Ovarian Cancer

Reviewed on 12/19/2022
Ovarian Cancer
The survival rate of ovarian cancer depends on the type and stage of the cancer.

Ovarian cancer refers to an abnormal and uncontrolled growth of cells in the ovaries or related areas of the fallopian tubes and peritoneum, which may invade nearby tissues or spread throughout the body.

Tumors that do not spread to other parts of the body are called benign tumors or masses, whereas tumors that spread beyond the point of origin to other parts or invade nearby tissues are called malignant tumors.

3 Types of Ovarian Cancer

Ovaries are made of three types of cells, which can develop into three different types of tumors:

  1. Epithelial ovarian tumor: The most common type of ovarian cancer (about 90 percent of cases) that forms in the outer layer of tissue on the ovaries. It has the following subtypes:
    • Serous
    • Endometrioid
    • Clear cell
    • Mucinous
  2. Stromal cell tumor: A rare type (eight percent or less) that grows in the hormone-producing (estrogen and progesterone) cells.
  3. Germ cell tumor: A rare type of ovarian cancer (approximately four percent of cases) that develops in egg-producing cells.

What Causes Ovarian Cancer?

The exact cause of ovarian cancer is still unknown, but researchers have identified factors that can increase the risk of the disease, such as:

  • Familial history of ovarian cancer
  • Genetic mutations (in BRCA1 or BRCA2 genes)
  • Personal history of breast, uterine, or colon cancer
  • Advanced age (common in women in the age group of 50 to 60 years)
  • Obesity
  • Smoking
  • Endometriosis (a condition wherein the lining of the uterus grows outside the uterus)
  • Use of certain fertility drugs or hormone therapies (long-term use of estrogen hormone replacement therapy)
  • Nulliparous women (who have no history of pregnancy) or those who have never carried a pregnancy to term
  • Conception after the age of 35 years
  • Lynch syndrome (a disorder that runs through families associated with a genetic predisposition to different cancers)

What Are the Symptoms of Ovarian Cancer?

The symptoms of ovarian cancer are persistent and may worsen with time.

Some of the earliest symptoms may include:

  • Abdominal bloating, pressure, discomfort, or pain
  • Pelvic discomfort
  • Early satiety (feeling full quickly after eating)
  • Poor appetite
  • Increase frequency and urgency of urination

Some of the late symptoms may include:

SLIDESHOW

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How is Ovarian Cancer Staged?

According to the International Federation of Gynecologists and Obstetricians system, ovarian cancer is staged into four groups:

  1. Stage I
    • Stage IA: Cancer localized to one of the ovaries.
    • Stage IB: Cancer in both ovaries.
    • Stage IC: Cancer cells have migrated outside of the ovary.
  2. Stage II
    • Stage IIA: Cancer has spread to the nearby organs, such as the uterus or fallopian tubes.
    • Stage IIB: Cancer has spread to other organs, such as the bladder or rectum.
  3. Stage III
    • Stage IIIA: Cancer has spread beyond the pelvis to the lining of the abdomen or abdominal lymph nodes.
    • Stage IIIB: Cancer has spread beyond the pelvis to the lining of the abdomen, but the tumor measures less than 2 cm in diameter.
    • Stage IIIC: Cancer has spread outside the spleen or liver and the tumor measures more than 2 cm in diameter.
  4. Stage IV
    • Stage IVA: Cancer cells are found in the fluid around the lungs, causing malignant pleural effusion.
    • Stage IVB: Cancer cells have spread to other distant organs, such as the skin or brain.

How is Ovarian Cancer Diagnosed?

Because there is no simple and reliable way to screen ovarian cancer, it is important to recognize warning signs.

To detect ovarian cancer early, the doctor may recommend certain tests, such as:

  • Pelvic examination: A pelvic examination is performed by the doctor to palpate the tumor. 
  • Biopsy: A tissue sample from the tumor is obtained and checked under a microscope to confirm the diagnosis.
  • Screening tests:
    • Transvaginal ultrasound: The uterus, fallopian tubes, and ovaries are analyzed using sound waves.
    • CA-125 blood test: The amount of a protein called CA-125 in the blood (found on the surface of ovarian cancer cells) is measured.
  • Imaging scans:
    • CT scan: X-rays are used to create a detailed picture of the inside of the body.
    • Positron emission tomography scan: A specialized imaging test that uses a radioactive substance (tracer) to evaluate the spread of cancer in the body.
    • MRI scan: Detailed pictures of the inside of the body are created by using a powerful magnet and radio waves.

How is Ovarian Cancer Treated?

The treatment of ovarian cancer usually includes:

  • Surgery:
    • Unilateral or bilateral salpingo-oophorectomy: Removal of one or both ovaries surgically.
    • Total hysterectomy and bilateral salpingo-oophorectomy: Surgical removal of ovaries along with the uterus.
  • Chemotherapy: A drug treatment that uses chemicals to kill fast-growing cancerous cells in the body.
  • Targeted therapy: Specific cancer cells are identified and attacked.
  • Hormonal therapy: This therapy uses drugs to block the effects of the hormone estrogen on ovarian cancer cells.
  • Immunotherapy: The immune system is activated using substances made by the body or in a laboratory to fight cancer.
  • Radiation therapy: It is used to treat ovarian cancer that has spread to the pelvis or other parts of the body.
  • Palliative care: It includes specialized medical care that provides relief from pain and other symptoms of a serious condition.

What is the Survival Rate of Ovarian Cancer?

Table 1: The survival rate of different ovarian cancers
Type of ovarian cancer Stage 5-year relative survival rate (in percent)
Epithelial ovarian cancer Localized 93
Regional 75
Distant 31
All stages combined 49
Stromal tumors Localized 97
Regional 90
Distant 70
All stages combined 90
Germ cell tumors Localized 98
Regional 94
Distant 74
All stages combined 93

What Are the Complications of Ovarian Cancer?

 Ovarian cancer may complicate into:

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Ovarian Cancer Symptoms and Signs

The only early symptom of the disease can be menstrual irregularity. Symptoms that come later include the following:

  • Pelvic pain or pressure
  • Pain with intercourse
  • Abdominal swelling and bloating
  • Urinary frequency
  • Constipation
  • Ascites: Collection of fluid in the abdomen, contributing to abdominal distension and shortness of breath
  • Loss of appetite
  • Feeling full after eating little
  • Gas and/or diarrhea
  • Nausea and vomiting
  • Abnormalities in menstruation, pubertal development, and abnormal hair growth (with tumors that secrete hormones)
Reviewed on 12/19/2022
References
Image Source: iStock image

All About Ovarian Cancer. OncoLink: https://www.oncolink.org/cancers/gynecologic/ovarian-cancer/all-about-ovarian-cancer

Ovarian Cancer. Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941

Ovarian Cancer. Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

About Ovarian Cancer. OCRA: https://ocrahope.org/patients/about-ovarian-cancer/#common-symptoms-of-ovarian-cancer

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