Ovarian Cancer
Ovarian cancer is an aggressive tumor that affects the ovaries. The amount that the cancer has spread to other parts of the body affects a woman’s chance of survival. Most doctors use surgery, chemotherapy or targeted medication therapy to treat ovarian cancer. Drugs and cosmetic products such as fertility drugs, hormone therapy after menopause or talcum powder may increase ovarian cancer risk.
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Ovarian cancer starts when cells in the ovaries grow out of control and form tumors. More women die of ovarian cancer than any other type of reproductive cancer.
In 2022, about 19,880 women will be diagnosed with ovarian cancer. About 12,810 women will die from it. Some drugs, surgeries and cosmetic products can affect the risk of ovarian cancer.
New cases and deaths from ovarian cancer have declined since 1992.
Detecting ovarian cancer early increases chances of survival. Gynecologic oncologists are doctors who specialize in treating ovarian cancer. There are also several treatment options for ovarian cancer.
What Are the Symptoms of Ovarian Cancer?
Symptoms of ovarian cancer vary depending on how serious it is. Many times, ovarian cancer has no symptoms. If there are symptoms, they are mild. This makes ovarian cancer difficult to detect.
- Pelvic or abdominal pain
- Unexplained back pain
- Vaginal bleeding
- Abnormal periods
- Urinating often and with more urgency
- Difficulty eating, less appetite
- Bloating
- Gas, nausea or vomiting
- Could these symptoms mean I have cancer?
- Are there tests to check for cancer?
- Could these symptoms be from another health issue?
- Do I need to see a specialist?
How Doctors Diagnose Ovarian Cancer?
Often, early ovarian cancer doesn’t have symptoms. If there are symptoms, the doctor will ask questions and do a physical exam. Then, he or she will run some tests. A biopsy is the only way to tell for sure if a tumor is cancerous.
- Ultrasound
- uses sound waves to make pictures of the ovaries.
- CT scans
- are X-rays that take pictures of the ovaries. The pictures are then put together to create a 3-D image.
- MRI
- uses magnetic fields to create pictures of the ovaries
- Laparoscopy
- is a type of surgery that uses a small camera attached to a tube to look at the ovaries and other body parts.
- Blood tests
- detect certain protein levels in the blood. Cancer cells cause proteins to go up.
- Biopsies
- use samples of ovarian tissue to check for cancer cells. This is the only way to tell for sure if you have cancer.
- Molecular tests
- detect certain features of a tumor, including mutations. The information from these tests can help guide treatment.
- What tests will I need to have?
- How long with these tests take?
- Can you explain the tests to me?
- When will I get results?
What Are the Types of Ovarian Cancer?
There are several types of ovarian cancer, but they fall into three main types. The type of cancer determines the treatment. It also affects survival rates.
- Can you write down what type of cancer I have?
- What is the next step?
- What should I know about this type of cancer?
- How do you know I have cancer?
Ovarian Cancer Staging and Survival Rates
Doctors use tumor staging to determine how serious ovarian cancer is. The stage depends on 3 things: the size of the tumor, if the cancer has spread to lymph nodes and if the cancer has spread to other parts of the body, also called metastasis.
Stages range from 1 to 4. Stage 4 cancer is the most serious. The stage of cancer determines how likely it is that someone will survive five years or more.
Stromal tumors and germ cell tumors have better survival rates than epithelial tumors. Stromal tumors have an 88 percent 5-year survival rate. Germ cell tumors have a 93 percent survival rate. Epithelial tumors have a 47 percent survival rate.
