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Ovarian cancer
Cancer - ovaries
Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs.
Causes
Ovarian cancer is the fifth most common cancer among women. It causes more deaths than any other type of female reproductive organ cancer.
The cause of ovarian cancer is unknown.
Risk of developing ovarian cancer include any of the following:
- The fewer children a woman has and the later in life she gives birth, the higher her risk of ovarian cancer.
- Women who have had breast cancer or have a family history of breast or ovarian cancer have an increased risk of ovarian cancer (due to defects in the BRCA1 or BRCA2 genes).
- Women who take estrogen replacement only (not with progesterone) for 5 years or more may have a higher risk of ovarian cancer. Birth control pills, though, decrease the risk of ovarian cancer.
- Fertility medicine probably does not increase the risk of ovarian cancer.
- Older women are at highest risk of developing ovarian cancer. Most deaths from ovarian cancer occur in women age 55 and older.
Symptoms
Ovarian cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.
See your doctor if you have the following symptoms on a daily basis for more than a few weeks:
-
Bloating
or swollen belly area
Bloating
Abdominal bloating is a condition in which the belly (abdomen) feels full and tight. Your belly may look swollen (distended).
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Difficulty eating or
feeling full quickly
(early satiety)
Feeling full quickly
Satiety is the satisfied feeling of being full after eating. Early satiety is feeling full sooner than normal or after eating less than usual....
ImageRead Article Now Book Mark Article - Pelvic or lower abdominal pain. The area may feel "heavy" (pelvic heaviness)
Other symptoms are also possible with ovarian cancer, but these symptoms are also common in women who do not have cancer:
- Abnormal menstrual cycles
- Digestive symptoms, such as no appetite, indigestion, nausea and vomiting, constipation, and increased gas
- Back pain for unknown reasons that worsens over time
- Vaginal bleeding that occurs between periods
-
Weight gain
or loss
Weight gain
Unintentional weight gain is when you gain weight without trying to do so and you are not eating or drinking more.
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Other symptoms that can occur:
-
Excessive hair growth
that is coarse and dark
Excessive hair growth
Most of the time, women have fine hair above their lips and on their chins, chests, abdomens, or backs. The growth of coarse dark hair in these area...
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-
Needing to urinate more often than usual (
increased urinary frequency or urgency
)
Increased urinary frequency or urgency
Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong urge to urinate. This causes a discomfort i...
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Exams and Tests
A physical exam is often normal. With advanced ovarian cancer, the doctor may find a swollen abdomen often due to accumulation of fluid ( ascites ).
Ascites
Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
A pelvic examination may reveal an ovarian or abdominal mass .
Abdominal mass
An abdominal mass is swelling in one part of the belly area (abdomen).
A CA-125 blood test is not considered a good screening test for ovarian cancer. But, it may be done if a woman has:
CA-125 blood test
The CA-125 blood test measures the level of the protein CA-125 in the blood.
- Symptoms of ovarian cancer
- Already been diagnosed with ovarian cancer to determine how well treatment is working
Other tests that may be done include:
-
Complete blood count
and blood chemistry
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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-
CT
or
MRI
of the pelvis or abdomen
CT
A computed tomography (CT) scan of the pelvis is an imaging method that uses x-rays to create cross-sectional pictures of the area between the hip bo...
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A pelvis MRI (magnetic resonance imaging) scan is a imaging test that uses a machine with powerful magnets and radio waves to create pictures of the ...
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Ultrasound
of the pelvis
Ultrasound
Transvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix and pelvic area. Transvaginal means across or through the ...
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Surgery, such as a pelvic laparoscopy or exploratory laparotomy , is often done to find the cause of symptoms. A biopsy will be done to help make the diagnosis.
Pelvic laparoscopy
Pelvic laparoscopy is surgery to examine pelvic organs. It uses a viewing tool called a laparoscope. The surgery is also used to treat certain dise...
Laparotomy
Abdominal exploration is surgery to look at the organs and structures in your belly area (abdomen). This includes your:AppendixBladderGallbladderIn...
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
No lab or imaging test has ever been shown to be able to successfully screen for or diagnose ovarian cancer in its early stages, so no standard screening tests are recommended at this time.
Treatment
Surgery is used to treat all stages of ovarian cancer. For early stages, surgery may be the only treatment. Surgery may involve removing both ovaries and fallopian tubes, the uterus, or other structures in the belly or pelvis.
Chemotherapy is used after surgery to treat any cancer that remains. Chemotherapy can also be used if the cancer comes back (relapses). Chemotherapy can be given intravenously (through an IV). Or it can be injected directly into the abdominal cavity (intraperitoneal, or IP).
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Radiation therapy is rarely used to treat ovarian cancer in the United States.
Radiation therapy
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
After surgery and chemotherapy, follow instructions about how often you should see your doctor and the tests you should have.
