Ovarian cancer is a disease where abnormal cells in the ovary begin to grow and divide uncontrollably, forming a mass of undifferentiated tumor cells. These cells tend to invade nearby and distant sites in the body, deteriorating their function. The ovaries are pair of internal reproductive glands found only in females. The main role of ovaries is to produce eggs or ova for reproduction and act as the major source of female hormones: estrogen and progesterone.
Ovarian cancer is the most common cause of cancer death from gynecologic tumors, which mainly affects women who have been through menopause and are older than 50 years. However, this cancer can also affect younger women. In most cases, ovarian cancer is not diagnosed until it has progressed to an advanced stage. This is because the symptoms of ovarian cancer aren’t apparent in the early stages of the disease or are similar to the common stomach and digestive issues that are often mistaken for minor ailments. Women are more likely to experience symptoms once the disease has spread beyond the ovaries. It typically spreads to the lymph nodes outside the abdomen, skin, liver, spleen, fluid around the lungs, intestines or brain. Stage III ovarian cancer is an advanced disease and difficult to treat because cancer has spread beyond the ovaries. The five-year survival rate of stage III ovarian cancer is approximately 39 percent. This means the likelihood of a woman surviving for five years with stage III ovarian cancer is just 39 percent as compared to a healthy woman. (This figure is derived from various studies and represents an average value. The actual longevity may vary from person to person.)
Stages of ovarian cancer
- Stage I: This is the early stage of ovarian cancer. Cancer is limited to one or both ovaries.
- Stage II: Cancer has spread to organs close to the ovaries (uterus, fallopian tubes, bladder, colon, rectum, etc.) but not to the lymph nodes.
- Stage III: Cancer has spread to the stomach lining and/or the lymph nodes behind the stomach.
- Stage IV: The is the most advanced stage of ovarian cancer. Cancer has spread to some distant organs, such as the lungs, abdomen, brain or skin.
What are the signs and symptoms of ovarian cancer?
Common signs and symptoms may include
- Abdominal bloating, indigestion or nausea
- Changes in appetite, such as a loss of appetite or feeling full sooner
- Pressure in the pelvis or lower back
- More frequent or urgent need to urinate and/or constipation
- Changes in bowel movements
- Increased abdominal girth
- Tiredness or low energy
- Changes in menstruation, such as excessive bleeding through the vagina or bleeding between menstrual periods
What are the types of ovarian cancer?
The type of cell where cancer begins determines the type of ovarian cancer. Types of ovarian cancer are
- 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.
What causes ovarian cancer?
Ovarian cancer develops when cells around the ovaries divide and multiply in an uncontrolled way. Several factors may increase the risk of developing the disease. The likelihood of developing the disease may be higher if a woman has one or more risk factors. One key risk factor is age. Most women who develop ovarian cancer are diagnosed after menopause, at the age of 55 years or older.
Some common risk factors for ovarian cancer include
- Inherited gene mutations. A small percentage of ovarian cancers are caused by gene mutations inherited from the parents. BRCA1 and BRCA2 genes are known to increase the risk of ovarian cancer. 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. People with two or more close relatives with ovarian cancer have an increased risk of developing the disease.
- Hormone replacement therapy, especially with long-term use and in large doses.
- Age of menstruation. Beginning menstruation at an early age, starting menopause at a later age or both may increase the risk of ovarian cancer.
- Reproductive history. Having children later in life (after the age of 35 years) or never having children is associated with a higher risk.
How is ovarian cancer diagnosed?
A pelvic exam is usually one of the first steps in evaluating a patient with a known or suspected diagnosis of ovarian cancer. During a pelvic exam, the doctor will manually examine the abdomen and pelvic area for nodules or bumps. To determine the type and stage of the disease, gynecologic oncologists use
What is the treatment of ovarian cancer?
Treatment will depend on many factors, including
- The type, stage and grade of the cancer
- The individual’s age and overall health
- Their personal preferences
- Accessibility and affordability of treatment
Treatment options include