Ovarian Cancer

The ovaries are the part of the female reproductive system that produce eggs every month during a woman's reproductive years. They are located on either side of the lower abdomen. Ovarian cancer occurs when cells in the ovary grow and divide uncontrollably. The cells may form a tumor on the ovary, or they can also break off from the main tumor and spread to other parts of the body. Although ovarian cancer can spread throughout the entire body, in most cases it stays in the abdomen and affects organs such as the intestines, liver and stomach. There are many different types of ovarian cancer. However, most cancers of the ovary (85 percent-90 percent) come from the cells that make up the outer lining of the organ, and are called epithelial ovarian cancers.

There are usually no obvious symptoms of ovarian cancer. Women complain about vague symptoms including abdominal swelling or bloating, generalized abdominal discomfort, fullness after meals, lack of appetite, upset stomach, malaise, urinary frequency or weight change (either gain or loss). Women may develop unexplained fluid in the abdominal cavity that contributes to the abdominal discomfort. Because these symptoms are not unique to ovarian cancer, the disease can be difficult to identify and diagnose.

A definitive diagnosis of ovarian cancer requires surgery. The initial surgery has two aims. First, to remove any cancer that exists (or as much as possible), including removing the ovaries and the uterus. Second, to sample tissues and surrounding nodes to determine where the tumor has spread (to determine the stage of the disease). The best results for survival occur when all the cancer can be removed.

After the initial diagnosis has been established at surgery, additional therapy will depend on several factors, including the cell type, the stage, the extent of spread of the cancer and the amount of tumor remaining at the end of the initial surgery. Treatment includes chemotherapy or radiation.

The following may increase your chances of getting ovarian cancer: a high-fat diet, never having children or not having children until late in life, infertility, using fertility drugs but not becoming pregnant, starting your periods at a young age or going through menopause at an older than average age, use of talcum powder on the genital area, belonging to the Caucasian race or being of Jewish descent, and having a family history of ovarian or breast cancer. Of these risk factors, the most significant is a family history of breast and/or ovarian cancer. Having one close relative with ovarian cancer increases a woman's risk of developing ovarian cancer by nearly three times. There also are a number of factors that are associated with a lower risk of ovarian cancer, including use of birth control pills, having multiple children, breast feeding, tubal ligation and having the ovaries removed. Even with significant risk factors such as family history, the overall chances of getting ovarian cancer are still small.

Most ovarian cancers are not inherited. However, about 5 percent to 10 percent of ovarian cancers do run in families. Generally, the risk of developing ovarian cancer increases as the number of family members affected by ovarian cancer increases. Having a first-degree relative affected by ovarian cancer (for example, a mother or a sister) increases a woman’s lifetime risk from 1.4 percent to 3.1 percent. Sometimes ovarian, breast and other cancers seem to run in families. Talk to your doctor about genetic tests that can tell you more about your chances of getting ovarian cancer.

There are no known ways to guarantee prevention of ovarian cancer. Women who are diagnosed in an early stage, however, have a higher survival rate. Unfortunately, ovarian cancer is usually not diagnosed at an early stage. Currently, no effective methods for diagnosing ovarian cancer early exist.

Women at a very high risk of developing ovarian cancer can consider removal of the ovaries. This appears to lower the risk of developing ovarian cancer, but does not eliminate the risk. In general, women found to be carriers of an ovarian or breast cancer gene or who have a strong family history may be appropriate candidates for removal of the ovaries.

• American Cancer Society
• National Cancer Institute