Ovarian Cancer and Prognosis
Ovarian cancer is a type of cancer that begins in the ovaries. The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone
Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.
Surgery and chemotherapy are generally used to treat ovarian cancer.
Ovarian cancer facts
- Ovarian cancer is a relatively uncommon type of cancer that arises from different types of cells within the ovary.
- The most common ovarian cancers are known as epithelial ovarian cancers (EOC) or ovarian carcinoma.
- Other types of ovarian cancer include ovarian low malignant potential tumor (OLMPT), germ cell tumors, and sex cord-stromal tumors like the granulosa-stromal tumors and Sertoli-Leydig cell tumors.
- Inherited mutations in the BRCA1 and BRCA2 genes greatly increase a woman's ovarian cancer risk as well as breast cancer risk.
- A gynecologic oncologist is a specialist with expertise in the management of ovarian cancer.
- Most ovarian cancers are diagnosed in advanced stages because there are no reliable early symptoms and signs of ovarian cancer. Even in more advanced tumors, symptoms and signs are vague and nonspecific.
- There are no reliable screening tests for ovarian cancer.
- Treatment of ovarian cancer involves surgery to remove as much of the tumor as possible and chemotherapy.
Types of ovarian cancer
- Epithelial tumors: which begin in the thin layer of tissue that covers the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors.
- Stromal tumors: which begin in the ovarian tissue that contains hormone-producing cells. These tumors are usually diagnosed at an earlier stage than other ovarian tumors. About 7 percent of ovarian tumors are stromal.
- Germ cell tumors: which begin in the egg-producing cells. These rare ovarian cancers tend to occur in younger women.
How is ovarian cancer staging determined?
- Stage 1: Limited to one or both ovaries
- Stage 2: Limited to the pelvis
- Stage 3: Disease outside of the pelvis, but limited to the abdomen, or lymph node involvement, but not including the inside of the liver
- Stage 4: Disease spread to the liver or outside of the abdomen
Risk factors
- Older age: Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
- Inherited gene mutations: A small percentage of ovarian cancers are caused by gene mutations you inherit from your parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer.
- Other gene mutations, including those associated with Lynch syndrome, are known to increase the risk of ovarian cancer.
- Family history of ovarian cancer: People with two or more close relatives with ovarian cancer have an increased risk of the disease.
- Estrogen hormone replacement therapy, especially with long-term use and in large doses.
- Age when menstruation started and ended: Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer.
Prevention
- Consider taking birth control pills. Ask your doctor whether birth control pills may be right for you. Women who use oral contraceptives may have a reduced risk of ovarian cancer. But oral contraceptives do have risks, so discuss whether the benefits outweigh those risks based on your situation.
- Discuss your risk factors with your doctor. If you have a family history of breast and ovarian cancers, bring this up with your doctor. Your doctor can determine what this may mean for your own risk of cancer. In some cases, your doctor may refer you to a genetic counselor who can help you decide whether genetic testing may be right for you. If you're found to have a gene mutation that increases your risk of ovarian cancer, you may consider surgery to remove your ovaries to prevent cancer