Learning more about Ovarian Cancer

From prevention to cure

If you have been diagnosed with ovarian cancer or if you face an increased risk, it's common to feel overwhelmed and afraid. But many types of ovarian cancer can be cured if treated early. Our mission is to help you overcome your fears and conquer cancer, by understanding how this disease is detected, diagnosed and treated.

What is ovarian cancer?

The ovaries are a pair of female reproductive organs. One ovary sits on each side of the uterus, in the pelvis, and produces eggs and hormones.

Each ovary is made of three kinds of cells. Cancer occurs if abnormal cells grow out of control. These cells can create a mass of tissue, called a tumor.

Types of ovarian cancer

Tumors can develop from any of the three types of cells found in the ovaries:

Epithelial cell tumors: Most ovarian cancers begin in epithelial cells, which cover the outer surface of the ovary. This is also the most dangerous type of ovarian cancer, as many women are not diagnosed until the disease is at an advanced stage.

Germ cell tumors: Germ cells, which develop into eggs, also can be cancerous. Germ cell tumors are more common in teenagers and women in their 20s. Most women today can be cured and are still able to become pregnant after treatment.

Stromal tumors: Cancer also can begin in the cells of the stroma - the tissue that produces hormones and gives the ovary structure. Stromal tumors are rare, and have a high cure rate, as most women are diagnosed when the cancer has not spread beyond the ovaries.

Non-cancerous growths

It's important to know that not all ovarian growths are malignant (cancerous). Benign (non-cancerous) ovarian tumors usually grow slowly and rarely become cancerous. Most do not cause any symptoms, but can cause pain or a feeling of heaviness in the pelvis.

Non-cancerous conditions include:

Functional cysts: These fluid-filled sacs form in or on an ovary. They are fairly common and sometimes disappear on their own.

Benign epithelial tumors: Most epithelial tumors are not cancerous, do not spread to other parts of the body and usually don’t cause serious problems.

Cystadenomas: These fluid-filled cysts develop from the surface of the ovary and contain some tissue from glands in the ovaries.

Borderline tumors (or tumors of low malignant potential): When seen through a microscope or ultrasound scan, these masses, which form in the tissue that covers the ovaries, look like cancerous epithelial tumors. To get an accurate diagnosis, your doctor will take a sample, called a biopsy. But borderline tumors rarely become cancerous. They grow slowly and most are diagnosed at an early stage, when the abnormal cells are still limited to the ovary.

Dermoid cysts: Also called benign cystic teratomas, these tumors can develop from germ cells - the cells that produce eggs.

Fibromas: Fibromas are benign, slow-growing, solid masses made of connective tissue.

Endometriomas: These benign cysts can develop because of endometriosis - a condition in which tissue abnormally grows outside of the uterus. If this tissue attaches to the ovary, it can form a growth.

Calculating your Risk

While many women diagnosed with ovarian cancer do not have any known risk factors, your risk is higher if you:
• Have been diagnosed with another type of cancer, including breast, uterine, colon or rectal
• Have a mother, daughter or sister who has been diagnosed with ovarian, breast, uterine, colon or rectal cancer
• Have an inherited gene mutation that increases your risk of breast or colon cancer
• Are 55 or older or have gone through menopause
• Began menstruating before age 12 or entered menopause late, after age 52
• Have never given birth
• Have taken hormones after menopause that contain estrogen, but not progesterone, for 10 years or more
• Smoke
• Had fertility treatments
• Diagnosed with polycystic ovary syndrome

Symptoms

Many symptoms of ovarian cancer can be mistaken as signs of less-threatening conditions:
• Increased gas, bloating, long-term stomach pain or feelings of indigestion
• Ongoing swelling in the abdomen (belly)
• Increased pressure or pain in the pelvis, abdomen, back or legs
• Loss of appetite and unexpected weight loss or gain
• Shortness of breath

Prevention

While you can't control some risk factors for ovarian cancer, you can take precautions to lower your risk and increase your chance of detecting cancer early:
• Get annual pelvic exams.
• See your doctor right away if you experience any symptoms of ovarian cancer.
• If you have an increased risk for ovarian cancer, talk to your doctor about screening tests.
• Before beginning hormone replacement therapy, talk to your doctor about your risk for ovarian cancer.

Diagnosis

To check for ovarian cancer, your doctor may perform a pelvic exam or blood test. If your doctor suspects you have ovarian cancer, a minimally invasive surgery may be done to collect a sample of tissue and abdominal fluid.

Staging

If cancer is found, your doctor will perform tests to determine the "stage" of the disease. This is based on the size of the tumor, if it has affected nearby organs or tissue, and if the cancer has spread to other areas in the body, including the lymph nodes. Surgery often is required to determine the stage.

Stages include:
Stage I: Cancer is limited to one or both ovaries
Stage II: Cancer has spread to other parts of the pelvis
Stage III: Cancer has spread to the abdomen
Stage IV: Cancer has spread beyond the abdomen

Treatment

Treatment options for ovarian cancer depend on several factors, including:
• The stage of the disease
• Your overall health and age
• Your personal preferences

Treatment usually involves a combination of surgery and chemotherapy.

Surgery

Surgery is the most common method for treating ovarian cancer, and doctors often can remove the tumor during the diagnostic surgery, if cancer is found.

Surgery aims to remove as much of the tumor as possible. If the cancer is not at an advanced stage, surgery could be limited to removing just one ovary and fallopian tube, which can allow a woman to still become pregnant. In more advanced stages, both ovaries and fallopian tubes, the uterus, nearby lymph nodes and abdominal tissue might also have to be removed. This means that a woman can no longer become pregnant. Without ovaries, the body will not produce estrogen and progesterone, which will cause a woman to go into menopause.

Chemotherapy

Chemotherapy drugs are used to kill cancer cells or stop them from growing, and can be injected directly into the abdomen or into a vein. Most women undergo chemotherapy following surgery, but this sometimes is the first course of treatment for women with advanced ovarian cancer.

Mercy Health — Gynecological Oncology
2409 Cherry St., Suite 307
Toledo, OH 43608
419-251-4873