What is Ovarian Cancer?

Ovarian cancer happens when abnormal cells grow together in the ovaries of the female reproductive system and form masses called tumors. When these tumors are cancerous, they can spread to other parts of the body. The main types of ovarian cancer are:

• Epithelial tumors, which start in the lining on the outside of the ovaries.
• Germ cell cancer, which starts in the egg-producing cells of the ovaries.
• Sex cord stromal tumors, which begin in the connective tissue of the ovaries. 

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of ovarian cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Signs and symptoms of ovarian cancer can go unnoticed or are mild until the cancer is in an advanced stage. Discuss any of these signs and symptoms, especially if they are new symptoms and last for more than two weeks:

• Abnormal bleeding or discharge from the vagina 
• Bloating
• Constipation
• Frequent urination or urgency
• Difficulty eating or feeling full quickly
• Nausea, vomiting, gas
• Pain in the back that worsens over time
• Pain or pressure in the lower abdomen
• Unexplained weight gain or loss

Diagnosis

To diagnose ovarian cancer, we perform a physical examination, a pelvic exam and ask questions about your medical condition and family history. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Biopsy: In this procedure, a thin needle is used to remove a small amount of ovarian tissue that will be tested in a laboratory to see if the tissue is cancerous. 

Blood tests: Substances released into the blood can be checked to determine if ovarian cancer is present.

Computed tomography (CT) scan: A series of detailed pictures of the ovaries, uterus and pelvis, taken from different angles, are created by a computer linked to an X-ray machine.

Genetic testing: If a woman has two or more close relatives with ovarian or breast cancer (diagnosed before age 50), testing can show whether she has the cancer gene. If she does, the chance of developing ovarian or breast cancer can be decreased with non-surgical or surgical treatments.

Magnetic resonance imaging (MRI):A large magnet, radio waves and a computer are used to produce pictures of the ovaries, uterus and pelvis.

Pelvic ultrasound: An ultrasound device allows doctors to see images of the ovaries, uterus and pelvis area to look for the presence of ovarian cancer. 

Causes

The cause of ovarian cancer is unknown. Lifestyle factors that can contribute to the development of ovarian cancer include:

• Obesity
• Sedentary lifestyle
• Smoking 

Risk Factors

Risk factors that can contribute to ovarian cancer include:

Age: Women older than age 63 are at greater risk for developing ovarian cancer.

Breast cancer: Previously having breast cancer raises the risk of developing ovarian cancer.

Estrogen hormone replacement therapy: Taking estrogen after menopause increases the risk for ovarian cancer. The risk is higher for women who take estrogen without progesterone for at least five years.

Family history: The chance of getting ovarian cancer rises if close relatives have had ovarian, breast or colorectal cancer. In addition, inherited gene mutations BRCA1 and BRCA2, Lynch syndrome and Cowden disease raise the risk for ovarian cancer.

Fertility drugs: Taking the fertility drug Clomid® (clomiphene citrate) for more than one year increases the risk of getting ovarian cancer. The risk seems highest in women who did not get pregnant while on the drug.

Polycystic ovary syndrome: Women of reproductive age with enlarged ovaries, who experience abnormal menstruation, excess facial hair, severe acne or male-patterned baldness caused by increased levels of male hormones, are at higher risk for developing ovarian cancer.

Pregnancy after age 35 or never being pregnant: Women in either case are at higher risk for developing ovarian cancer.

Prevention   

There is no known way to prevent ovarian cancer, but monitoring your health and making lifestyle changes may lower some risk factors:

Eat healthy foods and exercise: Eating lower-fat and plant-based foods and exercising can reduce the risk of developing ovarian cancer.

Get screenings: If personal or family medical history is a risk factor, get regular screenings to detect and treat ovarian cancer early.

Maintain a healthy weight or lose weight: Aim for a body mass index no higher than 25 to avoid development of ovarian cancer from fat cells producing too much estrogen. 

Prognosis

The prognosis for ovarian cancer depends upon how early the disease is diagnosed, the size and location of the tumor and if it has spread. Stages of ovarian cancer range from being contained to an ovary to spreading to reproductive organs and the rest of the body. If ovarian cancer is found early, the five-year survival rate is 92 percent.

Treatment and Recovery

Ovarian cancer treatment depends upon the stage of cancer, size of the tumor, age and health of the woman. Most often, ovarian cancer is treated with a combination of surgery and chemotherapy.

Surgery

Surgery is the most common treatment for ovarian cancer. Surgery options can include:

• Salpingo-oophorectomy: Removal of one or both ovaries and fallopian tubes.
• Debulking: Removal of as much of the tumor as possible.  
• Hysterectomy: Removal of the uterus and sometimes the cervix.
• Omentectomy: Removal of the fatty tissue that covers the organs in the lower abdomen.

Radiation Therapy

External beam radiation treatments may be used for recurring ovarian cancer. During this treatment, a high-energy beam of radiation is directed to the tumor for a few minutes. This procedure is repeated five days a week for several weeks.

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill, as an IV or injected into the abdominal cavity. Chemotherapy can be given in combination with surgery.

Complications

Ovarian cancer can return after treatment or spread to other areas of the body. Ovarian cancer treatment can cause these complications:

• Loss of fertility
• Numbness, tingling and pain
• Fatigue
• Nausea, vomiting