Ovarian Cancer
(Cancer of the Ovaries)
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Ovarian Cancer Symptoms, Early Warning Signs, and Risk Factors
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor:
Dennis Lee, MD
 Ovarian cancer is the seventh most common cancer in
women in the U.S. with over 25,000 women newly diagnosed each year with this
disease. It is the fifth
leading cause of cancer deaths in women and frequently does not result in
symptoms until the cancer has spread extensively. Less than one-third of ovarian
cancers are detected before they have spread outside of the ovaries.
Ovarian cancer actually represents a group of different
tumors that arise from diverse types of tissue contained within the ovary. The most common type of
ovarian cancer arises from the epithelial
cells (the outside layer of cells ) of the surface of the ovary. Other, rare
types of ovarian cancer develop from the egg-forming germ
cells or from the supporting tissue (stroma) of the organ. Benign
(non-cancerous) tumors and cysts are also found in the ovary and are much more
common than ovarian cancers.
The majority of ovarian cancers are diagnosed late, after the cancers have spread. Only about 20% of women are diagnosed early, when the disease may be curable. There is no definitive screening test for early ovarian cancer. Regular pelvic examinations, sometimes supplemented by ultrasound examinations or blood tests for cancer-related markers, have been routinely used for ovarian cancer screening, but none of these tests
are specifically able to detect ovarian cancer. Traditionally, it was believed that ovarian cancer does not produce any characteristic symptoms until the tumor is widespread, and that early symptoms of ovarian cancer were not recognizable.
However, in June 2007, the American Cancer Society, along with other medical societies including the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists, released a consensus statement about possible early symptoms of ovarian cancer. This statement was based on research suggesting that some of the early symptoms of ovarian cancer can, in fact, be recognized. In particular, possible early ovarian cancer symptoms include the following:
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The ovaries
The ovaries are part of a woman's reproductive system. They are in the
pelvis. Each ovary is about the size of an almond.
The ovaries make the female hormones -- estrogen and progesterone. They also
release eggs. An egg travels from an ovary through a fallopian tube to the womb
(uterus).
When a woman goes through her "change of life" (menopause), her ovaries stop
releasing eggs and make far lower levels of hormones.
Understanding ovarian cancer
Cancer begins in cells, the building blocks that make up tissues. Tissues
make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them.
When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
Benign tumors are not cancer:
- Benign tumors are rarely life-threatening.
- Generally, benign tumors can be
removed. They usually do not grow back.
- Benign tumors do not invade the tissues
around them.
- Cells from benign tumors do not spread to other parts of the body.
Malignant tumors are cancer:
- Malignant tumors are generally more serious than benign tumors. They may be
life-threatening.
- Malignant tumors often can be removed. But sometimes they grow
back.
- Malignant tumors can invade and damage nearby tissues and organs.
- Cells
from malignant tumors can spread to other parts of the body. Cancer cells spread
by breaking away from the original (primary) tumor and entering the lymphatic
system or bloodstream. The cells invade other organs and form new tumors that
damage these organs. The spread of cancer is called metastasis.
Benign and malignant cysts
An ovarian cyst may be found on the surface of an ovary or inside it. A cyst
contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are
benign (not cancer).
Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst
that does not go away or that gets larger. The doctor may order tests to make
sure that the cyst is not cancer.
Ovarian cancer
Ovarian cancer can invade, shed, or spread to other organs:
- Invade: A malignant ovarian tumor can grow and invade organs next to
the ovaries, such as the fallopian tubes and uterus.
- Shed: Cancer cells can shed (break off) from the main ovarian tumor.
Shedding into the abdomen may lead to new tumors forming on the surface of
nearby organs and tissues. The doctor may call these seeds or implants.
- Spread: Cancer cells can spread through the lymphatic system to lymph
nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through
the bloodstream to organs such as the liver and lungs.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the original
tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in
the liver are actually ovarian cancer cells. The disease is metastatic ovarian
cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not
liver cancer. Doctors call the new tumor "distant" or metastatic disease.
Next: What are risk factors for ovarian cancer? »
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