Ovarian Cancer
Ovarian cancer starts in the ovaries. There are two ovaries, one on each side of the uterus in the pelvis. The ovaries produce eggs that travel through the fallopian tubes into the uterus, where the fertilized egg implants and develops into a fetus. The ovaries are the main source of the female hormones estrogen and progesterone.
The ovaries consist of three kinds of cells where tumors can develop: germ cells, which form eggs; stromal cells, which release hormones and connect the structures of the ovaries; and epithelial cells, which cover the outer surface of the ovaries (most ovarian tumors are epithelial cell tumors). Some tumors are non-cancerous and never spread beyond the ovary. Benign tumors can be treated either by removing the ovary or the portion of the ovary that contains the tumor. However, malignant (cancerous) or low malignant potential ovarian tumors can spread to other parts of the body and could be fatal.
Symptoms
Although women and those with ovaries are more likely to experience symptoms of ovarian cancer after the disease has spread beyond the ovaries, symptoms can present in the early stages of the disease. Symptoms might include:
- An upset stomach, trouble eating or feeling full quickly
- Bloating
- Menstrual changes
- Pelvic or abdominal pain
- Fatigue
- Back pain
- Feeling the need to urinate urgently or quite frequently
- Pain during sex
- Constipation
Any of these symptoms may be caused by cancer or by other, less serious health problems.
Diagnosis
If there is any reason to suspect ovarian cancer, the doctor will use one or more methods to find out if the disease is actually present. We use a variety of imaging tests to detect and diagnose ovarian conditions. Some of the tests that may be done include:
Ultrasound
An ultrasound uses sound waves to create an image on a video screen. This method can be helpful in locating an ovarian tumor and determining if it is a solid mass (tumor) or a fluid-filled cyst.
CT scans
CT scans (computed tomography) use an X-ray beam to take a series of pictures of the body from many angles. A computer combines the pictures to form a detailed image. CT scans can spot larger tumors and help determine whether a tumor has spread to other organs. CT scans can also be used to guide a biopsy needle into a tumor in order to remove a sample of tissue. While CT scans can show whether or not there is a mass in the pelvis, it cannot tell if it is cancer.
MRI
MRI (magnetic resonance imaging), like a CT scan, displays a cross-sectional picture of the body. But the MRI uses radio waves and strong magnets instead of X-rays. While MRI scans can show whether or not there is a mass in the pelvis, it cannot tell if it is cancer.
Chest X-rays
Chest X-rays may be taken to see if the cancer has spread to the lungs.
Laparoscopy
Laparoscopy (lap-uh-ROS-ku-pe) is another method that lets the doctor see the ovaries and other pelvic organs. A thin, lighted tube is placed through a small cut (incision) into the lower abdomen.
Biopsy
Biopsy is the only way to tell for certain if a growth in the pelvis is cancer. A sample of tissue or fluid is removed and examined under a microscope to see if cancer cells are present.
Treatment
The main treatments for ovarian cancer are surgery, chemotherapy, hormone therapy, targeted therapy and radiation therapy. In some cases, multiple treatment options may be recommended.
Surgery
Surgery is the main treatment for most ovarian cancers. How much and what type of surgery a patient undergoes depends on how far the cancer has spread, her general health and whether she still hopes to have children. Your surgeon should be experienced in ovarian cancer surgery. Many doctors refer their patients to gynecologic oncologists.
Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated. The Medical Oncology/Hematology Division at Sinai directs the chemotherapy program at LifeBridge Health.
Radiation therapy
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. The Department of Radiation Oncology at Sinai Hospital provides the most advanced radiotherapy for many cancers.