Ovarian cancer refers to any cancerous growth that begins in the ovary.
Around 22,000 Americans receive a diagnosis of ovarian cancer yearly.
Risk factors for developing ovarian cancer include family history, older age, reproductive history, and obesity.
Treatment options include surgery, radiotherapy, and chemotherapy.
Pelvic pain can be a sign of ovarian cancer.
Most ovarian cancers start in the epithelium, or outer lining, of the ovary.
In the early stages, there may be few or no symptoms.
Using an injectible contraceptive hormone, depot medroxyprogesterone acetate (DMPA or Depo-Provera CI), especially for 3 years or more, reduces the risk further.
For this reason, women who are diagnosed with breast cancer and who test positive for the BRCA1 or BRCA2 gene may opt to have an oophorectomy as preventive therapy.
HRT slightly increases a women's risk of developing ovarian cancer. The risk appears to increase the longer the HRT continues, and returns to normal as soon as treatment stops.
Androgen therapy, such as the use of the drug, Danazol, may also increase the risk.
Having surgery on the reproductive organs appear to reduce the risk of ovarian cancer. In women who undergo tubal ligation, this may be reduced by up to two thirds. A hysterectomy may reduce the risk by one third.
If ovarian cancer is diagnosed, the next step is to identify its stage and grade.
The stage of a cancer refers to the cancer's spread.
There are different ways of staging cancer. The American Cancer Society uses a four-stage system.
A doctor will carry out a pelvic examination and check for any palpable abnormalities in the uterus or ovaries. They will also check the patient's medical history and family history.
Abdominal fluid aspiration: If the patient's abdomen is swollen, there may be a buildup of fluid, which can be examined by using a fine needle to remove some fluid through the abdomen.
Hysterectomy: The surgeon removes the uterus and any surrounding tissue that is affected. If only the uterus is removed, this is a partial hysterectomy. In premenopausal women, menopause will begin immediately after this procedure.
Lymph node dissection: The surgeon removes lymph nodes in the pelvis and near the aorta.
Chemotherapy is the use of certain medications to destroy cancer cells. Cytotoxic medication delivers drugs that are poisonous to cells. These drugs prevent the cancer cells from dividing and growing.
Chemotherapy is used to target cancer cells that surgery cannot or did not remove.
Treatment usually involves 3 to 6 chemotherapy sessions, or cycles. These will be given 3 to 4 weeks apart, to allow the body time to recover. If the cancer returns or begins to grow back again, chemotherapy may be given again to shrink it.
Newer medications can directly target specific pathways or functions in cancer cells. These medications include bevacizumab (Avastin) and olaparib (Lynparza).
Unlike traditional chemotherapy, these drugs limit damage to normal cells. This reduces common side effects.
Chemotherapy targets rapidly dividing cells. Unfortunately, healthy rapidly dividing cells, such as red and white blood cells, and hair follicles may also be affected.
The damaged healthy cells normally repair themselves rapidly after treatment is over, and the side effects soon disappear.
Followup tests, such as blood tests and imaging scans, will be carried out to determine how well the treatment is working.
If cancer is still present after chemotherapy treatment, doctors will switch to other treatments.
Hormone therapy (HT) may be added to the treatment plan in order to prevent estrogen from reaching the cancer cells.
Cutting off the supply of estrogen slows the growth of the cancer cells.
Radiation is less often used in ovarian cancer treatment. It may be used if there are small traces of cancer in the reproductive system, or to treat the symptoms of advanced cancer.
Successful treatment is possible, but it depends on the stage at which the cancer is diagnosed.
At stage I, the 5-year survival rate is 90 percent.
At stage II, it is 70 percent.
At stage III, it is 39 percent.
At stage IV, it is 17 percent.
For this reason, it is important to attend all recommended screening and to seek medical help as soon as any symptoms appear.
There are over 30 types of ovarian cancer, and they are defined by the type of cell in which they start.
Epithelial tumors: These grow in the cells lining the surface of the ovary. They are the most common and the most dangerous, occurring in 85 to 90 percent of woman with ovarian cancer.
Germ cell tumors: This type of tumor occurs in the cells that produce eggs for reproduction. They are often benign, and in the cases where they become cancerous, 90 percent can be cured.
Primary peritoneal carcinoma: This is similar to epithelial ovarian cancer, but it is not affected by the removal of the ovaries.
The type of ovarian cancer will shape a person's treatment, symptoms, and likelihood of survival.