Ovarian cancer

Ovarian cancer is cancer of the ovaries and fallopian tubes. These are parts of a woman’s reproductive system. Ovaries are where the female body makes and stores eggs. Ovaries also make female hormones. Fallopian tubes carry an egg from the ovary to the uterus. The body has two ovaries and two fallopian tubes, one on each side of the uterus.

There are three main types of ovarian cancer.

• Cancer that starts in the cells that cover the outside of the ovary is called epithelial cancer. This cancer may start near the end of the fallopian tube near to the ovary. It can also start in the lining of the abdomen (belly). This tissue is called the peritoneum.
• Ovarian germ cell tumor is a rare type of ovarian cancer that tends to affect young women. This cancer develops inside the ovary in the cells that make eggs.
• Another rare ovarian cancer is a stromal tumor. Stromal tumors start in the cells that form the structure of the ovaries and release hormones such as estrogen and progesterone.

There is no known way to prevent ovarian cancer. Some factors that may lower your risk of ovarian cancer include:

• Taking birth control pills
• Giving birth (risk goes down with each pregnancy)
• Breastfeeding, especially for those who breastfeed at least eight to ten months
• Having your tubes tied (tubal ligation )Surgically removing the Fallopian tubes

National Cancer Institute
Ovarian Cancer Research
American Cancer Society

Symptoms

Ovarian cancer doesn’t always cause symptoms in its earliest stages. When symptoms do occur, they include:

• Bloating or feeling full
• Getting full quickly or not being able to eat much at a time
• Pain in the pelvis or lower abdomen (belly)
• Feeling like you have to pee more than usual
• Vaginal bleeding that is heavy or happens when it is not expected, especially after menopause

These symptoms can happen for other reasons, too. But if they don’t go away and are a noticeable change from the way you usually feel, contact your doctor.

Causes

Risk Factors

The cause of ovarian cancer is not yet certain. But some things affect the chances of developing ovarian cancer.

These factors can increase your risk of ovarian cancer:

• Age. Most cases of ovarian cancer happen in women after menopause.
• Family history or breast, ovarian, or colorectal cancer. The risk of ovarian cancer is greater for women who have a parent or sibling who has had ovarian cancer. Women who inherited a mutation (change) in the genes BRCA1 and BRCA2 have a greater risk of ovarian and breast cancers.
• Inherited gene mutations. Women who have the BRCA1 and BRCA2 genes, as well as some others, have a greater risk of ovarian cancer.
• Hormone replacement therapy. Women who take estrogen or progesterone therapy after menopause are at slightly greater risk for developing ovarian cancer.
• Obesity. Women who have a BMI (body mass index) of 30 or higher have a greater risk of ovarian cancer.
• History of endometriosis. Endometriosis [en-doh-mee-tree-OH-sis] occurs when tissue that normally lines the inside of the uterus grows outside the uterus.

Diagnosis and Tests

There are several screening tests for ovarian cancer. So far, none of them has been shown to reduce the chance of dying from the disease.

• Pelvic exam. This is part of a woman’s regular gynecologic exam. The doctor feels the shape of the uterus and ovaries by putting one or two gloved fingers into the vagina. The doctor will also feel the outside of your abdomen (belly).
• Transvaginal ultrasound. The doctor puts an ultrasound probe (like a wand) into the vagina. The ultrasound wand uses sound waves to make pictures of the uterus, ovaries, and fallopian tubes so the doctor can see if a tumor or other problems exist.
• CA-125 assay. This is a blood test to check for how much CA-125 is in your blood. CA-125 is a substance released into the bloodstream by ovarian cancer cells. Having a higher level of CA-125 can sometimes be a sign of some cancers, including ovarian cancer.

If the doctor suspects ovarian cancer, some additional tests may be used to confirm the diagnosis.

• Abdominal ultrasound. This ultrasound is done on the outside of your abdomen. The sound waves make a picture of the organs inside your abdomen. It is used to find a tumor.
• CT scan. This scan uses x-rays and a computer to make pictures of the inside of your body. You may be asked to drink a liquid or get an injection with a dye before the CT scan to make the images clearer.
• MRI. This test makes pictures of the inside of the body by using a magnet and radio waves.
• PET scan. You are given glucose (sugar drink) mixed with a small amount of radioactive material. Since cancer cells use glucose faster than other cells, the scanner can better detect them.
• Biopsy. If any of the scans or images show a tumor, the doctor will remove some or all of the tumor. Pieces of the tumor are examined under a microscope to see if it is cancerous.

Treatment depends on the type of ovarian cancer you have and how much it has spread. For the most common type of ovarian cancer, ovarian epithelial, these treatments are used:

• Surgery to remove the tumor and all or part of the organs involved. This may include one or both ovaries and fallopian tubes. It may also include lymph nodes.
• Chemotherapy to stop the cancer cells from growing. Chemotherapy may be delivered straight to the abdomen where the cancer is. Or it may go throughout the whole body if the cancer has spread.
• Targeted therapy to attack specific cancer cells and causing less harm to healthy cells.