What is Ovarian Cancer?
Ovarian cancer is a disease caused by the cells in the ovaries growing out of control and forming cancerous growths.
It’s a condition which typically develops after a woman reaches menopause. However, indicators which can increase your risk of development include: family history, being overweight, IVF treatment and having children later in life. (1)
Ovarian cancer is in the top ten most common forms of the disease, with around 20 thousand women in the US diagnosed each year. (2)
Symptoms
The ovaries are women’s reproductive glands which produce egg cells. They are an important part of the female body, because they also produce female hormones estrogen and progesterone.
There are three main types of cells in the ovaries and each one has the potential to develop into a different type of tumor. Some of these are non-cancerous and can’t spread to other body organs.
However, some do form cancerous tumors and these are called malignant and low-malignant tumors. These types can spread beyond the ovaries and cause cancer in other organs such as the stomach, skin or in some cases the brain.
Some women who are at high risk of developing ovarian cancer choose to get their ovaries removed.
Symptoms of ovarian cancer are similar to other conditions.
However some women may experience other symptoms such as fatigue, indigestion or period irregularities. (3)
Below are listed prominent symptoms which can display in the early stages. These include: (4, 5)
Bloating
Persistent bloating can be an early warning sign of ovarian cancer which many women are unaware of. Therefore it’s important to mention excessive or persistent bloating to your doctor. (6)
Pelvic or Abdominal Pain
One typical sign of ovarian cancer is abdominal pain. This can also be described as a feeling of heaviness.
Considering where the ovaries are situated, pain will normally be experienced in the lower abdomen leading into the pelvis. (7)
Feeling of Fullness
Women with ovarian cancer often report a loss of appetite or a rapid feeling of fullness when eating. (8)
Urinary Symptoms
This is a typical symptom for women to experience, but most often occurs in later stages. (9)
As ovarian cancer spreads to the lower abdomen, tumors can put pressure on the bladder walls giving the person a feeling of needing to urinate frequently. (10)
If any of these symptoms persist it’s important to contact your doctor.
Stages
After a woman is diagnosed with ovarian cancer doctors will start by examining which stage the cancer is at.
Ovarian cancer is split into four stages typically using a surgical result system. (11)
This method uses surgical results to look at the extent of the tumor and if it’s present in the lymph nodes or has spread to other organs like the liver or brain.
The stages are numbered I, II, III and IV and has a number of subcategories.
Stages will also help determine the severity of the cancer, if you are diagnosed with stage I the prognosis is fairly good.
However, staging of cancer does not change, for example if you’re diagnosed with stage II ovarian cancer then no matter how much it spreads or remains dormant it will still be referred to as a stage II cancer. (12)
Below is a general explanation of the stages including their subcategories.
Stage I
During the first stage the cancer is confined to the ovaries and as of yet hasn’t spread to the abdomen, lymph nodes or pelvis.
This stage has three subcategories: IA, IB and IC.
IA is when the cancer is confined to one ovary, IB where cancer is inside both ovaries and IC is when cancer is inside both ovaries and is spreading. (13)
The cancer can advance during surgery or the tumor might rupture prior to surgery. The cancer cells may also be present in abdominal fluids.
Stage II
In this stage the cancer is present in the pelvic region where it has spread to the fallopian tubes as well as the uterus. (14)
This stage has two subcategories: IIA and IIB.
IIA is if the cancer has spread to the fallopian tubes or uterus, whereas IIB is when the cancer has spread to other organs in the pelvic region, such as bladder or rectum. (15)
Stage III
In this stage the cancer is still present in either one or both ovaries, but it could have spread beyond the pelvis to the abdomen, maybe even into the lymph nodes.
This stage has four subcategories: IIIA1, IIIA2, IIIB and IIIC.
These groups indicate where and if the cancer has spread. The last subcategory IIIC is when the cancer has spread or grown to the outside of other organs such as the spleen, liver or the lymph nodes. Some of the cancer deposits are now larger than two cm. (16)
Stage IV
This is the most advanced stage of ovarian cancer.
In this stage the cancer has spread or outgrown to further organs in and beyond the abdomen such as spleen, liver or lungs and is now present on the inside of those organs. (17)
Stage IV has two subcategories: IVA and IVB. IVA is where the cancer cells are now found in the fluid surrounding the lungs.
In the IVB category the cancer has spread to the inside of organs beyond the pelvic and abdomen, and may even have spread to the skin or brain. (18)
Treatment
There are a few different ways to treat ovarian cancer of which all are based upon the type and stage. In some cases the tumor is removed when staging the cancer, in this case further treatment might not be needed. (19)
Generally two or more treatments are used so your doctor will help you find the best options for you. (20)
There are many options for treatment of ovarian cancer. Below is a general explanation:
Surgery
This is the main way to treat ovarian cancer.
It can involve removing one or both ovaries including the uterus and some of the tissues and organs surrounding it, this is called debulking. (21)
But in some cases it is enough to just remove one ovary. This is usually the case of a stromal cell tumor. (22)
Chemotherapy
This is a drug treatment of cancer. For ovarian cancer it’s usually a combination of two or more drugs given every three to four weeks.
It’s usually given through an IV so it can enter the bloodstream and reach the required areas. (23)
It can also be given as intraperitoneal (IP) chemotherapy, this is done through a thin tube placed on the abdominal wall, where the chemo drugs can run directly to the area. (24)
Hormone Therapy
This type of treatment uses hormone or hormone blocking drugs. It’s typically used for ovarian stromal tumors because it affects cells which hold together the ovary as well as producing hormones. (25)
Some of these drug therapies work to keep estrogen from stimulating cell growth, whereas others work to lower the production of estrogen. (26)
Targeted Therapy
This treatment involves certain drugs and substances which identify and attack cancer cells, while minimum damage is done to healthy cells.
Targeted therapy is a new type of treatment. There are different kinds, but overall they work to alter how the cancer cells grow, divide, repair and interact with other cells. (27)
Radiation Therapy
This therapy consists of removing the cancer cells using high energy x-ray radiation or certain particles.
There are three kinds of radiation therapy, but the one most commonly used in ovarian cancer is called external beam. (28)
Radiation passes through the skin and into the area affected by cancer.
All the above treatments come with side effects that can be mild or severe. Discuss with your doctor what the best options are for you.
FAQ
What is ovarian cancer? Ovarian cancer results from the formation of cancerous tumors in the ovaries..
What are the signs of ovarian cancer? Common signs can include: excessive bloating, pelvic and abdominal pain, a feeling of fullness and loss of appetite or frequent urinations.
How do you develop ovarian cancer? The exact causes of ovarian cancer are still somewhat unknown. However theories surround development through a alteration of DNA. There are also certain risk factors for women, which include age, obesity, family history or IVF treatment.. (29, 30)
How are you diagnosed for ovarian cancer? Doctors will do a physical examination of the pelvis or check for fluid in the abdomen. This will be followed by imaging tests which can include: ultrasound, CT scans, MRI scans or PET scans. Lastly, laboratory tests will be done to determine the stage of the cancer. (31)
What is the best treatment for ovarian cancer? It depends on the type of ovarian cancer you have, some cancers can be removed by surgery, others require continued treatment such as chemotherapy.
What are the long term complications for ovarian cancer? Long term complications can include early menopause and it’s symptoms such as hot flashes. If you have to have your ovaries or womb removed as result, fertility problems will also be an issue.
Is ovarian cancer considered a disability? No it’s not considered disability, however women with advanced stages of ovarian cancer can qualify for disability benefits. (32)
Is there a cure for ovarian cancer? Yes, the right treatment can lead to a cure of the disease.
Is ovarian cancer life threatening? Yes it can be. If the cancer is in the advanced stages life expectancy is sometimes less than five years, although many women do live much longer. (33)
Summary
Ovarian cancer, is the formation of cancerous tumors in either one or both ovaries.
This condition has different stages and these determine the severity of the disease. However, the good news is that it is treatable and many women are declared cancer free.
However, the earlier this disease is caught, the better the chances of recovery. Therefore is crucial for women to be aware of the symptoms and also to get regular screening checks.