| STAGE | LOCATION AND/OR SIZE OF TUMOR | 5-YEAR SURVIVAL RATE |
|---|---|---|
| 1 | Limited to ovaries | 90% |
| 1A | In one ovary, tumor is not on outside surface of ovary | 94% |
| 1B | In both ovaries, tumor is not on outside surface of ovary | 92% |
| 1C | In one or both ovaries, AND the tissue around the tumor ruptured, tumor on ovary surface OR cancer cells in peritoneal (abdominal) fluid | 85% |
| 2 | Spread to other nearby organs in the pelvis | 70% |
| 2A | Spread to uterus or fallopian tubes | 78% |
| 2B | Spread to other organs in pelvis (bladder, colon, rectum) | 73% |
| 3 | Spread to organs in the abdomen, also known as peritoneum | 39% |
| 3A | Spread to surface of peritoneum but cells are microscopic OR spread to lymph nodes around the peritoneum only | 59% |
| 3B | Spread to peritoneum, but tumors are less than or equal to 2 cm | 52% |
| 3C | Peritoneal metastasis greater than 2 cm, may have spread to lymph node or the surface of the liver or spleen | 39% |
| 4 | Distant metastasis | 17% |
| 4A | Spread to fluid around the lung | |
| 4B | Spread to other organs outside of the abdomen |
Questions to Ask Your Doctor
- What stage is my cancer?
- Can you explain the stage to me?
- How does this affect my treatment options?
- How long will I likely live?
What Are the Treatments for Ovarian Cancer?
A doctor will determine the treatment plan depending on the stage and type of ovarian cancer. The health of a patient and treatment side effects also affect treatment options.
“Although ovarian cancer is a highly fatal cancer…there is hope. There is a substantial portion of women who live a long time after diagnosis.”
Surgery
Most of the time, doctors recommend surgery. Oncologists will remove as much of the cancer as they can. Sometimes, the doctor will have to remove the ovary or other organs affected by the tumors.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells or shrink tumors, but it can also kill healthy cells. Some ovarian cancer chemotherapy drugs have serious side effects. For example, Taxotere may cause temporary or permanent hair loss.
Other chemotherapy side effects include, but are not limited to: decreased appetite, bleeding and bruising, diarrhea, fertility issues and infection.
Targeted Therapy
Targeted therapy uses drugs to attack cancer cells and reduce harm to healthy cells. This is a newer treatment. There are several kinds of targeted therapy.
Hormone Therapy
Hormone therapy uses hormones or hormone-blocking drugs to fight cancer. This is more common for stromal tumors.
Radiation Therapy
Radiation therapy uses high-energy rays to shrink or kill tumors. It is less effective than chemotherapy, but it is useful for tumors that have spread.
- What is the best treatment for me?
- What are the side effects or complications with this treatment?
- Will vitamins, herbs or certain foods help?
- What happens if this treatment doesn’t work or the cancer comes back?
Ovarian Cancer Risk Factors and Prevention
Certain factors can increase or decrease the risk of getting ovarian cancer. The number one risk factor for getting ovarian cancer is age, according to the American Cancer Society. There are also certain drugs or products that may increase ovarian cancer risk.
- Age
- Cancer risk goes up with age. About half of all ovarian cancers affect women 63 or over.
- Fertility drugs
- The use of fertility drugs and in vitro fertilization (IVF) may increase the risk of ovarian tumors.
- Gene mutations
- Women who have BRCA1 or BRCA2 genes have a higher risk of ovarian cancer.
- Hormone therapy
- Women who take estrogen after menopause have an increased risk of ovarian cancer.
- Male hormones
- Drugs referred to as androgens, such as testosterone, may increase ovarian cancer risk.
- Obesity
- Women with a body mass index of 30 or higher are at increased risk of developing ovarian cancer.
- Talcum powder
- Some studies have linked long-term genital talcum powder use to an increased risk of ovarian cancer.
- Zantac
- Women who take the antacid Zantac may be at an increased risk of ovarian cancer, as the drug may contain the cancer-causing chemical NDMA.
- Diet
- Women who eat high vegetable, lower fat diets may lower their risk of ovarian cancer.
- Surgeries
- Women who have undergone a hysterectomy or tubal ligation (also referred to as getting tubes tied) may have a reduced risk of ovarian cancer.
- Birth control
- Women who use birth control pills or an IUD (intrauterine device) have a lower risk for ovarian cancer.
- Reproductive history
- Women who had babies before age 26 have the lowest risk of ovarian cancer. The risk goes down with each child born.
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