Support Groups
You can ease the stress of illness by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society -- www. cancer. orgCancerCare -- www. cancercare. or...
Outlook (Prognosis)
Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made:
- Three of four women with ovarian cancer survive 1 year after diagnosis
- Nearly half of women live longer than 5 years after diagnosis
- If diagnosis is made early in the disease and treatment is received before the cancer spreads outside the ovary, the 5-year survival rate is high
When to Contact a Medical Professional
Contact your health care provider if you are a woman 40 years or older who has not recently had a pelvic exam. Routine pelvic exams are recommended for all women 20 years or older.
Call for an appointment with your provider if you have symptoms of ovarian cancer.
Prevention
There are no standard recommendations for screening for ovarian cancer. Pelvic ultrasound or a blood test, such as CA-125, has not been found to be effective and is not recommended.
BRCA1 or BRCA2 genetic testing may be recommended for women at high risk for ovarian cancer. These are women who have a personal or family history of breast or ovarian cancer.
BRCA1 or BRCA2 genetic testing
No definition available for this article.
Removing the ovaries and fallopian tubes in women who have a proven mutation in the BRCA1 or BRCA2 gene may reduce the risk of developing ovarian cancer. But, ovarian cancer may still develop in other areas of the pelvis.
References
Coleman RL, Ramirez PT, Gershenson DM. Neoplastic diseases of the ovary: screening, benign and malignant epithelial and germ cell neoplasms, sex-cord stromal tumors. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 33.
Morgan M, Boyd J, Drapking R, Seiden MV. Cancers arising in the ovary. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 89.
National Cancer Institute. BRCA1 and BRCA2: cancer risk and genetic testing. Cancer.gov Web site. Updated April 1, 2015. www.cancer.gov/cancertopics/factsheet/Risk/BRCA . Accessed December 21, 2016.
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Female reproductive anatomy - illustration
External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.
Female reproductive anatomy
illustration
-
Ascites with ovarian cancer, CT scan - illustration
This CT scan of the lower abdomen shows a massive amount of free abdominal fluid (ascites) in a patient with ovarian cancer.
Ascites with ovarian cancer, CT scan
illustration
-
Peritoneal and ovarian cancer, CT scan - illustration
A CT scan series of the lower abdomen showing ovarian cancer that has metastasized (spread) to the peritoneum.
Peritoneal and ovarian cancer, CT scan
illustration
-
Ovarian cancer dangers - illustration
Ovarian cancer is particularly dangerous because its presence is difficult to detect until it has spread beyond the ovaries.
Ovarian cancer dangers
illustration
-
Ovarian growth worries - illustration
Prior to menopause, a mass on the ovary that is smaller than 2 centimeters is probably a follicle cyst that will go away on its own. However, if the growth is larger and doesn't go away over the course of a few menstrual cycles, then it may need to be removed.
Ovarian growth worries
illustration
-
Uterus - illustration
The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.
Uterus
illustration
-
Ovarian cancer - illustration
Cancer of the ovaries is considered very dangerous because the ovaries are in close proximity to many other abdominal organs and the risk of metastasis is high.
Ovarian cancer
illustration
-
Ovarian cancer metastasis - illustration
A malignant neoplasm (abnormal growth) located on the ovaries.
Ovarian cancer metastasis
illustration
-
Female reproductive anatomy - illustration
External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.
Female reproductive anatomy
illustration
-
Ascites with ovarian cancer, CT scan - illustration
This CT scan of the lower abdomen shows a massive amount of free abdominal fluid (ascites) in a patient with ovarian cancer.
Ascites with ovarian cancer, CT scan
illustration
-
Peritoneal and ovarian cancer, CT scan - illustration
A CT scan series of the lower abdomen showing ovarian cancer that has metastasized (spread) to the peritoneum.
Peritoneal and ovarian cancer, CT scan
illustration
-
Ovarian cancer dangers - illustration
Ovarian cancer is particularly dangerous because its presence is difficult to detect until it has spread beyond the ovaries.
Ovarian cancer dangers
illustration
-
Ovarian growth worries - illustration
Prior to menopause, a mass on the ovary that is smaller than 2 centimeters is probably a follicle cyst that will go away on its own. However, if the growth is larger and doesn't go away over the course of a few menstrual cycles, then it may need to be removed.
Ovarian growth worries
illustration
-
Uterus - illustration
The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.
Uterus
illustration
-
Ovarian cancer - illustration
Cancer of the ovaries is considered very dangerous because the ovaries are in close proximity to many other abdominal organs and the risk of metastasis is high.
Ovarian cancer
illustration
-
Ovarian cancer metastasis - illustration
A malignant neoplasm (abnormal growth) located on the ovaries.
Ovarian cancer metastasis
illustration
-
Ovarian cancer
(In-Depth)
Review Date: 11/10/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
