Ovarian cancer is a broad term for several types of malignant tumors that originate in the ovaries. These tumors can develop in the outer surface of the ovaries (epithelial tumors), or less commonly in the eggs (germ cell tumors) or structural tissue (stromal tumors) of the ovaries.

Ovarian cancer tends to develop in women who are over the age of 63. However, younger women can develop tumors in the ovaries as well, especially when exposed to certain risk factors, such as specific genetic mutations, a family history of cancer, or using talcum powder in the genital area.

Ovarian Cancer Survival Rate and Life Expectancy

According to the American Cancer Society, ovarian cancer is the fifth largest cause of cancer deaths among women, with more than 14,000 women dying from the disease every year. In 2017, more than 22,000 women are expected to develop this terrible disease.

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Ovarian cancer is the fifth largest cause of cancer deaths among women, causing over 14,000 deaths each year.American Cancer Society

While these statistics are staggering, the good news is that over the last 20 years, the rate of diagnosis for ovarian cancer has been steadily falling. However, there is still a long way to go with respect to increasing the survival rate and life expectancy of women who develop ovarian tumors.

Women who are diagnosed with ovarian cancer at an early stage generally have a much better chance of surviving than those who are diagnosed at a later stage. Therefore, it is important to talk with your doctor about any potential symptoms of ovarian cancer right away.

Survival Rates for Ovarian Cancer
Ovarian Cancer Stage5-Year Survival Rate
Stage 187% – 95%
Stage 270% – 94%
Stage 339% – 87%
Stage 417% – 69%

Ovarian Cancer Causes and Prevention

There is no single cause of ovarian cancer. However, there are a number of risk factors associated with the disease, some of which are based on an individual’s biological makeup, while others relate to environmental or lifestyle factors.

Age: Generally speaking, the risk of developing ovarian cancer increases as you get older. Approximately half of women who are diagnosed with ovarian cancer are age 63 or older.

Genetics: Certain genetic mutations, such as BRCA1 or BRCA2, have been associated with the development of malignant ovarian tumors. Also, a hereditary condition known as Lynch syndrome has been linked to a higher risk of ovarian cancer.

Lifestyle Factors: Cigarette smoking, diet, and obesity may lead to an increased risk of ovarian cancer.

Environment: Medical studies have linked ovarian cancer and talc, especially when used in the genital area. Other environmental factors that can increase risk include pesticides and herbicides.

Ethnicity: Women who have an Eastern European or Ashkenazi Jewish background tend to have a higher incidence of BRCA gene mutations, which likewise puts them at a higher risk of ovarian cancer.

Family History: Women whose mother, sisters, aunts, or grandmothers had ovarian tumors are more likely to develop the cancer.

Other Diseases: Women who have or have had other types of cancer, including breast, uterine, or colorectal cancer, are at a higher risk of developing ovarian cancer. Also, women with endometriosis are at an increased risk of developing the disease.

Preventing Ovarian Cancer

There is currently no guaranteed way to prevent ovarian cancer. That said, some preventative measures can be taken to help decrease the risk of developing tumors in the ovaries.

Pregnancy: Women who become pregnant tend to have a lower rate of ovarian cancer than those who never become pregnant or who experience fertility problems.

Surgery: Tubal ligation and hysterectomy procedures have both been linked to a lower risk of developing tumors in the ovaries.

Contraceptives: Oral contraceptives have been shown to provide some measure of protection against developing ovarian cancer.

Healthy Lifestyle: Maintaining a healthy diet and body weight can reduce the risk of developing the disease. Also, avoiding cigarettes (including second-hand smoke) and other tobacco products may reduce your risk of ovarian tumors.

Environmental: Avoiding the use of certain products like talcum powder, herbicides and pesticides could lower the risk of developing ovarian cancer.

Screening: Being screened for ovarian cancer, especially if you are at a high risk due to genetic or family history factors, could help catch tumors early before they spread, thereby increasing your chance at long-term survival.

Ovarian Cancer Symptoms

The first signs of cancer can be mild, and they may even be felt in a part of the body far away from the site of origin. Such can be the case with ovarian cancer, which are often mistaken for other types of diseases or conditions.

