Ovarian Cancer

Ovaries contain three different types of cells, which can become three types of ovarian cancer.
 

Epithelial Cells

Epithelial cells are found in the outer layer of the ovaries. Tumors that form from these cells are called epithelial tumors, and they are the most common form of ovarian cancer.
 

Germ Cells

Germ cells form eggs inside the ovaries. Germ cell ovarian cancer is rare, and many of the tumors that form in germ cells are benign.
 

Stromal Cells

Stromal cells make up the tissue inside the ovaries and produce hormones. Stromal cell cancer is another rare form of ovarian cancer.

There are several factors that can raise the risk of ovarian cancer. The most common ovarian cancer risk factors fall into two categories: controllable and non-controllable.
 

Non-controllable Risk Factors

Some of the risk factors for ovarian cancer are non-controllable, meaning they’re linked to genetics or other factors outside of your control. Some non-controllable factors include:

Family History of Cancer 

Women who have relatives with ovarian cancer are at a higher risk of developing ovarian cancer themselves. This is especially true for direct relatives including mothers, sisters and/or daughters. Additionally, those with a family history of other types of cancer are at a higher risk. This might include colon, rectal, pancreas or breast cancer. Having relatives with cancer may raise the risk due to an inherited gene mutation.

Inherited Mutations in the BRCA1 or BRCA2 gene

Both of these genes are linked to a higher risk of developing breast and ovarian cancer. Some women choose to have genetic testing for inherited gene mutations.

Age 

Ovarian cancer is most often found in women who are over age 65, and few women under 40 are diagnosed with this cancer.

Endometriosis

Women with endometriosis have a slightly higher risk of ovarian cancer than those without this condition, though treatment for endometriosis can reduce this risk.

Controllable Risk Factors

Other risk factors for ovarian cancer are controllable, as they are part of your lifestyle and health choices. Some controllable risk factors include:

Weight

Obesity can increase the risk of getting many kinds of cancer, including ovarian cancer.

Reproductive History

Having a child later in life or never carrying a pregnancy to term can increase the risk of developing ovarian cancer.

Fertility Treatment

In vitro fertilization (IVF) treatments have not been proven to increase the risk of ovarian cancer, but some studies have shown that there is a slight chance of borderline ovarian cancer with IVF.

Hormone Therapy

Women who take hormones to improve symptoms of menopause may have an increased risk of ovarian cancer.

In the early stages of ovarian cancer, you may not notice any symptoms. The symptoms you do feel might seem to be unrelated to cancer, such as abdominal bloating, feeling full quickly or a frequent need to urinate. However, stronger symptoms can mean that ovarian cancer is advanced. This is why frequent screening is so important.
 

Signs and symptoms of ovarian cancer may include:

• Abdominal discomfort or pain
• Bloating (gas, indigestion, cramps)
• Feeling full, even after a light meal, or having difficulty eating
• Frequent urination or frequently feeling the need to urinate
• Abdominal swelling with weight loss
• Unusual vaginal bleeding
• Back pain, especially lower back pain
• Pain during sex
• Menstrual changes

Ovarian cancer can be prevented only by removing the ovaries, but you can help lower your risk by:

• Maintaining a healthy weight
• Eating a low-fat diet
• Taking birth control pills for at least three months – the risk is lower the longer the contraceptives are taken, and the lower risk continues for many years after you stop taking them
• Having a child – Childbirth can lower your risk of ovarian cancer
  
• Discussing hormone replacement therapy with your doctor

Mercy doctors and cancer specialists are skilled in diagnosing and treating ovarian cancer. We’ll make sure you understand your condition and we’ll work with you to find the treatment plan that’s best for you.

A regular pelvic exam allows your gynecologist to check for any abnormalities in your reproductive system, including tumors.

The protein CA-125 is naturally found in the reproductive system, but the amount increases if you have ovarian cancer. A blood test can determine what the levels of CA-125 are in your system. While the CA-125 is not considered to be an ovarian cancer screening test, it is used to monitor treatment response for patients with ovarian cancer.

A gynecologic ultrasound is used to take a look at the uterus, fallopian tubes and ovaries. It can help reveal abnormalities throughout your reproductive system.

Surgery is usually the first treatment for ovarian cancer. It's performed to remove as much of the tumor as possible (also called debulking) as well as to determine how far cancer may have spread. Mercy has many skilled gynecologic surgeons who can perform minimally invasive, robotic-assisted approaches to surgery. Based on the results, surgical oncology treatments may include the following:

• Oophorectomy - an oophorectomy is the removal of either one or both ovaries, often along with the fallopian tubes
• Hysterectomy - a hysterectomy is the total removal of both the uterus and cervix.

Preventive Surgical Options

Preventive surgery isn’t recommended for everyone, but if you have a strong family history of ovarian cancer, surgery can reduce your risk of developing cancer as well. Options for preventive surgery include partial hysterectomy (only removing uterus) and tubal ligation (removing fallopian tubes). Talk to your Mercy provider about the risks and benefits of having preventive surgery for ovarian cancer. You may be a candidate for preventive surgery if you have:

• Family history of ovarian or breast cancer
• BRCA1 or BRCA2 gene mutation
• Previous breast, colorectal or endometrial cancer diagnosis

Hormone therapy is not commonly used to treat epithelial cell cancer, but it can help with stromal cell cancer. Hormone therapy uses medication to raise or lower certain hormones in the reproductive system, often to increase estrogen and decrease androgens.

This type of cancer treatment focuses on the proteins that control how cancerous cells grow and divide. Targeted therapy can eliminate cancer cells while doing less damage to normal cells. Not all types of cancer can be targeted, but ovarian cancer is one type that can benefit from targeted therapy.

This type of therapy uses X-ray energy to eliminate cancer cells. The kind of radiation therapy most often used with ovarian cancer is called external beam radiotherapy. In this type of radiation, the X-rays come from a machine that targets a specific point on the body.

Chemotherapy is more commonly used than radiation therapy with ovarian cancer. In this treatment, one or more medications are used to fight cancer cells. Unlike targeted therapy, however, chemotherapy treatment can cause greater damage to healthy cells as the medication can’t always differentiate between cancerous and healthy cells.