Ovarian Cancer (cont.)
Andrew Green, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
Germ cell ovarian cancers
Germ cells tumors arise from the reproductive cells of the ovary. These account for less than 2% of all ovarian tumors. They include dysgerminomas, yolk sac tumors, embryonal carcinomas, polyembryomas, non-gestational choriocarcinomas, immature teratomas, and mixed germ cell tumors. They are relatively uncommon and also generally present in younger-aged women than does EOC.
Stromal ovarian cancers
Another category of ovarian tumor is the sex cord-stromal tumors. These arise from supporting tissues within the ovary itself. As with germ cell tumors, these are uncommon, accounting for only 5% to 8% of ovarian tumors. These cancers come from various types of cells within the ovary. They are much less common than the epithelial tumors. These include granulosa-stromal tumors and Sertoli-Leydig cell tumors.
The statistics for ovarian cancer
According to the National Cancer Institute (NCI), in 2013 there will be an estimated 22,240 new cases of ovarian cancer and 14,030 deaths from the disease. The vast majority of the cases are EOC and are found at stage 3 or later, meaning the cancer has spread beyond the pelvis or to the lymph nodes. This is mostly due to the lack of definite symptoms at the early stages of development of the disease process. An individual woman has a lifetime risk of 1.37%, thus it is an uncommon disease. The median age of diagnosis is 63. However, approximately 25% of cases are diagnosed between ages 35 and 54. Caucasian women have the highest rate at 13.3 cases per 100,000.
Like many other cancers, when ovarian cancer is found at an early stage (for example, localized to the ovary or fallopian tube) the survival at 5 years is very good. Approximately 92% of women at stage 1 will still be alive at 5 years. However, the 5-year survival for all women diagnosed with ovarian cancer is only 45%. This is because it is often found at an advanced stage in which the disease has already spread within the abdomen.
Survival is also dependent on the type of care the patient receives. Unfortunately, approximately half of all women with the disease are never referred to a gynecologic oncologist. These are physicians with special training in gynecologic (ovarian, uterine, cervical, vulvar, and vaginal) cancers. If a woman does not involve a doctor with this specialized training in her care, then studies show very clearly that her survival is significantly worse, often by many years. For this reason, every woman with this disease ideally will obtain a referral to a gynecologic oncologist before she starts any treatment or has any surgery.
Reviewed by Melissa Conrad Stöppler, MD on 9/24/2013
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