Ovarian Cancer
Services: Cancer
Ovarian Cancer
Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes.
Typically, treatment plans are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have surgery to remove the tumor.
Early cancers of the ovaries often cause no symptoms. Other, less severe conditions can also cause symptoms of ovarian cancer.
- About
What Is Ovarian Cancer?
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread.
Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes.
Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus.
The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor:
- Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
- Germ cell tumors start from the cells that produce the eggs (ova).
- Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
Some of these tumors are benign (non-cancerous) and never spread beyond the ovary. Malignant (cancerous) or borderline (low malignant potential) ovarian tumors can spread (metastasize) to other parts of the body and can be fatal.
- Symptoms
Signs and Symptoms of Ovarian Cancer:
Ovarian cancer may cause several signs and symptoms. Women are more likely to have symptoms if the disease has spread, but even early-stage ovarian cancer can cause them. The most common symptoms include:
- Bloating
- Pelvic or abdominal (belly) pain
- Trouble eating or feeling full quickly
- Urinary symptoms such as urgency (constantly feeling like you have to go) or frequency (having to go often)
These symptoms are also commonly caused by benign (non-cancerous) diseases and by cancers of other organs. When they are caused by ovarian cancer, they tend to be persistent and a change from normal − for example, they occur more often or are more severe. These symptoms are more likely to be caused by other conditions, and most of them occur just about as often in women who don’t have ovarian cancer. But if you have these symptoms more than 12 times a month, see your doctor so the problem can be found and treated if necessary.
Other symptoms of ovarian cancer can include:
- Fatigue (extreme tiredness)
- Upset stomach
- Back pain
- Pain during sex
- Constipation
- Changes in a woman’s period, such as heavier bleeding than normal or irregular bleeding
- Abdominal (belly) swelling with weight loss
- Diagnosis
See a doctor if you have symptoms.
Early cancers of the ovaries often cause no symptoms. Other, less severe conditions can also cause symptoms of ovarian cancer. When ovarian cancer is considered a possible cause of these symptoms, it has already spread. Also, some types of ovarian cancer can rapidly spread to nearby organs. Prompt attention to symptoms may improve the odds of early diagnosis and successful treatment. If you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks, report them to your health care professional.
Screening tests for ovarian cancer:
Screening tests and exams are used to detect a disease, like cancer, in people who don’t have any symptoms. (For example, a mammogram can often detect breast cancer in its earliest stage, even before a doctor can feel cancer.)
There has been a lot of research to develop a screening test for ovarian cancer, but there hasn’t been much success. The two tests used most often (in addition to a complete pelvic exam) to screen for ovarian cancer are transvaginal ultrasound (TVUS) and the CA-125 blood test.
TVUS (transvaginal ultrasound) tests sound waves to examine the uterus, fallopian tubes, and ovaries by putting an ultrasound wand into the vagina. It can help find a mass (tumor) in the ovary, but it can’t tell whether it is benign. When used for screening, most of the groups found are not cancer.
The CA-125 blood test measures the amount of a protein called CA-125 in the blood. Many women with ovarian cancer have high levels of CA-125. This test can be helpful as a tumor marker to help guide treatment in women with ovarian cancer because a high level often goes down if treatment is working. But checking CA-125 levels is not as valuable as a screening test for ovarian cancer. The problem with using this test for ovarian cancer screening is that high levels of CA-125 are more often caused by common conditions such as endometriosis and pelvic inflammatory disease. Also, not everyone who has ovarian cancer has an elevated CA-125 level. When someone not known to have ovarian cancer has an abnormal CA-125 level, the doctor might repeat the test (to make sure the result is correct) and consider ordering a transvaginal ultrasound test.
Better ways to screen for ovarian cancer are being researched, but currently, there are no reliable screening tests. Hopefully, improvements in screening tests will eventually lead to fewer deaths from ovarian cancer.
- Treatment
Common approaches:
Typically, treatment plans are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have surgery to remove the tumor. Depending on the type of ovarian cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.
Local treatments:
Some treatments are local, meaning they treat the tumor without affecting the rest of the body.
Types of local therapy used for ovarian cancer include:
- Surgery for Ovarian Cancer
- Radiation Therapy for Ovarian Cancer
Systemic treatments:
Drugs used to treat ovarian cancer are considered systemic therapies because they can reach cancer cells almost anywhere in the body. They can be given by mouth or put directly into the bloodstream.
Depending on the type of ovarian cancer, different types of drug treatment might be used, including:
- Chemotherapy for Ovarian Cancer
- Hormone Therapy for Ovarian Cancer
- Targeted Therapy for Ovarian Cancer
Your treatment plan will depend on many factors, including your overall health, personal preferences, and whether you plan to have children. Age alone isn’t a determining factor since several studies have shown that older women tolerate ovarian cancer treatments well.
It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also essential to ask questions if there’s anything you’re not sure about.
It is often a good idea to seek a second opinion if time permits. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.
What are BRCA1 and BRCA2 Genes?
BRCA1 and BRCA2 are tumor suppressor genes, which means that they keep cells from growing too rapidly. Everyone has these genes. Changes or mutations in these genes mean they do not work properly and cells can grow out of control, which can lead to cancer.
How much do BRCA mutations increase the risk of cancer?
The risk of breast cancer for the average American woman is about 12% in her lifetime. Having a BRCA mutation greatly increases the risk. The estimated risk of breast cancer in women with a BRCA mutation is 45–85% by age 70 years.
The risk of ovarian cancer for the average American woman is about 2% in her lifetime. The estimated risk of ovarian cancer in women with a BRCA1 mutation is 39–46% by age 70 years. For women with a BRCA2 mutation, the risk of ovarian cancer by age 70 years is 10–27%.
Women who have a BRCA mutation also have an increased risk of cancer of the fallopian tube, peritoneum, pancreas, and skin (melanoma). Men who have a BRCA mutation have an increased risk of cancer of the breast, prostate, and pancreas.
Why don’t doctors test everyone for BRCA mutations?
BRCA testing is only recommended for people with a high risk of having BRCA mutations. It is important to remember that most cases of breast and ovarian cancer are not caused by gene mutations. If there is a low chance of finding a BRCA mutation, your ob-gyn or other health care professional may not recommend genetic testing.
What is multigene panel testing?
Multigene panel testing is a type of genetic testing that looks for mutations in several genes at once. This is different from single-gene testing, which looks for a mutation in a specific gene. Single-gene testing is often used when a known gene mutation is already in a family. You may consider genetic testing if your personal or family history shows an increased cancer risk.
How can I prevent cancer if I test positive for a gene mutation?
If you test positive for a gene mutation, you can discuss cancer screening and prevention options with your ob-gyn, genetic counselor, or other healthcare professionals. It may be helpful to have earlier or more frequent cancer screening tests to find cancer at an early and more curable stage. Risk reduction steps like medication, surgery, and lifestyle changes also may be recommended.
If I have a gene mutation, should I tell my family?
Having a gene mutation means you can pass the mutation to your children. Your siblings also may have the gene mutation. Although you do not have to tell your family members, sharing the information could be life-saving. With this information, your family members can decide whether to be tested and get cancer screenings early.
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