Ovarian Cancer
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More InDepth Information on This Condition

Definition
Ovarian cancer is the growth of cancer cells in the ovaries. The ovaries make eggs for reproduction and female hormones. The most common type of ovarian cancer is epithelial.

Cancer occurs when cells in the body divide without control or order. If cells keep dividing uncontrollably, a mass of tissue forms. This is called a growth or tumor. The term cancer refers to malignant tumors. They can invade nearby tissue and spread to other parts of the body.

Germ cell tumors come from the reproductive tissue. They account for 20% of tumors. Stromal cancers are more rare. These come from the connective cells of the ovary. They typically make hormones that cause symptoms.

Cancerous Mass in the Left Ovary

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Causes
The causes of ovarian cancer are not known. However, research shows that certain risk factors are associated with the disease.

Risk Factors
Ovarian cancer is most common in women age 50 or older. Factors that may increase your chance of getting ovarian cancer include:

  • Family history of ovarian cancer, especially in mother, sister, or daughter
  • Menstrual history—first period before age 12, no childbirth or first childbirth after age 30, and late menopause
  • Personal history of breast cancer or endometrial cancer
  • Certain gene mutations, including BRCA1, BRCA2
  • Postmenopausal hormone replacement therapy
  • Polycystic ovary syndrome or obesity
  • Endometriosis
Use of birth control pills for more than five years appears to decrease the risk of getting ovarian cancer.

Symptoms
Many ovarian tumors grow to be very large without showing symptoms. Symptoms often only appear in the later stages. These tumors can also be hard to find during a physical exam. As a result, about 70% of patients are found with advanced disease.

Symptoms include:

  • Abdominal discomfort and/or pain
  • Gas, indigestion , pressure, swelling, bloating, or cramps
  • Nausea, diarrhea , constipation , or frequent urination
  • Loss of appetite
  • Feeling of fullness even after only a light meal
  • Unexplained weight gain or loss
  • Abnormal bleeding from the vagina
  • Hair growth, voice deepening, acne , loss of menstrual periods in some rare stromal tumors
Diagnosis
You will be asked about your symptoms and medical history. A physical exam and pelvic exam will be done.

Your bodily fluids and tissue may be tested. This can be done with:

Images may be taken of your bodily structures. This can be done with:

Treatment
Treatment depends on the extent of the cancer and your general health.

General Approach
If ovarian cancer is found, staging tests are done. They will help to find out if the cancer has spread and, if so, to what extent.

Surgery is often the first step. Afterwards, you may receive chemotherapy. Sometimes, radiation therapy of the abdomen is given.

Treatments include:

Surgery
The cancerous tumor and nearby tissue will be removed. Nearby lymph nodes may also be removed.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms including pill, injection, and via a catheter. The drugs enter the bloodstream. They travel through the body killing mostly cancer cells. Some healthy cells are killed as well.

Radiation Therapy (Radiotherapy)
This therapy uses radiation to kill cancer cells and shrink tumors. Radiation may be:

  • External radiation therapy—radiation directed at the abdomen from a source outside the body
  • Intra-abdominal P32—sometimes a radioactive solution may be introduced into the abdomen as part of treatment
Prevention
If you think you are at risk for ovarian cancer, talk to your doctor. Schedule check-ups with your doctor if needed. All women should have regular physical exams. These should include vaginal exams and palpation of the ovaries.

Genetic testing may help identify patients who should consider having surgery to remove both ovaries and the fallopian tubes. In some cases, it may prevent ovarian cancer in high-risk women.

Eating a low-fat diet that includes lots of fruits and vegetables may also reduce your risk of ovarian cancer. It is also important to maintain a healthy weight.




RESOURCES:
American Cancer Society

National Cancer Institute

CANADIAN RESOURCES:
Canadian Cancer Society

The Society of Obstetricians and Gynaecologists of Canada

References:
Detailed guide: ovarian cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/ovariancancer/detailedguide/index. Accessed January 6, 2014.

Ovarian cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 31, 2013. Accessed January 6, 2014.

Ovarian cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/ovarian. Accessed January 6, 2014.

9/18/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA clears a test for ovarian cancer. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm182057.htm. Published September 11, 2009. Accessed January 6, 2014.

Last Reviewed December 2013



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