Ovarian cancer

Causes and Risks:
The exact cause of ovarian cancer is unknown. Oddly enough, ovarian cancer is fairly uncommon, yet it is the 5th leading cause of cancer death in women. It is also the leading cause of death from gynecologic malignancies. This is a result of a number of factors. Malignant tumors of the ovaries develop quickly, often times involving both ovaries, and they shed malignant cells relatively early in the disease. These cells, which frequently land on the uterus, bladder, and bowel, can begin forming new tumor growths before cancer is ever even suspected. In addition to the rapid rate of development, there is not a screening test for ovarian cancer and symptoms of early disease are minimal, if even present. For these reasons, over 50 percent of women with ovarian cancer are in the advanced stages of the disease at the time of diagnosis.

Ovarian cancer is more common in industrialized nations, with the exception of Japan. In the United States, females have a 1.4 to 1.5% (1 out of 70 women) chance of developing ovarian cancer at some point in their lives. The incidence is higher in older women. More than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age. Approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age.

Risk factors include poor reproductive history ( infertility , repeated spontaneous abortions, delayed childbearing beyond age 30); past medical history of breast cancer (twice the risk of other women); family history of breast cancer or ovarian cancer in mother or sister; family history of Lynch syndrome II (the familial pedigree includes cancers of the colon, lung, prostate, and uterus), exposure to asbestos or high levels of radiation; high dietary fat ; the use of talcum powder in the genital area; and the use of estrogen (other than that in oral contraceptives, which has actually been shown to have a protective effect).

Prevention:
Having regular pelvic examinations and avoiding risk factors listed above may decrease the overall risk; however, no complete prevention is known.

Studies have shown that there may be a lower risk of ovarian cancer in patients who have used the oral contraceptive pill. After five or more years of use, there is a 60 percent reduction in the risk of ovarian cancer.

Symptoms:

Additional symptoms that may be associated with this disease:

Note: There may be no symptoms until late in the disease.

Signs and Tests:
Physical examination may reveal increased abdominal girth and /or ascites (fluid within the abdominal cavity). Pelvic examination may reveal an ovarian or abdominal mass .

Tests include:



Treatment:
OVERVIEW:
Surgery is the preferred treatment and is frequently necessary for diagnosis. Chemotherapy is most frequently used as adjunctive therapy. Radiation therapy may be considered but is used less often than chemotherapy after surgery.

The stress of illness can often times be helped by joining a support group where members share common experiences and problems. See cancer - support group .

Prognosis:
Ovarian cancer is rarely diagnosed in its early stages; it is usually quite advanced by the time diagnosis is made. The outcome is often poor: the 5-year survival rate for all stages is only 35 to 38%. If, however, diagnosis is made early in the disease, 5-year survival rates can reach 85%.

Complications:

  • spread of the cancer to other organs
  • progressive function loss of various organs



Call Your Healthcare Provider:
Call for an appointment with your health care provider if you are a woman over 40 years old who has not followed the recommendation for an annual Pap smear and pelvic examination. (Note: routine Pap smears and pelvic examinations are recommended for all women over 20 years old.).

Call for an appointment with your health care provider if symptoms appear.


This is an illustration of the female reproductive system. Both internal and external views are shown here.



This CT scan of the lower abdomen shows a massive amount of free abdominal fluid (ascites) in a patient with ovarian cancer.



A CT scan series of the lower abdomen showing ovarian cancer that has metastasized (spread) to the peritoneum.