Symptoms of Ovarian Cancer
Common SymptomsOther Signs of a Mass or Cyst
  • Bloating or an increase in abdominal size
  • Changes in appetite, such as a loss of appetite or feeling full sooner
  • Pelvic or lower back pressure
  • Frequent urination or constipation
  • Changes in bowel movements
  • Menstruation changes
  • Nausea, indigestion or vomiting
  • Fatigue or low levels of energy
  • Abdominal or pelvic pain or pressure
  • Pain during or just before or after your period
  • Pressure, swelling or pain in the abdomen
  • Lower back or thigh aches
  • Bladder problems
  • Abnormal bleeding
  • Nausea or vomiting

 

Talk to your doctor if you experience any of these symptoms, especially if you experience them for any extended period of time.

Ovarian Cancer Diagnosis and Types

Ovarian cancer develops in a part of the body that is not easily accessible, making it hard to identify and classify the tumors. Ovarian cancer can also sometimes be misdiagnosed as other types of cancer, including primary peritoneal cancer, peritoneal mesothelioma, or fallopian tube cancer.

Diagnostic Tests for Ovarian Cancer

Initially, doctors will often try one or more of the following tests to verify the presence of tumors in the ovaries and rule out other diseases.

  • Blood Test: Ovarian cancer can cause an increase in certain biomarkers, such as the protein CA-125 or hormones like estrogen and testosterone. While these blood tests are not foolproof, they can help point doctors in the right direction.
  • Imaging Tests: Ultrasounds, X-rays (including barium enema X-rays), CT scans, and PET scans may all be used to try and identify tumors and whether the cancer has spread.
  • Diagnostic Surgery: A laparoscopy or colonoscopy allows the doctor to see inside the body using a scope, which can help confirm the presence of a tumor.

As with many types of cancer, the only definitive test for ovarian cancer is to conduct a biopsy. Typically, this is done by removing the tumor and then sending it to a lab for analysis. In some cases where an individual cannot undergo tumor removal surgery, a small needle may be used to collect cells from the tumor.

Types of Ovarian Cancer

There are three types of ovarian cancer, categorized by where tumors first develop in the ovary.

  • Epithelial tumors: The ovaries are covered by a membrane of cells known as the epithelial layer. Most ovarian tumors originate here and are known as epithelial cell tumors.
  • Germ cell tumors: Tumors that originate in the eggs (ova, also known as germ cells) are called germ cell tumors.
  • Stromal tumors: The soft, connective tissue of the ovaries produces the hormones estrogen and progesterone. Tumors that start here are called stromal tumors.

Most tumors and cysts that develop on the ovaries are benign. However, low malignant potential (LMP) tumors and malignant tumors, also known as carcinomas, can spread if not treated or removed right away.

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Ovarian Cancer Treatment

The most common treatment for ovarian cancer is surgery to remove tumors (called debulking). In more advanced stages of the disease, one or both ovaries may be removed, and a hysterectomy may even be performed to ensure that all of the cancerous cells are removed from the body. Typically, this surgery is performed by a gynecologic oncologist that specializes in diagnosing, staging, and treating ovarian cancer.

In addition to surgery, most ovarian cancer patients will receive a course of chemotherapy, often using two or more drugs (called a “cocktail”). The most commonly used chemotherapy drugs for ovarian cancer include a platinum-based drug like cisplatin or carboplatin and a taxane drug, such as paclitaxel (Taxol) or docetaxel (Taxotere). However, a number of other drugs may be used in combination, such as pemetrexed (Alimta) or gemcitabine (Gemzar).

In recent years, a technique known as intraperitoneal chemotherapy has been used in combination with surgery to improve results of the operation. In this method, heated chemotherapy drugs are injected into the abdominal area immediately after debulking to kill any cancer cells that may be left behind.

Targeted Therapy for Ovarian Cancer

A newer type of treatment for ovarian cancer is known as targeted therapy. This approach uses specialized medications to attack cancer cells without doing damage to healthy cells, unlike traditional chemotherapy. Some examples of targeted therapy include:

  • Bevacizumab (Avastin): This immunotherapy drug prevents new blood vessels from forming, effectively starving the tumor.
  • PARP inhibitors: These drugs block poly(ADP)-ribose polymerase (PARP) pathways, making it difficult for cancer cells with BCRA mutations to repair themselves, ultimately leading to the cancer cells’ death. The three most common PARP inhibitors used to treat ovarian cancer are olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula).

Other experimental treatments and targeted therapies are currently being tested for ovarian cancer.