ovarian cancer can occur in women of any age, but about 80% are found in women under the age of 30. The main subtypes are teratoma, dysgerminoma, endodermal sinus tumor and choriocarcinoma.
  • Stromal ovarian cancer: These tumors, about 5% of ovarian cancers, grow in the connective tissue that holds the ovary together and makes estrogen and progesterone. Most are found in older women, but sometimes they occur in girls.

Stromal tumors usually do not spread as fast as other ovarian tumors. Sub-types include granulosa, granulosa-theca and Sertoli-Leydig cell tumors.

  • Primary peritoneal ovarian cancer is a rare cancer. It has cells like those on the outside of the ovaries, but it starts in the lining of the pelvis and abdomen. Women can get this type of cancer even after their ovaries have been removed. Symptoms and treatment are similar to epithelial ovarian cancer. Fallopian tube cancer is also a rare cancer. It starts in the fallopian tube and acts like epithelial ovarian cancer. Symptoms and treatment are similar to ovarian cancer.

Ovarian Cancer Symptoms

Ovarian cancer is difficult to detect, especially in the early stages. This is partly due to the fact that the ovaries are deep within the abdominal cavity.

Ovarian cancer may cause one or more of these signs and symptoms:

  • Vaginal bleeding (particularly if you are past menopause) or discharge from your vagina that is not normal for you.
  • Pain or pressure in the pelvic or abdominal area (the area below your stomach and in between your hip bones).
  • Back pain.
  • Bloating, which is when the area below your stomach swells or feels full.
  • Feeling full too quickly or difficulty eating.
  • A change in your bathroom habits, such as more frequent or urgent need to urinate and/or constipation.

Pay attention to your body, and know what is normal for you. If you have vaginal bleeding that is not normal for you, see a doctor right away. If you have any of the other signs for two weeks or longer, see a doctor. These symptoms may be caused by something other than cancer, but the only way to know is to see your doctor. Treatment is most effective when ovarian cancer is found and treated early.

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected.

Ovarian Cancer Screening

Screening Tests

You are considered high risk if you have:

  • BRCA1 or BRCA2 gene
  • Hereditary breast ovarian cancer syndrome
  • Hereditary non-polyposis colorectal cancer (HNPCC), also called Lynch syndrome
  • BRIP1, RAP51C, or RAD51D gene

There is no simple and reliable way to test for ovarian cancer in women who do not have any signs or symptoms. The Pap test does not screen for ovarian cancer. The only cancer the Pap test screens for is cervical cancer.

However, here are steps you can take:

  • Pay attention to your body, and know what is normal for you.
  • If you notice any changes in your body that are not normal for you and could be a sign of ovarian cancer, talk to your doctor and ask about possible causes, such as ovarian cancer.
  • Ask your doctor if you should have a test, such as a rectovaginal pelvic exam, a transvaginal ultrasound, or a CA-125 blood test if:
    • You have any unexplained signs or symptoms of ovarian cancer. These tests sometimes help find or rule out ovarian cancer.
    • You have had breast, uterine, or colorectal cancer; or a close relative has had ovarian cancer.

Ovarian Cancer Treatment Surgery

If you are diagnosed with ovarian cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:

  • The stage of the cancer
  • The size of the tumor after surgery (debulking)
  • Your desire to have children
  • Your age and overall health

One or more of the following therapies may be recommended to treat ovarian cancer or help relieve symptoms.

Surgery

  • Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.
  • Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals.

Surgical Specialists

Chemotherapy

  • Before treatment begins, it is important to understand how chemotherapy works. Chemotherapy is the treatment of cancer using chemicals designed to destroy cancer cells or stop them from growing. The goal of chemotherapy is to cure cancer, shrink tumors prior to surgery or radiation therapy, destroy cells that might have spread, or control tumor growth.

IVOP/OCC

Radiation

  • Radiation therapy uses high-­energy X­-rays to kill cancer cells and shrink tumors. Please note that this therapy is rarely used in the treatment of ovarian cancer in the United States. It is more often used in other parts of the body where cancer has spread.

Radiation Onccology

Complementary Therapies

  • Some women with ovarian cancer turn toward the whole­body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and lessen side effects, such as fatigue, pain, and nausea.
  • Complementary therapies are diverse practices and products that are used along with conventional medicine. Many women have tried and benefited from the complementary therapies listed below. Speaking with other women, in addition to the healthcare team, can suggest the therapies that may be most helpful and appropriate for each woman’s lifestyle.

Integrative Therapy

Clinical Trials

  • Clinical trials are research studies designed to find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. Many women undergoing treatment for ovarian cancer choose to participate in clinical trials. Through participation in these trials, patients may receive access to new therapy options that are not available to women outside the clinical trial setting.

Clinical Trials

Your Ovarian Cancer Treatment Team

Understanding your diagnosis and treatment options is the first step in fighting ovarian cancer. At Frederick Regional Health System, we’re committed to providing you with a cancer treatment experience that is focused on you.

Learn more about your treatment team:

Resources: