Ovarian Cancer: Types, Risk Factors, Symptoms and Treatment

Cancer is a disease in which abnormal cells grow out of control and form a tumor. Ovarian cancer is a cancerous tumor that forms in the tissues of an ovary — one of the pair of female reproductive glands that make eggs and female hormones.

Types

The most common type is epithelial ovarian cancer, which begins in the cells covering the ovary. Two related epithelial cancers can spread to the ovaries:

• fallopian tube cancer, which forms in the lining of a fallopian tube — one of the two long, slender tubes on either side of the uterus, the organ where a fetus grows during pregnancy; and
• primary peritoneal cancer, which forms in the lining of the peritoneum, the tissue that covers the organs of the abdomen.

These two behave like ovarian cancer and are treated the same way, so some medical experts count them as ovarian cancer too. Rarer types include malignant germ cell tumors and stromal tumors.

Causes

Ovarian cancer begins with changes, or mutations, in a cell’s DNA. What causes those changes is often unknown. Most arise during a person’s lifetime, but some are inherited — present from birth — and cancer caused by them is called hereditary ovarian cancer. Changes in the BRCA1 and BRCA2 genes raise the risk of ovarian cancer, and of breast and other cancers as well. Lifestyle and environment also play a part.

Who is more likely to get it

The risk is higher for people who:

• have a mother, aunt, grandmother or sister who had ovarian cancer;
• have inherited changes in BRCA1 or BRCA2;
• have certain other genetic conditions, such as Lynch syndrome;
• have endometriosis;
• took hormone therapy for menopause;
• are overweight or have obesity;
• are tall;
• are older, especially after menopause; or
• have never been pregnant.

Symptoms

Ovarian cancer may cause no early signs, and by the time symptoms appear it is often advanced. They can include:

• pain, swelling or pressure in the abdomen or pelvis;
• a sudden or frequent urge to urinate;
• trouble eating, or feeling full;
• a lump in the pelvic area; and
• gas, bloating, constipation or other digestive problems.

Diagnosis

A health care provider will ask about symptoms and medical history, and about family history — including any relatives who had ovarian cancer. They will do a physical exam, including a pelvic exam, will likely order imaging tests, and may order blood tests such as the CA-125 test.

Often the only way to be sure is a biopsy of the tissue, which is taken during surgery to remove the tumor.

Treatment

Treatment may combine:

• surgery to remove as much of the cancer as possible;
• chemotherapy; and
• targeted therapy — drugs or other substances that attack particular cancer cells while doing less harm to normal ones.

A provider may also suggest genetic testing for the gene changes that raise ovarian cancer risk. Knowing whether one is present can help shape the treatment plan.

Sources

Based on "Ovarian Cancer," MedlinePlus, National Library of Medicine, with information from the National Cancer Institute; a work of the United States government in the public domain.