What is Ovarian Cancer?
Ovarian cancer is a cancer that begins in the ovaries or fallopian tubes. More than 21,000 women in the U.S. will be diagnosed with ovarian cancer this year. Despite significant advances in research, more than 75 percent of women are diagnosed when their cancer is at an advanced stage -- when symptoms and signs become visible. As of now, there is no effective screening or early detection test for ovarian cancer. If your cancer spreads to the bone, visit our bone metastases page.
Ovarian cancer is often treated as a chronic condition because, in 85 percent of women, it returns after initial treatment is completed. As a result, it is important to ask your health care team about long-term side effects when you discuss treatment options.
Risk Factors, Signs & Symptoms
Known risk factors that may increase a woman’s chance of developing ovarian cancer include:
- Family History and Genetics - Heredity is a strong risk factor for ovarian cancer even though it only accounts for a limited number of cases. Women with a mother, daughter, or sister who has had ovarian cancer are at increased risk. Also, women with a personal or family history of cancer of the breast, prostate, pancreas, uterus, colon or rectum may have a higher risk. Mutations in the following genes have been linked to increased risk of ovarian cancer: BRCA1, BRCA2, and genes associated with Lynch Syndrome.
"When I learned I was BRCA positive, I was told 'your body is the same as it has been for the past 30 years, you are just learning more about it.' This has helped me so much."
- Age - The average age of diagnosis for ovarian cancer is 63, but ovarian cancer can occur in older and younger women.
- Pregnancies - Women who have never been pregnant have an increased risk of ovarian cancer.
- Menstruation - More menstrual cycles/early menarche (first menstrual period) is associated with an increased risk of ovarian cancer.
- Hormone Replacement Therapy - Women who have used hormone therapy to alleviate symptoms of menopause may be at an increased risk for ovarian cancer.
Diagnosis and Staging
There are no early detection tests to diagnose ovarian cancer. If ovarian cancer is suspected, your doctor may perform a pelvic and rectal exam as part of a series of diagnostic tests, followed by a transvaginal ultrasound. Once the diagnosis is made, the tumor type, stage and grade of the cancer are used to determine the best treatment.
The stages of ovarian cancer are classified as Roman numerals I-IV (1-4). The higher the number, the more the disease has spread:
- Stage I: The cancer is only in one or both ovaries.
- Stage II: Ovarian cancer has spread to another area within the pelvis without spreading elsewhere in the abdomen.
- Stage III: Cancer has spread from one or both ovaries to the lining of the abdomen or lymph nodes.
- Stage IV: Ovarian cancer has spread beyond the abdomen to distant organs, such as the lung or liver.
Grades and Types of Ovarian Cancer
Treatment for ovarian cancer depends upon how and where the cancer has grown (the stage of cancer), whether or not you have symptoms, and your overall health.
Surgery involves removing as much of the tumor as possible. Depending on the stage of your cancer, doctors may also remove the ovaries, uterus, fallopian tubes, nearby lymph glands, and a fold of fatty tissue. It is very important to have surgery performed by a trained doctor known as a gynecologic oncologist. Contact the Society of Gynecologic Oncology or visit www.sgo.org to find a list of gynecologic oncologists in your area.
After surgery, most women with ovarian cancer receive drugs to kill any remaining cancer cells. The most common combination of chemotherapy for ovarian cancer is a platinum compound such as carboplatin or cisplatin plus a taxane, such as paclitaxel (Taxol®) or docetaxel (Taxotere®).
Other chemotherapy drugs used to treat ovarian cancer include: Albumin bound paclitaxel (nab-paclitaxel, Abraxane®), Altretamine (Hexalen®), Capecitabine (Xeloda®), Cyclophosphamide (Cytoxan®), Etoposide (VP-16), Gemcitabine (Gemzar®), Ifosfamide (Ifex®), Irinotecan (CPT-11, Camptosar®), Liposomal doxorubicin (Doxil®), Melphalan (Alkeran®), Pemetrexed (Alimta®), Topotecan (Hycamtin®) or Vinorelbine (Navelbine®). Lynparaza™ may be an option for women with BRCA mutations who have recurrent disease.
You or your doctor may be interested in a clinical trial. Clinical trials offer patients the opportunity to benefit from the latest treatments or combinations of treatments while helping advance our knowledge of the disease and its treatment options.
Ask your doctor if a clinical trial is right for you. The Internet offers abundant information on clinical trials but only your health care team will know if there is a possible trial for you. Each trial has specific guidelines and eligibility criteria, as well as exclusions based on prior treatments, overall health, and stage of your disease. Your doctor or nurse can explain what participating in a clinical trial will involve and how it may affect your care and daily life.
Side Effects Management
Ask about possible side effects before you start treatment, and continue to talk with your health care team about side effects during treatment. Treatment for side effects is important to maintaining your quality of life. Common side effects include:
- Hair loss
- Nerve pain
- Mouth sores
- Diarrhea or constipation