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Understanding Ovarian Cancer

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Women First Health Center

Drs. Sylvester, Lo, Youngren and Sansobrino

Created by: Megan Blomeyer, St. George’s University, MS-IV

woman image

Image courtesy of: The Los Angeles Post. <www.losangelespost.org>.

Ovarian cancer is a disease that affects one or both of the ovaries, the glands that are found on either side of the uterus. The ovaries contain eggs, which are released during ovulation and produce hormones. Ovarian cancer is the fifth leading cause of cancer deaths in women with about 14, 270 women dying from ovarian cancer each year. Cancer develops when old cells become damaged or do not die as they are designed to do. Normally, the body can compensate by killing or repairing these cells, but if something goes wrong, these “bad” cells can grow out of control. This excessive growth causes a tumor to form.

vag

Image courtesy of: The Reed Group.  <http://www.mdguidelines.com/cancer-ovary>.

 

Types:

There are three types of ovarian cancer that can be defined by examining a segment of the ovary under a microscope. These three types are described below.

 

  1. Epithelial cell cancer
    1. Epithelial cells are the cells that cover the surface of the ovary
    2. 85-90% of ovarian cancers are this subtype
    3. Long term prognosis is dismal
    4. Germ cell cancer
      1. Germ cells are the cells in the ovary that develop into eggs
      2. More common in younger women
      3. High cure rate
      4. Stromal cell cancer
        1. Stromal cell cancer occurs in the internal structure or connective tissue of the ovary
        2. High cure rate

 

Risk Factors:

Risk factors for ovarian cancer include the following:

 

  1. Family history of breast, ovarian, colon or endometrial (the lining of the uterus) cancer
  2. Age greater than 55 years
  3. Personal history of breast cancer
  4. Never having had children
  5. Infertility
  6. Endometriosis-a condition in which tissue similar to the normal lining of the uterus is found outside the uterus on the ovaries, fallopian tubes or other pelvic structures
  7. BRCA1 and/or BRCA2 gene mutation
  8. Early age of onset of menstruation
  9. Late age of onset of menopause
  10. Cigarette smoking

 

Protective Factors:

Factors that have been shown to protect against ovarian cancer are:

  1. Oral contraceptive use
  2. Pregnancy
  3. Breast feeding
  4. Removal of the uterus and/or ovaries and fallopian tubes before cancer development
  5. Having your tubes “tied”
  6. Healthy lifestyle choices such as eating vegetables and whole grains and exercising regularly may reduce your risk, however studies are inconsistent

 

Symptoms:

The American College of Obstetricians and Gynecologists states that most women with ovarian cancer have new and persistent symptoms that have been present for several months to more than one year prior to diagnosis. This delay can be due to the nonspecific nature of the symptoms causing women to postpone a visit to their physician or these symptoms being diagnosed as another illness. Common symptoms of ovarian cancer are as follows:

 

  1. Bloating or an increase in abdominal size
  2. Pelvic or abdominal pain
  3. Difficulty eating or feeling full quickly
  4. Increased urgency and/or frequency of urination
  5. Unintentional excessive weight loss
  6. Night sweats
  7. Feeling tired all the time, back pain, indigestion, constipation

 

Screening:

A pelvic exam can sometimes detect problems with the ovaries, but at this time, an effective screening test has not been developed.  A trans-vaginal ultrasound to look for changes in the ovaries and measuring CA-125 levels, which is elevated in the blood of some women with ovarian cancer, may be recommended in women at high risk of developing ovarian cancer. CA-125 is not specific to ovarian cancer and can also be elevated in other cancers.

 

Diagnosis:

Imaging such as a trans-vaginal ultrasound or measuring the CA-125 level in your blood may be used to detect ovarian cancer. The only way to definitely diagnosis ovarian cancer is through a biopsy. A biopsy is a surgical procedure where a small sample of ovarian tissue is removed and examined under the microscope for signs of cancer. Other tests such as a colonoscopy, chest x-ray and/or imaging of the abdomen may be used to determine if the cancer has spread to other parts of the body.

 

Treatment:

Treatment for ovarian cancer is based on multiple factors such as the type of ovarian cancer, the size of the tumor and degree to which the cancer has spread beyond the ovary.  Usually, surgical removal of the uterus, ovaries and fallopian tubes is performed.  Chemotherapy, the use of drugs to kill cancer cells, may also be used.

 

Ovarian cancer is responsible for over 10,000 deaths each year. Knowing the risk factors and symptoms of ovarian cancer are vital to early detection, which may save your life.

 

For more information or if you have any questions regarding ovarian cancer or other health related issues, please contact your doctor.

 

References:

American Cancer Society.  “What are the key statistics about ovarian cancer?” 21

March 2013. Accessed 19 March 2014.<http://www.cancer.org/cancer/ ovariancancer/detailedguide/ovarian-cancer-key-statistics>.

 

The American College of Obstetricians and Gynecologists. “Frequently Asked

Questions: Cancer of the Ovary.” August 2011. Accessed 19 March 2014.

<http://www.acog.org/~/media/For%20Patients/faq096.pdf?dmc=1&ts=20140319T1322464836>.

 

The American College of Obstetricians and Gynecologists. “Focus on Female Cancers:

Ovarian Cancer.” June 2009. Accessed 19 March 2014. <http://mail.ny.acog.org/website/OvarianCa.pdf>.

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