Ovarian Cancer

There are three main types of ovarian tumors: germ cell tumors, stromal cell tumors and epithelial cell tumors, each named for the kind of cells in which they start. Some tumors are benign (non-cancerous) and some are malignant (cancerous). Most ovarian cancers start in the epithelial covering.

Ovarian Cancer Risk Factors

There are several factors that may increase the likelihood of developing epithelial ovarian cancer including:

  • Age – most ovarian cancers develop after menopause, and half of all ovarian cancers are found in women over the age of 63
  • Obesity – a study by the American Cancer Society found a higher rate of death from ovarian cancer in obese women
  • Reproductive history – women who started menstruating before age 12, had no children or had their first child after age 30, and/or experienced menopause after age 50 may have an increased risk of ovarian cancer
  • Fertility drugs – prolonged use of the fertility drug clomiphene citrate, especially without achieving pregnancy, may increase the risk for developing ovarian tumors
  • Family history – a woman’s chance of developing ovarian cancer is increased if her mother, sister or daughter had ovarian, breast or colorectal cancer
  • Breast cancer – women with the BRCA mutation have an increased risk of ovarian cancer
  • Talcum powder – women who use talc in the genital area may have a slight increase in risk
  • Estrogen or hormone replacement therapy – some studies suggest using estrogen replacement therapy may increase a woman’s risk of developing the disease
  • Smoking and alcohol use – Some studies have found an increased risk for one type of ovarian cancer (mucinous)

There are also several factors that may decrease the likelihood of developing epithelial ovarian cancer, such as:

  • Female Surgery – Having your “tubes tied” (tubal ligation) may reduce the chance of developing ovarian cancer. A hysterectomy (removal of the uterus) also seems to reduce the risk of getting ovarian cancer.
  • Diet – A recent study of women who followed a low-fat diet for at least 4 years showed a lower risk of ovarian cancer. Some studies have shown a reduced rate of ovarian cancer in women who ate a diet high in vegetables, but other studies disagree.

Ovarian Cancer Signs and Symptoms

Early cancer of the ovaries tends to cause symptoms that are relatively vague, including:

  • Bloating – Bloating can be a common symptom of PMS or eating a lot of salt. However, if you have a sudden increase in the size of your abdomen it could also signal a problem with your ovarian health. You may or may not have pain along with bloating.
  • Pain or discomfort in the abdominal (belly) or pelvic area – Pain or a feeling of pressure in the abdomen or pelvis that can’t be explained by cramps or constipation.
  • Changes in appetite or feelings of fullness – Some women with ovarian cancer will notice they suddenly have trouble eating or are full very quickly. If you can’t explain these changes in your appetite due to stress or other known stomach problems, you should schedule an appointment with your physician.
  • Urgency or frequency to urinate – Because your bladder and ovaries are close together, your urinary tract can be affected by the health of your ovaries.
  • Changes in Menstruation Cycle – A change to your period cycle, such as heavier or irregular bleeding, could be related to ovarian health. If you are premenopausal and suddenly have more painful periods or an irregular cycle, you should schedule a physical with your doctor. This is especially true if you are unable to manage a regular and pain-free cycle even while on oral birth control. Similarly, if you are postmenopausal and have unexpected bleeding you should go to a gynecologist for an exam.

Symptoms tend to be persistent and an obvious change from normal if they are caused by ovarian cancer rather than another condition. If you notice any of these signs for a prolonged period of time or they can’t be explained, visit your doctor as soon as possible.

Some other ovarian cancer symptoms can include:

  • Fatigue
  • Back pain
  • Upset stomach
  • Constipation
  • Pain during sex
  • Swelling in the abdomen (belly) with weight loss

Women who experience any of these symptoms should consult their healthcare providers.

Ovarian Cancer Screening

Research is currently being done to develop a screening test for ovarian cancer, but currently no standard exists. There are some tests, however, that might be helpful to some women. For example, women with a strong family history of the disease may be screened with transvaginal sonography and blood tests.

Ovarian Cancer Diagnosis

If a woman is suspected to have ovarian cancer, her healthcare provider may recommend additional testing including:

  • Imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, or ultrasound to confirm that a pelvic mass is present
  • Barium enema X-ray or colonoscopy to see if the cancer has invaded the colon or rectum
  • Chest X-ray to see if the cancer has spread to the lungs
  • Laparoscopy to look at the ovaries and other pelvic organs
  • Biopsy to remove tissue from the suspicious area
  • Blood tests

Ovarian Cancer Treatment

Women with ovarian cancer are commonly treated with surgery and/or chemotherapy.

  • Surgery treats the cancer by removing the cancerous tissue. The type of surgery required depends on the stage of the cancer and where a woman is in her reproductive life. Often ovarian cancer is treated by removing the uterus, both ovaries and fallopian tubes. Sometimes, in younger women who may wish to become pregnant, only the affected ovary is removed. Often, a layer of fatty tissue called the omentum and lymph nodes in the pelvis area are removed as well.
  • Radiation therapy is the use of high-energy rays to kill cancer cells in the treated area. It can be administered externally from a machine outside the body, or internally through thin tubes placed in the vagina. It is rarely used in the treatment of ovarian cancer.
  • Chemotherapy is the use of drugs to kill cancer cells. Because the drugs enter the bloodstream, they travel throughout the body reaching cancer cells that may have spread beyond the point of origin.

Clinical Research

At Comprehensive Cancer Centers, research and the participation in clinical research trials is a vital part of our mission. Our physicians are dedicated to finding new ways to treat this disease. We are able to offer our patients access to groundbreaking clinical research close to home. Many of the advancements being made in cancer treatment are the result of in-depth clinical research. For more information about our research efforts, click here.