What is Ovarian Cancer?
Ovarian cancer is cancer that affects the ovaries. Ovaries produce eggs (female sex cells) as well as hormones such as estrogen and progesterone, which regulate the female reproductive system. Cancer forms in the ovaries when the cells mutate and replicate uncontrollably. These mutated cells can create tumors and can damage healthy tissue.
Different types of tumors can develop in the ovaries based on the type of cell in which the mutation begins. These tumors can be benign (noncancerous), malignant (cancerous), or borderline (low malignant potential). Malignant or borderline tumors can spread to other parts of the body.
Ovarian cancer is one of the leading causes of cancer death among people assigned female at birth (AFAB) in the United States. Because it often doesn’t cause symptoms early on, and its symptoms are general and similar to other illnesses, it has typically grown to an advanced stage by the time it is diagnosed.
Stages of Ovarian Cancer
There are four stages of ovarian cancer, each based on how much it has spread in the body. Cancer is considered metastatic when it has spread to a different place from where it originated . Ovarian cancer can take different paths as it spreads, but if left untreated, it typically spreads from the pelvic area to other areas in the abdomen, then to the lymph nodes, and possibly the liver. If the cancer continues to advance, it can spread to more distant body areas, which commonly include the lungs, spleen, brain, or lymph nodes outside of the abdominal region.
Staging will allow doctors to determine the treatment options that are best for each patient. The stages of ovarian cancer are:
- Stage I. This is ovarian cancer in its earliest stages. Stage I has three subgroups:
- Stage IA. The cancer is in one ovary or fallopian tube.
- Stage IB. The cancer is in both ovaries or both fallopian tubes.
- Stage IC. The cancer is in one or both ovaries or fallopian tubes, and:
- Cancerous tissue bursts during surgery, permitting the cancer cells to leak into the pelvic area and abdomen (Stage ICI).
- Cancerous tissue on the outside of the ovaries or fallopian tubes ruptures before surgery, permitting cancerous cells to leak into the pelvic area and abdomen (Stage IC2).
- Cancerous cells are found in the fluid in the pelvic or abdominal area (Stage IC3).
- Stage II. In this stage, the ovarian cancer has spread to other pelvis areas. There are two subgroups:
- Stage IIA. Cancer in the ovaries has spread to the fallopian tubes and/or uterus, or cancer in the fallopian tubes has spread to the ovaries and/or uterus.
- Stage IIB. The cancer has spread to other organs in the pelvic areas, such as the colon, rectum, or bladder.
- Stage III. Ovarian cancer in this stage is more advanced and has three subgroups. Each subgroup involves the possibility of the cancer spreading to the retroperitoneal lymph nodes (the lymph nodes in the back of the abdomen). The subgroups are described as:
- Stage IIIA. Under a microscope, the cancer can be seen to have spread to the peritoneum, which is the tissue that lines the abdominal wall and covers abdominal organs.
- Stage IIIB. The cancer has spread to the peritoneum and to organs outside of the pelvis The cancerous tissue is visible during surgery but is 2 centimeters or less in width.
- Stage IIIC. The cancer has spread to the peritoneum and organs outside of the pelvis. The cancerous tissue is wider than 2 centimeters.
- Stage IV. At this stage, the cancer is advanced and has spread to locations outside of the pelvic region. Stage IV ovarian cancer has two subgroups:
- Stage IVA. Cancer cells are found in the fluid around the lungs.
- Stage IVB. Cancer cells are found in areas in the body, like the liver, spleen, lungs, or lymph nodes other than retroperitoneal lymph nodes.
Types of Ovarian Cancer
The three main types of ovarian cancer are:
- Epithelial ovarian tumors. Epithelial tumors begin in the cells that surround the outside of the ovary. This is the most common type of ovarian tumor.
- Stromal tumors. These tumors develop in the hormone-producing tissues of the ovaries. They can produce excess estrogen, leading to symptoms like abnormal vaginal bleeding or early menstruation in young children. These tumors can also produce testosterone, which can cause the menstrual cycle to stop and can increase the growth of facial or body hair. Stromal tumors represent about 5 percent of ovarian cancers.
- Germ cell tumors. These form in egg cells. There are various types of germ cell tumors, and they are more common in children and young people. These tumors account for about 5 percent of ovarian cancers.
Signs & Symptoms of Ovarian Cancer
Signs and symptoms of ovarian cancer include:
- Abdominal bloating or swelling
- Feeling full quickly when eating
- Weight loss
- Discomfort in the pelvic area
- Changes in bowel habits, like constipation
- Frequent urination
- Back pain
- Pain during sex
- Menstrual changes, like heavy or irregular bleeding
Many people do not experience symptoms in the early stages of ovarian cancer. Also, some symptoms can be caused by other medical conditions. For this reason, it’s best to consult your doctor to determine the cause of your symptoms.
Ovarian Cancer Causes & Risk Factors
Cancer is caused by mutations that lead to abnormal cell growth. While we do not know exactly what causes the mutations that lead to ovarian cancer, we do know that certain factors can increase or decrease a person’s risk of developing this type of cancer.
Risk factors that increase the likelihood of ovarian cancer include:
- Age. The risk of ovarian cancer increases with age.
- Obesity. Though the link between ovarian cancer and obesity is still being investigated, obese people have a higher risk of developing ovarian cancer.
- Endometriosis. Endometrial tissue lines the inside of the uterus and builds up during the menstrual cycle. Endometriosis occurs when tissue that looks and acts like endometrial tissue grows outside the uterus.
- Starting/ending age of menstrual cycle. The risk of ovarian cancer increases when someone starts menstruation at a young age or begins menopause at a late age.
- No previous pregnancies. People who have never been pregnant have a higher chance of developing ovarian cancer.
- Family history of ovarian cancer. The risk of ovarian cancer increases if a relative has been diagnosed.
- Inherited genetic mutations. Ovarian cancer can be caused by mutations that are inherited by a parent. Genetic counseling and testing can be done to detect the mutations linked to ovarian cancer.
- Non-inherited mutations. Most mutations that transform into ovarian cancer are not inherited but acquired during one’s lifetime. The cause of these mutations is still being investigated.
There is no way to definitively prevent ovarian cancer, but certain measures can be taken to reduce the risk. These measures include:
- Taking birth control pills. Like pregnancy, this reduces the number of eggs being released from the ovary, which therefore reduces the risk of ovarian cancer. Birth control medications have side effects and risks, so talk with your doctor to explore this option.
- Maintaining a healthy weight. Obese people have a higher risk of ovarian cancer, though this link is still being investigated.
- Tubal ligation. This surgical procedure prevents pregnancy by blocking sperm from fertilizing an egg.
- Hysterectomy. This is the surgical removal of the uterus. It is thought that this procedure, like tubal ligation, may prevent cancer-causing agents from traveling through the uterus to reach the ovaries.
- Seeking genetic counseling. If genetic testing indicates an elevated ovarian cancer risk, we offer prophylactic oophorectomy (preventive surgery to remove the ovaries) to reduce your cancer risk. Your team will take the time to discuss this option with you if it is an approach you are interested in pursuing. Learn more about genetic counseling and testing options for cancer.
Trust NewYork-Presbyterian for Ovarian Cancer Care
NewYork-Presbyterian’s gynecologic oncologist team applies the latest treatment methods available to patients with ovarian cancer. Our team of specialists will develop a personalized care plan that addresses each patient’s individual needs and utilizes the best treatment method for you or your loved one. Contact us today to make an appointment.
At NewYork-Presbyterian, we offer ovarian cancer treatments based on the findings of the latest medical research as well as opportunities to participate in clinical trials of innovative therapies. Our ovarian cancer specialists are skilled and compassionate professionals who aim to cure your cancer while supporting your health and well-being.