Definition

Ovarian cancer is when cancer cells start and grow in the ovaries. The ovaries make eggs for reproduction and female hormones.

There are different types of ovarian cancer. They include:

• Epithelial— the most common, found on the surface of the ovary
• Germ cell tumors—from the reproductive cells
• Stromal cancers—rare, from the connective cells

Cancerous Mass in the Left Ovary Copyright © Nucleus Medical Media, Inc.

Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

Ovarian cancer is most common in women age 50 or older. Other things that may raise the risk are:

• Early first menstrual period and/or late menopause
• Family history of ovarian cancer—especially in a mother or sister
• BRCA1 or BRCA2 genes
• No childbirth or breastfeeding
• Not having tubal ligation
• Certain health conditions, such as:
  • Endometriosis
  • Polycystic ovary syndrome
  • Obesity
• A history of breast cancer or uterine cancer
• Hormone replacement therapy

Symptoms

Symptoms often only appear in the later stages. They may be:

• Belly discomfort, pain, or feeling sick
• Gas, indigestion, bloating, or cramps
• Loose stools or constipation
• Loss of hunger
• Weight gain or loss—without trying
• Abnormal bleeding from the vagina
• Feeling tired
• Problems breathing

Diagnosis

The doctor will ask about your symptoms and health history. A physical and pelvic exam will be done.

Tests may include:

• Blood tests—to look for certain tumor markers
• Biopsy—a sample of tissue is taken from the ovary and tested

Imaging tests will look for tumors and the spreading of cancer. They include:

• Ultrasound of the pelvic organs
• CT scan
• MRI scan
• Lower GI series or barium enema

Diagnosis is confirmed by the biopsy. The exam and test results are also used for staging. Staging outlines how far and fast cancer has spread.

Treatment

The goal is to remove the cancer. Treatment depends on the type and stage of the cancer. A combination of treatments may be used. Options may include:

• Surgery—to remove the cancer, and often the nearby tissues, such as:
  • The uterus and fallopian tubes
  • Lymph nodes
• Chemotherapyby mouth, injections, or IV—to kill the cancer cells

Radiation therapy may be used to treat areas where the cancer has spread.

Prevention

The risk of ovarian cancer may be reduced by:

• Eating a low fat, high fiber diet with lots of vegetables
• Surgery to remove the ovaries and fallopian tubes—in women with a genetic or family history of ovarian cancer
• Taking birth control pills
• Breastfeeding