Ovarian cancer originates in the cells of the ovaries, including surface epithelial cells, germ cells and the sex cord-stromal cells.
Ovarian tumors include:
- Germ Cell Tumors — Ovarian germ cell tumors develop from cells that produce the ova or eggs. Most germ cell tumors are benign, although some are cancerous and may be life-threatening. The most common germ cell malignancies are maturing teratomas, dysgerminomas and endodermal sinus tumors. Teenagers and women in their 20s are most often diagnosed with germ cell malignancies. Before combination chemotherapy was available as a treatment, the most aggressive of these tumors — the GNP abnormal sinus tumor — was associated with a one-year disease-free survival rate of only 10 percent to 19 percent, even though 70 percent of these tumors were diagnosed very early. Today, however, 90 percent of women with ovarian germ cell malignancies can be cured and their fertility preserved.
- Stromal Tumors — Ovarian stromal tumors develop from connective tissue cells that hold the ovary together and those that produce the hormones estrogen and progesterone. The most common types are granulosa-theca tumors and Sertoli-Leydig cell tumors. These tumors are fairly rare and usually are considered low-grade cancers.
- Epithelial Tumors — Epithelial ovarian cancer develops from the thin layer of cells, called the epithelium, that covers the ovary. Most epithelial ovarian tumors are benign, including serous adenomas, mucinous adenomas and Brenner tumors.
Cancerous epithelial tumors are the most common and the most serious of ovarian cancers, accounting for 85 percent to 90 percent of all ovarian cancer. Some ovarian epithelial tumors don't appear clearly cancerous under the microscope and are called borderline tumors or tumors of low malignant potential (LMP tumors).
When cancer is diagnosed early while the tumor is limited to the ovary, the cure rate is better than 90 percent. Unfortunately, about two-thirds of women with ovarian cancer initially seek medical attention when the tumor is already advanced and has spread outside of the ovary. In these instances, the five-year survival rate is significantly lower.
Ovarian cancer often does not have signs or symptoms until later in its development. Symptoms may include:
- Abdominal bloating or swelling
- Abdominal or pelvic pain
- Difficulty eating or feeling full quickly
- Frequent urination or feeling a need to urinate
To help find the cause of your symptoms, your doctor will evaluate your medical history, perform a physical exam and recommend diagnostic tests. The exams and tests may include some of the following:
- Pelvic Exam — A pelvic exam consists of feeling the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size. A Pap test, an effective test for cancer of the cervix, is often done along with the pelvic exam, but it is not a reliable way to find or diagnose ovarian cancer.
- Ultrasound — Ultrasound refers to the use of high-frequency sound waves that are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid-filled cysts and tumors look different on this picture.
Health care professionals specializing in pelvic cancers at UCSF Medical Center will discuss all available therapies with you and make recommendations based on the stage of your disease, age and the overall condition of your health.
Surgery to remove the cancerous growth is the primary method for diagnosing and treating ovarian cancer.
This treatment uses high-energy rays to damage cancer cells and stop them from growing. It is a localized treatment, which means that it works to attack cancer cells in one area. The radiation may come from a large machine, which is called external radiation, or from radioactive materials placed directly into the ovaries, called implant radiation. Some patients receive both types of radiation therapy.
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Reviewed by health care specialists at UCSF Medical Center.