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Ovarian Cancer is a type of cancer that is found in the Ovaries .

Some malignant tumors cause Reproductive Tract Cancer.

Ovarian cancer is the second most common Gynecologic Cancer.

It is the most deadly in terms of absolute numbers.

Some types are considered benign or non-malignant.

This cancer is very complex.

Typical lifetime risk is 1.5% – 7 % depending on no risk factors to two or more family members affected.

Hereditary factors such as mutation in genes associated are BRCA1 and BRCA2

BRCA1 has an associated risk of 45% and BRCA2 risk is 25%

Surgery is often recommended after 35 or when child bearing is complete.

***Most often no symptoms are experience by the individual.

Symptoms:

• Abdominal pain
• Back pain
• Mass or nodule
• Abnormal vaginal bleeding
• Ascites
• Urinary urgency
• Decrease or loss of appetite
• Indigestion
• Constipation
• Bloating
• Weight loss

Three Main Types are Recognized:

1. Epithelial Tumors – 85% – these occur in the tissue termed epithelial that cover the outer layer of the ovaries

2. Germ Cell Tumors  – occur in the cells whose function is to produce eggs and is often seen in women of younger age

3. Stromal Tumors – are found in ovarian tissue referred to as connective tissue where estrogen and progesterone are produced

–  Other types can be seen

Decreased Risk Factors

• Having children
• Breastfeeding may reduce risk
• Tubal ligation
• Complete Hysterectomy
• Bilateral Salpingo-oophorectomy
• Partial hysterectomy where x 1 ovary remains – 1/3 of the risk.

Diagnosis

• Pelvic Examination
• CT
• Ultrasound or Transvaginal Ultrasound
• X-ray
• Biopsies may be appropriate

Staging

Stage I  –  Remains in one or both ovaries
Stage II  –  Extends into pelvic region
Stage III  –  Extends into pelvic region and beyond such as Small Bowel
Stage IV  –  Distant spread to other organs such as liver Liver

Cancer spreading to other locations can be seen with malignant forms

Typically 75% of women diagnosed with ovarian cancer have advanced disease and often have spreading of cancer.

Treatment

*** Treatment largely depends on staging and location.

Cancer can remain in ovary itself or can move to other locations.

Surgery

• Surgical removal is often necessary.
• This is the preferred treatment if cancer is in Ovary.
• Different types of surgery may be seen depending on the location of the Cancer.

Chemotherapy

• Has been the standard of care for Decades.
• Often is done in combination with Surgery.

Radiation Therapy

• Not often used
• Has no effect of advanced cases

Prognosis

Usually there is a poor prognosis

Often the reason is that by the time it is found – it has spread to other parts of the body.

Initially little symptoms can be seen.

60% of women first found with Ovarian cancer are already at Stage III or IV.

The Five-Year Survival Rate for all stages is 47%