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 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
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 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
- Most women with ovarian cancer will have surgery at some point during the
course of their disease, and each surgery has different goals.
- 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.
- 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.
- 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.
- 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
Your Ovarian Cancer Treatment Team
Understanding your diagnosis and treatment options is the first step in
fighting ovarian cancer. At Frederick Health, we’re committed to
providing you with a cancer treatment experience that is focused on you.
Learn more about your treatment team: