Ovarian Cancer

Ovarian cancer is a cancer that begins in an ovary. The most common type of ovarian cancer is called epithelial carcinoma. It begins in the epithelial cells on the outer surface of the ovary. Fallopian tube and peritoneal cancers are often considered to be very similar to ovarian cancer and may represent the same cancer syndrome. There are more rare types of ovarian cancer but most cases, 85% – 90%, are epithelial carcinomas.

The average woman in the United States has a lifetime risk for ovarian cancer that is less than 1.4%. Most cases are diagnosed in women over the age of 50. Some hereditary cancer syndromes cause an increased risk for ovarian cancer. Approximately 10% of ovarian cancers are thought to be due to an inherited risk.

General Risk Factors

Health History

  • Beginning menstruation at an early age (before age 12)
  • A late age of menopause (after age 55)
  • Exposure to estrogen (estrogen-only hormone replacement therapy) after menopause

Lifestyle

  • Obesity (being very overweight; having too much body fat)

Hereditary

  • A family history of ovarian cancer

Symptoms and Screening Methods

Symptoms of ovarian cancer can include abdominal bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, urinary urgency or frequency, fatigue, indigestion, back pain, pain with intercourse, constipation, or menstrual irregularities. These are all symptoms that can be due to medical conditions other than ovarian cancer. If associated with ovarian cancer, these symptoms may occur more often and present differently than what is typical for a particular woman.

In the United States, there is no standard or routine screening test for ovarian cancer in the general population. If your doctor considers you to be at a higher risk than the average person for ovarian cancer due to any of the risk factors mentioned above or if you are experiencing any of the symptoms mentioned above, he or she may recommend that you undergo certain non-diagnostic and non-specific screening tests, which can include a CA-125 blood test (a blood test to measure a marker that can be found at higher levels if ovarian cancer is present but can also be found at higher levels if other conditions are present) or a transvaginal ultrasound (this type of ultrasound can be used to view the ovaries). Other screening tests may include additional types of imaging exams and blood tests. If ovarian cancer is suspected based on the results of any of these exams, your doctor will likely recommend surgery as a next step.

Treatment

If ovarian cancer is diagnosed during or following surgery, treatment will depend on the stage of the cancer (how far the cancer has grown or spread). Treatment can include some combination of additional surgery, chemotherapy and radiation therapy. Learn more about ovarian cancer treatments here.

References

  1. Erickson, BK American Journal of Obstetrics and Gynecology 2014 vol 209 Issue 5, pages 409-14
  2. American Cancer Society: Ovarian Cancer (http://www.cancer.org/cancer/ovariancancer/index)
  3. American College of Obstetricians and Gynecologists Committee Opinion No. 477: The role of the obstetrician–gynecologist in the early detection of epithelial ovarian cancer. Obstet Gynecol. 2011 March; 117: 742-6.
  4. American Society of Clinical Oncology: Ovarian Cancer (http://www.cancer.net/cancer-types/ovarian-cancer)
    Goldgar DE, Easton DF, Cannon-Albright LA, Skolnick MH. Systematic population-based assessment of cancer risk in first-degree relatives of cancer probands. J Natl Cancer Inst. 1994 Nov 2;86(21)1600-8. PubMed PMID: 7932824.
  5. National Cancer Institute: Ovarian Cancer treatment (http://www.cancer.gov/cancertopics/pdq/treatment/ovarian/patient)
  6. Stratton JF, Pharoah P, Smith SK, Easton D, Ponder BA. A systematic review and meta-analysis of family history and risk of ovarian cancer. Br J Obstet Gynaecol. 1998;105(5):493-499.
  7. Surveillance, Epidemiology and End Results Program, National Cancer Institute (seer.cancer.gov)
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