What Is It?

Any malignant tumor that begins in the ovaries is called ovarian cancer. Ovarian cancer accounts for 4 percent of all cancers in women. An estimated 23,300 new cases of ovarian cancer were expected to be diagnosed in the United States during 2002, according to the latest statistics available from the American Cancer Society.

Ovarian cancer comes in three forms. Cancers forming in the surface of the ovary (epithelial carcinoma) are by far the most common. Cancers forming in the egg-producing cells (germ-cell tumors) and in the supportive tissue around the ovaries (stromal tumors) are less common.

The disease often does not cause any symptoms until it has spread beyond the ovaries. It is difficult for a physician to detect the tumor during a pelvic exam before this late stage. This helps explain why ovarian cancer more often results in death than some other cancers. Ovarian cancer accounts for more deaths than any other cancer of the female reproductive system. An estimated 13,900 women were expected to die from ovarian cancer in the United States during 2002, according to the latest statistics.

Once the disease spreads to other organs, symptoms begin. But even then, the symptoms (frequent urination or bloating, for instance) might not be noticed, or might be attributed to less-serious problems. For these reasons, about 75 percent of ovarian cancer cases aren’t identified until the later, more dangerous, stages of the disease

Since the disease causes few or vague symptoms during its developing stages, doctors are working to find screening tests that will allow for early detection. The exact causes of the disease are unknown, but a number of risk factors have been identified. The disease has a strong genetic (inherited) component, and women who have had a first-degree relative (sister, mother or daughter) diagnosed with ovarian cancer are at a high risk of developing the disorder, as are women who have a relative who has had breast or colon cancer. The likelihood of developing ovarian cancer also increases with age. Most ovarian cancers occur in women over the age of 50, and the highest risk is in women over 60. Women who’ve never had children are at higher risk for ovarian cancer.

Ovarian cancer usually doesn’t produce obvious symptoms until late in its development, and, even then, the symptoms can be mistaken as signs of a minor disorder. Symptoms of ovarian cancer may include:

• Abdominal discomfort and pain
• Bloating
• Nausea
• Diarrhea
• Frequent urination
• Sudden weight gain or loss
• Abnormal bleeding from the vagina

Occasionally, a doctor may find signs of ovarian cancer (firm, enlarged ovary) at an early stage. Pelvic ultrasound can help to diagnose the disease at an early stage. However the ovaries often appear normal during early stages of ovarian cancer.

Blood tests also can help to confirm ovarian cancer by identifying blood levels of CA-125, a protein commonly found in elevated levels in women who have ovarian cancer. The usefulness of this test is limited, however, because CA-125 can be elevated in many noncancerous conditions. Body-imaging systems such as ultrasound, Computed tomography (CT) or magnetic resonance imaging (MRI) also can be used to identify misshapen or enlarged ovaries and other features that may indicate cancerous changes. The only way to be certain that cancer is present is to obtain a sample of the abnormal tissue and have a pathologist thoroughly examine it for cancerous changes.

Women who take birth-control pills are at a lower risk of ovarian cancer (a 50-percent lower lifetime risk), possibly because these drugs prevent ovulation. It is thought that breast-feeding, which also reduces the number of times a woman ovulates, can reduce the risk of ovarian cancer. Reducing the amount of fat in the diet also is thought to help reduce risk.

Surgery is the usual treatment for ovarian cancer. In most cases, the ovaries, the fallopian tubes, the uterus and the cervix are removed, and in some cases the omentum (the thin tissue covering the stomach and intestine) and surrounding lymph nodes also are removed.

Chemotherapy and, less often, radiation therapy may also be necessary to kill remaining cancer cells. Both of these treatments also kill healthy cells, which can cause side effects, and additional measures are often used to reduce these side effects.

It is important to check with a doctor when any of the symptoms of ovarian cancer appear. It is even more important to have regular pelvic exams, and to be particularly wary of symptoms if you are at high risk of ovarian cancer.

As with any cancer, the prognosis depends on how far the disease has advanced when treatment begins. If ovarian cancer is diagnosed and treated before the cancer has spread outside the ovary, the five-year survival rate is 95 percent, but only 25 percent of all ovarian cancers are found at this early stage.

In general, older women with ovarian cancer tend to have a poorer prognosis than younger women. About 78 percent of all ovarian-cancer patients survive one year after diagnosis. More than 50 percent survive longer than five years after diagnosis.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.