The ovaries are the pair of small glands in females that produce eggs and female sex hormones. Ovarian cancer occurs when abnormal cells grow uncontrollably in one or both of the ovaries. The exact cause of this abnormal growth is unclear.
Ovarian cancer originates in one or both ovaries.
The cause of ovarian cancer, as with other cancers, is damage to cellular DNA. This damage results in uncontrolled cell growth, which leads to a cancer forming. Cancers can invade nearby tissue, or cancerous cells can break off and spread throughout the body via the bloodstream or lymphatic system. The exact causes of this cellular damage in the ovaries are not known.
The genetic material of all living cells and some viruses. The full name is deoxyribonucleic acid.
A network of vessels, lymph nodes, the spleen and other organs that transport lymph fluid between tissues and bloodstream.
Risk factors for ovarian cancer include:
Women over 50 years of age are at a greater risk of developing ovarian cancer.
Women who have inherited an abnormal BRCA1 or BCRA2 gene have a greater risk of developing ovarian or breast cancer. Women with more than one relative in their family affected by ovarian cancer may be at increased risk of having inherited a genetic mutation. They can discuss having genetic testing and counselling with their doctors.
In endometriosis, the tissue normally lining the inside of the uterus can also grow in other areas, such as the ovary, bladder or bowel. Endometriosis in the ovaries can lead to an increased risk of a certain type of ovarian cancer.
Smoking, obesity and high-fat diets all increase the risk of developing ovarian cancer.
Early puberty or late menopause are associated with increased risk, believed to be due to hormonal influences.
Not having children is associated with a small increase in the risk. This is attributed to the ovaries not having a restful period normally experienced during child-bearing.
The point in a woman's life when she stops menstruating.
The period of life, initiated by hormonal signals, in which a person becomes capable of reproduction as the sexual and reproductive organs mature.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
A permanent change in the DNA that makes up a gene, which may significantly alter its function.
Relating to hormones, which are chemicals secreted in one part of an organism and transported to another part of that organism, where they have a specific effect.
This is the most common type of ovarian cancer. It begins in the cells that make up the outer layer of the ovaries (epithelium).
This is a type of epithelial tumor that is not aggressive and generally has good treatment outcomes.
This is a rare type of ovarian cancer that originates in the ovary cells that produce hormones (stromal cells).
This is a rare type of ovarian cancer that originates in the germ cells that then mature into eggs.
Treatment outcomes can vary greatly, depending on the stage of cancer. Cancer is staged according to its size and location and whether it has spread to nearby or distant lymph nodes or organs throughout the body.
| Stage I | The cancer is only in the ovaries. |
| Stage II | The cancer has spread to nearby organs in the pelvis. |
| Stage III | The cancer has spread outside the pelvis, and/or to surrounding lymph nodes. |
| Stage IV | The cancer has spread to the lungs and other areas outside the abdomen. |
Ovarian cancer can present with vague symptoms, which can commonly affect women throughout their life. Therefore, a high degree of suspicion is needed to detect the cancer in the early stages. Symptoms can include:
A doctor may feel for any masses within a woman's abdomen and perform a vaginal examination to assess her pelvic organs. Often there are no findings on examination, especially in the early stages of the condition.
A blood sample will be tested for CA125, a protein that is often produced in elevated amounts in women with ovarian cancer.
A doctor may organize an abdominal or transvaginal ultrasound to visualize the woman's internal pelvic organs. During the abdominal ultrasound she will lie down in a chair and a hand-held device will be moved over her abdominal area. During a transvaginal ultrasound, the doctor or radiographer will insert this device into the woman's vagina. This is preferable as it produces a better image of the uterus and ovaries.
CT can help to further identify the site and size of any abnormal lesions, found on ultrasound.
An MRI can be used to accurately assess the spread of the ovarian cancer, if present, within the pelvis.
PET requires an injection with a radioactive label, or a tracer, to be first administered. When combined with a CT scan, it produces images to assess the size, location and spread of a cancer. It is often used to help monitor response to treatment.
