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Conditions InDepth: Ovarian Cancer

Cancer is a disease in which cells grow in an abnormal way. Normally, the cells divide in a controlled manner to replace old or damaged cells. If cells keep dividing when new cells are not needed, a mass of tissue called a tumor forms.

Not all tumors are cancer, those that are cancer are called malignant. Cancer tumors invade and damage tissue around them. The cancer cells can also enter the lymph and blood streams, spreading to other parts of the body. Ovarian cancer is the development of malignant cells in one or both ovaries.

Cancer Cell Growth

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Normal Anatomy and the Development of Ovarian Cancer

The ovaries are part of the female reproductive system. They are two small, oval-shaped organs found inside the pelvic region on each side of the uterus. The main functions of the ovaries are to produce eggs and hormones (estrogen and progesterone) that control sexual development, reproduction, ovulation, and the menstrual cycle. As part of the menstrual cycle, ovarian cells shed in the peritoneum, a double-layered, fluid-filled membrane that surrounds and supports the abdominal cavity.

Each ovary is surrounded by a capsule and has 3 different types of cells:

  • Epithelial—The outermost layer that covers the ovary.
  • Germ—These cells are inside the ovary and develop into eggs.
  • Stroma—The connective tissue of the ovary.

Cell division and growth is a normal process in the body to replace old or damaged cells. Changes in hormones, which may or may not be affected by genetic abnormalities, cause changes in ovarian cells. These changes can alter the DNA of the cells which tells them when to grow and when to stop. Normally the cells only grow enough to replace old or damaged cells, but damaged DNA may cause the abnormal growth of cells, known as cancer.

Ovarian cancer can start anywhere in the ovarian tissue, but the most common place is in the epithelial cells that cover the ovary. Ovarian cancer can spread directly to nearby structures in the abdominal cavity. The cancer can also spread to adjacent lymph nodes or blood vessels, which can carry cancer cells to other areas of the body. The most common sites for ovarian cancer to spread outside of the abdomen are to lymph nodes in other parts of the body, lungs, liver, and bones.

Cancer in the Left Ovary

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Types of Ovarian Cancer

Ovarian cancer is characterized by where tumors start, where they grow, and their appearance under a microscope. Ovarian cancer types include:

  • Epithelial carcinoma —Makes up nearly 90% of ovarian cancers. There are eight different subtypes of epithelial carcinomas that differ on how they look under a microscope. The most common type of epithelial carcinoma is called serous.
  • Germ cell tumors —Tumors in the cells that produce eggs.
  • Stromal tumors —Tumors in the connective tissue that supports the ovary.

General information about ovarian epithelial, fallopian tube, and primary peritoneal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq. Updated October 13, 2017. Accessed January 29, 2018.

Ovarian cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900705/Ovarian-cancer. Updated November 17, 2017. Accessed January 29, 2018.

Ovarian cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/ovarian-cancer. Updated March 2017. Accessed January 29, 2018.

What is ovarian cancer? American Cancer Society website. Available at: https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html. Updated February 4, 2016. Accessed January 29, 2018.

Last reviewed November 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP