What is Ovarian Cancer?

Ovarian cancer, which affects the ovaries, most likely based on new evidence originates in the fallopian tubes. Like all cancers, ovarian cancer represents a change in the normal behavior of the cells within the organ such that they begin to grow and divide uncontrollably. There are approximately 22,000 cases of ovarian cancer (all subtypes) annually in the United States, which accounts for about 3% of all women’s cancers.1

Quick Facts About Ovarian Cancer

1/7

A woman’s risk of getting invasive ovarian cancer during her lifetime is about 1/7

5th

5th in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system

60%

60% of women are unfamiliar with ovarian cancer symptoms

Types of Ovarian Cancer2

Ovarian cancers are named after the types of cells of the ovaries that become cancers. Though there many types and subtypes of ovarian cancers, most are grouped into one of three categories: epithelial tumors, germ cell tumors, and stromal cell tumors.

Epithelial Cell Tumors

Epithelial tumors start from the cells that cover the outer surface of the ovaries. These are the most common type of ovarian cancerous tumors, accounting for about 80% – 88% of ovarian cancers. Epithelial ovarian cancer is divided into five main subtypes:

  • Serous (most common)
  • Endometrioid
  • Clear Cell
  • Mucinous
  • Unclassifiable

 

Stromal Cell Tumors

Stromal tumors, which form from the cells that hold ovaries together and produce female hormones, account for about 5% of ovarian cancer occurances. The most common subtype of stromal cell tumors are granulosa and Sertoli-Leydig cell tumors. Of these, granulosa stromal cell tumors are most common in postmenopausal women.

Germ Cell Tumors

Germ cell tumors, which start from cells that produce ova (the eggs), amount to about 1 – 2% of ovarian cancer cases. This type of ovarian cancer is most common in young women in their late teens and early 20s, and when caught early, germ cell tumors have about a 90% cure rate. The majority of instances of this type of germ cell tumors are benign, though malignant occurances do exist.  Some common subtypes include:

  • Teratoma
  • Dysgerminoma
  • Endodermal sinus tumor (EST)


Primary Peritoneal Carcinoma

Primary Peritoneal Carcinoma (PPC) is a rare cancer that affects the cells in the lining of the abdoman. Though PPC is closely related to epithelial cancer and displays similar signs and symptoms, women are still at risk for this cancer even after their ovaries have been removed. This type of cancer is an advanced cancer and is always categorized as either stage 3 or stage 4 during ovarian cancer staging.

Symptoms of Ovarian Cancer3

There are signs and symptoms of ovarian cancer that one can be on the lookout for. The following is a list of signs and symptoms which are associated with an increased risk of ovarian cancer. Having these risk factors however, does not necessarily mean that you have ovarian cancer.

Increasing Age

The risk for ovarian cancer increases as women grow older

Persistent symptoms

Bloating, fullness, pelvic or abdominal pain, frequent urination, difficulty eating

Previous history and/or Family history

Of ovarian cancer, breast cancer, or a known hereditary cancer syndrome

Suspicious features in a mass seen at imaging

Size, complexity, evidence of ascites (excess abdominal fluid)

According to the Ovarian Cancer National Alliance, “For years, women have known that ovarian cancer was not the silent killer it was said to be. Over the past decade, science has confirmed what women have long known: ovarian cancer has symptoms.” There are symptoms of ovarian cancer that women should know and look out for. The following is a list of symptoms which are associated with an increased risk of ovarian cancer.

Additional risk factors to consider for ovarian cancer are:

Diagnosis and Management10

Tests like OVA1 can help determine the pre-surgical risk and potentially lead to an earlier detection. Ovarian cancer is diagnosed in surgery. When ovarian cancer is found, the malignant tumor is removed and likely to be followed up with chemotherapy treatments. The survival rate of ovarian cancer depends on if and how extensively the cancer has spread beyond the ovaries. Finding ovarian cancer at an early stage can lead to a much higher success rate in treatment. Unfortunately, ovarian cancer often goes undetected until it has spread and becomes more difficult to treat.

A specialist may perform the following surgical interventions for ovarian cancer:

  • Tissue biopsy (examine for cancer under the microscope)
  • Ovarian Cancer Staging (to understand how / if the cancer has spread)
  • Cytoreduction (remove as much ovarian cancer as possible)

Ovarian Cancer Staging11

Staging is the process used to determine how widespread a cancer is and represents a critical step in diagnosis. Typically staging is done during surgery when tissue samples are collected to find out if cancer is present and where. Ovarian cancer is categorized in four stages:

Stage I

Tumor is confined to the ovaries

Stage II

Tumor involves one or both ovaries and has spread within the pelvis

Stage III

Tumor involves one or both ovaries and has spread outside of the pelvis or to the lymph nodes

Stage IV

Tumor involves the ovaries and has spread to other organs outside of the pelvis

StageDescriptionsIncidence5-Year Survival
Stage IConfined to the ovary23%90%
Stage IIExtends to true pelvis13%80%
Stage IIIExtends beyond true pelvis47%15-20%
Stage IVDistant Disease16%<5%
Stages of Ovarian Cancer

Ovarian Cancer Survival Rate12

The survival rate for ovarian cancer is dependent on the type of cancer found and the stage in which it was discovered. Women diagnosed at an early stage (Stage I), before the cancer has spread, have a much higher survival rate than those diagnosed at a later stage. Many other factors, including age, general health, and how well the cancer responds to treatment will have an effect on survival rate.

The survival rate for ovarian cancer is dependent on the type of cancer found and the stage in which it was discovered. Women diagnosed at an early stage (Stage I), before the cancer has spread, have a much higher survival rate than those diagnosed at a later stage. Many other factors, including age, general health, and how well the cancer responds to treatment will have an effect on survival rate.

OVARIAN CANCER SURVIVAL RATES
Invasive Epithelial Ovarian Cancer
Stage I
 
90%
Stage II
 
70%
Stage III
 
39%
Stage IV
 
17%
Invasive Epithelial Ovarian Cancer
Ovarian Stromal Tumors
Stage I
 
95%
Stage II
 
78%
Stage III
 
68%
Stage IV
 
35%
Ovarian Stromal Tumors
Germ Cell Tumors of the Ovary
Stage I
 
98%
Stage II
 
94%
Stage III
 
87%
Stage IV
 
69%
Germ Cell Tumors of the Ovary
Fallopian Tube Carcinoma
Stage I
 
87%
Stage II
 
86%
Stage III
 
52%
Stage IV
 
50%
Fallopian Tube Carcinoma
Sources
  1. American Journal of Obstetrics & Gynecology, The role of the fallopian tube in the origin of ovarian cancer
    10.1016/j.ajog.2013.04.019
  2. National Cancer Institute, SEER Stat Fact Sheets: Ovarian Cancer, http://seer.cancer.gov/statfacts/html/ovary.html
  3. Ovarian Cancer National Alliance, Ovarian Cancer Statistics, http://www.ovariancancer.org/about/statistics/
  4. American Cancer Society, Ovarian Cancer, http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-detection
  5. Ovarian Cancer National Alliance, Risk Factors, http://www.ovariancancer.org/about/risk-factors/
  6. Japanese Journal of Clinical Oncology,  The association between overweight, obesity, and ovarian cancer: a meta-analysis, https://www.ncbi.nlm.nih.gov/pubmed/26491203
  7. University of Pennsylvania, Preventive Strategies in Epithelial Ovarian Cancer, http://www.med.upenn.edu/schollerlab/documents/InTech-Preventive_strategies_in_epithelial_ovarian_cancer.pdf
  8. National Cancer Institute, Reproductive History and Breast Cancer Risk, http://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/reproductive-history-fact-sheet
  9. Ovarian Cancer Research Fund Alliance, Risk Factors,  http://www.ovariancancer.org/contact-info/
  10. American Cancer Society, What are the risk factors of ovarian cancer? http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-risk-factors.
  11. Ovarian Cancer National Alliance, Treatment, http://www.ovariancancer.org/about/treatment/.  
  12. Memorial Sloan Kettering Cancer Center, Stages of Ovarian Cancer, https://www.mskcc.org/cancer-care/types/ovarian/diagnosis/stages
  13. American Cancer Society, Ovarian Cancer Survival Rates, http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-survival-rates
Education for Women

How OVA1 is Improving Ovarian Cancer Detection

Having risk factors doesn’t guarantee a diagnosis. It simply means you may have a greater chance of developing the disease. Learn more about how OVA1 test is improving ovarian cancer detection.