Like the PET scan, the bone scan involves an injection of radioactive material. It is used to determine if the cancer has spread to the bones.
A colonoscopy may be performed to check if the symptoms are a result of a bowel problem.
A laparoscopy involves a small incision being made in the abdomen so a camera can be inserted to view the internal organs. It can be used to plan a surgery, or to help perform a biopsy.
The only way to definitively diagnose ovarian cancer is to perform a biopsy of the suspect tissue. The sample will be sent to the pathologist for examination under a microscope.
A medical procedure that uses a colonoscope to examine the large bowel.
A type of imaging that uses a magnetic field and low-energy radio waves, instead of X-rays, to obtain images of organs.
During positron emission tomography (PET) scan, an injection with a radioactive label is administered and then combined with a computerized tomography (CT) scan to produce functional images.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
Treatment will vary according to the type and stage of the cancer.
A range of surgeries are available to treat ovarian cancer, including the following:
Other therapies can be used in addition to surgical treatments, to further improve treatment outcomes. They may be given before surgery (neoadjuvant therapy) and/or after surgery (adjuvant therapy). When given before surgery, they aim to reduce the size, and therefore stage, of the cancer. When given after surgery, they aim to help prevent the cancer returning. These non-surgical treatments include chemotherapy, radiotherapy and hormone therapy.
Occasionally, these therapies may be used if individuals are not suitable for surgical treatment. Often, in these situations, the aim of treatment is to control symptoms, and not necessarily for cure. The treatment options and aims can differ based upon the individual, the stage and type of cancer. A doctor can help explain this information in more detail.
Chemotherapy works by damaging cancer cells and stopping their reproduction. Various medications can be used, which can be administered intravenously or orally. They are often given in cycles, with intervening rest periods, to help reduce toxic side effects. Side effects occur because chemotherapy can also affect healthy cells. A doctor will monitor their patient's dosage carefully to achieve an optimum therapeutic effect.
A doctor might suggest intraperitoneal chemotherapy. This is where the medication is delivered straight into the abdominal cavity through a tube, rather than intravenously. Its suitability depends on the outcome of surgery.
Chemotherapy medication can be administered intravenously or orally.
In this type of therapy, focused X-rays from an external beam radiation source are applied to the area where the cancer is located. Radiotherapy can be used alone, or in addition to surgery and/or chemotherapy.
Hormone therapy works to add, block or remove hormones from the body to slow or stop the growth of cancer cells. This is only used to treat some types of ovarian cancer, such as recurrent epithelial tumors. A doctor will advise if this treatment is appropriate.
Some people diagnosed with cancer seek out complementary and alternative therapies. None of these therapies are proven to cure cancer, but some can help people feel better when used together with conventional medical treatment. It is important to discuss any additional treatments with a doctor before starting them.
The lower part of the uterus, leading out into the vagina.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
In cancer, hormone therapy is the use of medication to block the action of hormones that some cancers require for growth. Hormone therapy can also refer to the use of female hormones to treat symptoms of menopause.
Side effects from treatment for ovarian cancer include the following:
In cases of advanced cancer, the cancer can metastasize to other parts of the body through the bloodstream and lymphatic system. The growth of cancer in the organs and other body parts has a destructive effect on their function.
A network of vessels, lymph nodes, the spleen and other organs that transport lymph fluid between tissues and bloodstream.
The point in a woman's life when she stops menstruating.
Survival rates are often used by doctors as a standard way of discussing a person's prognosis (outlook). Some patients with cancer may want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or may even not want to know them.
Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any individual's case. Many other factors can affect a person's outlook, such as their general health, the grade of the cancer, the treatment received, and how well the cancer responds to treatment. You should discuss any concerns you may have with your doctor as he or she is familiar with the particular aspects of your situation.
It is important to remember survival rates are only an indication and are based upon the averages of previously-treated patients. It is not an absolute prognosis for an individual. It is often difficult to accurately predict an individual's cure or survival rate. Constant advances in treatment are continually improving these statistics.
As yet, there is no proven method of preventing ovarian cancer. In addition, there is no screening program for ovarian cancer, as an effective test is not yet available.