Ovarian Cancer

What are the ovaries?

The ovaries are female reproductive organs located in the pelvis. There are two of them, one on each side of the uterus. The ovaries produce eggs and the female hormones estrogen and progesterone. Estrogen and progesterone control the development of female body characteristics (i.e., breasts, body shape and body hair), and regulate the menstrual cycle and pregnancy.

What is ovarian cancer?

Ovarian cancer is a disease in which malignant cells are found in an ovary. There are three types of ovarian tumors, named for the tissue in which they are found:

epithelial cell - cells that cover the surface of the ovary

Most of these tumors are benign. However, epithelial ovarian cancer accounts for 85 to 90 percent of ovarian cancer cases.
germ cell - cells that form the eggs in the ovary
stromal cell - cells that form the ovary and produce female hormones

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.

Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop cancer, while others develop cancer and have no known risk factors.

But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What causes ovarian cancer?

The cause of ovarian cancer is not yet known. An estimated 22,220 new cases of ovarian cancer are expected in the US in 2005. Ovarian cancer accounts for nearly 4 percent of all cancers among women and ranks second among gynecologic cancers.

What are risk factors for ovarian cancer?

The cause of ovarian cancer is unknown, but there are certain risk factors that indicate an increase in a woman's chance of developing ovarian cancer. The following have been suggested as risk factors for ovarian cancer:

early menarche - starting monthly periods early - before the age of 12
late menopause (after the age of 52)
age-over the age of 50
hormone replacement therapy
Some studies have suggested that women who use hormone replacement therapy after menopause may have a slightly increased risk of ovarian cancer.
infertility (inability to become pregnant)
having a first child after the age of 30
personal history of breast or colon cancer
family history
First-degree relatives (such as mother, daughter, sister) of a woman who has had ovarian cancer are at a risk for developing the disease. The risk increases if two or more first-degree relatives have had ovarian cancer. A family history of breast or colon cancer is also associated with an increased risk of developing ovarian cancer.
fertility drugs

How can ovarian cancer be prevented?

Suggested preventive measures include a:

healthy diet (high in fruits, vegetables, grains, and low in saturated fat)
birth control pills
pregnancy and breast feeding
hysterectomy
tubal ligation
removal of ovaries

What are the symptoms of ovarian cancer?

The following are the most common symptoms of ovarian cancer. However, each individual may experience symptoms differently. Symptoms may include:

general discomfort in the lower abdomen, including any/all of the following:
- feeling swollen or bloated
- a loss of appetite or a feeling of fullness - even after a light meal
- gas, indigestion, and nausea
weight loss
diarrhea or constipation, or frequent urination caused by the growing tumor, which may press on nearby organs, such as the bowel or bladder
bleeding from the vagina
build up of fluid around the lungs, which may cause shortness of breath

In many cases, symptoms may be so vague that they are easily ignored. The symptoms of ovarian cancer may resemble other conditions or medical problems. Consult a physician for diagnosis.

How is ovarian cancer diagnosed?

Diagnosis includes a medical history and physical exam, including a pelvic exam to feel the vagina, rectum, and lower abdomen for masses or growths. A Pap test may be requested as part of the pelvic exam. The physician may also order other tests, including:

ultrasound - an imaging technique that uses sound waves to produce an image on a monitor of the abdominal organs, such as the uterus, liver, and kidneys.
computed tomography (CT or CAT scan) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray. The CT scan may indicate enlarged lymph nodes - a possible sign of a spreading cancer or of an infection.
lower gastrointestinal (GI) series - x-rays of the colon and rectum using a contrast dye called barium.
intravenous pyelogram (IVP) - x-ray of the kidneys and ureters, taken after the injection of a dye.
blood test - to measure a substance in the blood called CA-125 - a tumor marker. This test is more often used to monitor the progress of treatment than as a screening test since non-cancer problems can cause it to be elevated.
biopsy - removal of sample of tissue via a hollow needle or scalpel.

Treatment for ovarian cancer:

Specific treatment for ovarian cancer will be determined by your physician based on:

your overall health and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Ovarian cancer may be treated with surgery, chemotherapy, radiation therapy, or a combination of treatments.

surgery
Surgery for ovarian cancer may include:
- salpingo-oophorectomy - surgery to remove the fallopian tubes and ovaries.
- hysterectomy - surgical removal of the uterus.
- pelvic lymph node dissection - removal of some lymph nodes from the pelvis.
chemotherapy - the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual.
radiation therapy - the use of high-energy radiation to kill cancer cells and to shrink tumors. There are two ways to deliver radiation therapy, including the following:
- external radiation (external beam therapy) - a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
- internal radiation (brachytherapy, implant radiation) - radiation is given inside the body as close to the cancer as possible. In some cases, a treatment called intraperitoneal radiation therapy is used. A radioactive liquid is given through a catheter into the abdomen.

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