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Ovarian Cancer


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Women Should Understand This Serious Health Threat

The American Cancer Society estimates for 2016 are that about 22,280 women will receive a new diagnosis of ovarian cancer in the U.S., and about 14,240 women will die from it. Ovarian cancer accounts for about 3 percent of cancers among women, but it causes more deaths than any other cancer of the female reproductive system.

The risk of developing ovarian cancer gets higher with age. It is rare in women younger than 40. Most ovarian cancers develop after menopause; half of all ovarian cancers are found in women 63 years of age or older. It is more common in white women than African American women.

What is ovarian cancer?

The ovaries are made up of three main kinds of cells: epithelial, germ cell and stromal. Each type of cell can develop into a different type of tumor. Most of these tumors are benign (non-cancerous) and never spread beyond the ovary. Benign tumors can be treated by removing either the ovary or the part of the ovary that contains the tumor.

Epithelial tumors make up the majority of ovarian tumors and start from the cells that cover the outer surface of the ovary. Most epithelial ovarian tumors are benign, don’t spread and usually don’t lead to serious illness.

Germ cell tumors start from the cells that produce the eggs (ova). Most ovarian germ cell tumors are benign, but some are cancerous and may be life-threatening. Less than 2 percent of ovarian cancers are germ cell tumors. Overall, they have a good outlook, with more than 9 out of 10 patients surviving at least 5 years after diagnosis.

Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone. About 1 percent of ovarian cancers are ovarian stromal cell tumors. More than half of stromal tumors are found in women older than 50, but about 5 percent of stromal tumors occur in young girls.

The most common symptom of these tumors is abnormal vaginal bleeding. This happens because many of these tumors produce female hormones. These hormones can cause vaginal bleeding to start again after menopause. In young girls, these tumors can also cause menstrual periods and breast development to occur before puberty.

Tumors of low malignant potential. Some ovarian epithelial tumors don’t clearly appear to be cancerous. These are called tumors of low malignant potential (LMP tumors) and are also known as borderline epithelial ovarian cancer. These are different from typical ovarian cancers because they don’t grow into the supporting tissue of the ovary. Likewise, if they spread outside the ovary, for example, into the abdominal cavity, they might grow on the lining of the abdomen but often don’t grow into it.

LMP tumors tend to affect younger women than typical ovarian cancers. These tumors grow slowly and are less life-threatening than most ovarian cancers..

Malignant epithelial ovarian tu­mors. About 85 to 90 percent of ovarian cancers are epithelial ovarian carcinomas, making them the most likely ovarian cancer a woman would have. These tumor cells have several features that can be used to classify epithelial ovarian carcinomas into different types.

What causes ovarian cancer?

We don’t yet know exactly what causes most ovarian cancers. We do know some factors that make a woman more likely to develop epithelial ovarian cancer. Much less is known about risk factors for germ cell and stromal tumors of the ovaries.

There are many theories about the causes of ovarian cancer. Some of them came from looking at the things that change the risk of ovarian cancer; for example, pregnancy and taking birth control pills both lower the risk of ovarian cancer. Since both of these things reduce the number of times the ovary releases an egg (ovulation), some researchers think that there may be some relationship between ovulation and the risk of developing ovarian cancer.

Also, we know that tubal ligation and hysterectomy lower the risk of ovarian cancer. One theory to explain this is that some cancer-causing substances may enter the body through the vagina and pass through the uterus and fallopian tubes to reach the ovaries. This would explain how removing the uterus or blocking the fallopian tubes affects ovarian cancer risk. Another theory is that male hormones (androgens) can cause ovarian cancer.

Tests that may be done

Early cancer of the ovary often causes no symptoms. Some signs of ovarian cancer are bloating, trouble eating or feeling full quickly, abdominal or pelvic pain, and needing to urinate more often or feeling like you have to urinate right away. Your doctor will ask you questions about your health and do a physical exam.

If signs are pointing to ovarian cancer, more tests will be done. Some of the tests you may need might include ultrasound, CT (computed tomography) scans, chest x-rays, laparoscopy, blood tests and ovarian biopsy.

How serious is my cancer?

Doctors talk about ovarian cancer in stages, which describes the growth or spread of the cancer through the ovaries or to other places in your body. Cancer can be stage 1, 2, 3 or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a worse cancer that has spread to areas of the body farther from the ovary.

About 20 percent of ovarian cancers are found at an early stage. When ovarian cancer is found early at a localized stage, about 94 percent of patients live longer than five years after diagnosis.

Which treatment will I need?

The best treatment plan for you will depend on the type of ovarian cancer you have; the cancer’s stage; your overall health; and your feelings about the treatment and the side effects that may come with it.

With ovarian cancer, treatments may not cure it; you may need ongoing treatment and care.

Surgery is the main treatment for most ovarian cancers. How much and what type of surgery you have depends on how far the cancer has spread, your health (other than the cancer) and if you still hope to have children. Since ovarian cancer often spreads, the doctor may also need to take out other parts of the body affected by the cancer.

Chemotherapy is the use of drugs to kill cancer cells or shrink tumors. Most doctors believe that using more than one drug works better than using one drug alone.

Targeted therapy is a newer type of cancer treatment that uses drugs to find and attack cancer cells while doing little harm to normal cells. Targeted therapies change the way a cancer cell grows, divides, heals itself or acts.

Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. It is used more often to treat ovarian stromal cancers.

Radiation therapy uses high-energy rays (like x-rays) to kill cancer cells or shrink tumors. Radiation is rarely, if ever, used as the main treatment for ovarian cancer. It is sometimes used to treat areas where cancer has spread.

Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better. Clinical trials are one way to get the newest cancer treatment.

Visit cancer.org/cancer/ovariancancer for more information, or call the American Cancer Society at 1-800-227-2345 to talk to one of its cancer information specialists.

Courtesy of the American Cancer Society


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