What Is Ovarian Cancer? A Comprehensive Guide

Ovarian cancer is a disease that begins in the ovaries. At WHAT.EDU.VN, we aim to provide clear, accessible information about ovarian cancer, including ovarian epithelial cancer, ovarian germ cell tumors and ovarian stromal tumors to empower individuals with knowledge and support. Explore the ovarian cancer types, ovarian cancer symptoms and potential treatments.

Table of Contents

What Is Ovarian Cancer? Understanding the Basics
- Defining Ovarian Cancer
- Types of Ovarian Cancer
Epithelial Ovarian Tumors: A Detailed Look
- Benign Epithelial Ovarian Tumors
- Borderline Epithelial Tumors
- Malignant Epithelial Ovarian Tumors
- Other Cancers Similar to Epithelial Ovarian Cancer
Ovarian Germ Cell Tumors: Types and Outlook
- Teratoma
- Dysgerminoma
- Endodermal Sinus Tumor (Yolk Sac Tumor) and Choriocarcinoma
Ovarian Stromal Tumors: Characteristics and Symptoms
Ovarian Cysts: Understanding and Management
Ovarian Cancer: Understanding the risk factors
Ovarian Cancer: Recognizing the symptoms
Ovarian Cancer: How is it diagnosed?
Ovarian Cancer: What are the treatment options?
Frequently Asked Questions About Ovarian Cancer
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1. What Is Ovarian Cancer? Understanding the Basics

1.1. Defining Ovarian Cancer

Ovarian cancer is a type of cancer that begins in the ovaries, which are part of the female reproductive system. The ovaries are responsible for producing eggs (ova) and the hormones estrogen and progesterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. This late detection makes it more difficult to treat. Understanding what is ovarian cancer and its various forms is critical for early detection and effective management.

1.2. Types of Ovarian Cancer

The ovaries are composed of three main types of cells, each of which can develop into a different type of tumor. These include epithelial tumors, germ cell tumors, and stromal tumors. Each ovarian cancer type has unique characteristics and treatment approaches.

Epithelial Tumors: These tumors start from the cells covering the outer surface of the ovary. They are the most common type of ovarian cancer.
Germ Cell Tumors: These tumors originate from the cells that produce eggs (ova).
Stromal Tumors: These tumors develop from the structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.

Some ovarian tumors are benign (non-cancerous) and do not spread beyond the ovary. However, malignant (cancerous) or borderline (low malignant potential) ovarian tumors can metastasize to other parts of the body and can be fatal.

2. Epithelial Ovarian Tumors: A Detailed Look

Epithelial ovarian tumors start in the outer surface of the ovaries. These tumors can be benign (not cancer), borderline (low malignant potential), or malignant (cancer). Understanding the differences is key to appropriate management.

2.1. Benign Epithelial Ovarian Tumors

Benign epithelial ovarian tumors do not spread and usually do not lead to serious illness. Several types of benign epithelial tumors exist, including serous cystadenomas, mucinous cystadenomas, and Brenner tumors. These tumors are typically managed with surgical removal, and patients usually recover fully.

2.2. Borderline Epithelial Tumors

Some ovarian epithelial tumors do not clearly appear cancerous when examined in the lab. These are known as borderline epithelial ovarian cancer, with the two most common types being atypical proliferative serous carcinoma and atypical proliferative mucinous carcinoma. Previously, these tumors were called tumors of low malignant potential (LMP tumors). They differ from typical ovarian cancers because they do not grow into the supporting tissue of the ovary (the ovarian stroma). If they spread outside the ovary, they might grow on the lining of the abdomen but not into it. Borderline tumors tend to affect younger women and grow slowly, making them less life-threatening than most ovarian cancers.

2.3. Malignant Epithelial Ovarian Tumors

Cancerous epithelial tumors are called carcinomas. Approximately 85% to 90% of malignant ovarian cancers are epithelial ovarian carcinomas. These tumor cells have distinct features that can be used to classify them into different types. The serous type is the most common, and can include high-grade and low-grade tumors. Other main types include mucinous, endometrioid, and clear cell.

Serous Carcinomas (52%)
Clear Cell Carcinoma (6%)
Mucinous Carcinoma (6%)
Endometrioid Carcinoma (10%)

Each ovarian cancer is given a grade based on how much the tumor cells resemble normal tissue. Grade 1 epithelial ovarian carcinomas look more like normal tissue and tend to have a better prognosis, while Grade 3 epithelial ovarian carcinomas look less like normal tissue and usually have a worse outlook. Other traits, such as how fast the cancer cells grow and how well they respond to chemotherapy, are also considered to determine the tumor’s type.

Type I Tumors: These tend to grow slowly and cause fewer symptoms. They often do not respond well to chemotherapy. Examples include low-grade (grade 1) serous carcinoma, clear cell carcinoma, mucinous carcinoma, and endometrioid carcinoma.
Type II Tumors: These grow fast and tend to spread sooner. They often respond better to chemotherapy. High-grade (grade 3) serous carcinoma is an example of a type II tumor.

2.4. Other Cancers Similar to Epithelial Ovarian Cancer

2.4.1. Primary Peritoneal Carcinoma

Primary peritoneal carcinoma (PPC) is a rare cancer closely related to epithelial ovarian cancer. During surgery, it appears the same as an epithelial ovarian cancer that has spread through the abdomen. In the lab, PPC also looks just like epithelial ovarian cancer. Other names for this cancer include extra-ovarian primary peritoneal carcinoma (EOPPC) and serous surface papillary carcinoma. PPC appears to start in the cells lining the inside of the fallopian tubes.

Like ovarian cancer, PPC tends to spread along the surfaces of the pelvis and abdomen, making it difficult to determine where the cancer started. This cancer can occur in women who still have their ovaries but is of more concern for women who have had their ovaries removed to prevent ovarian cancer. Rarely, this cancer occurs in men.

Symptoms of PPC are similar to those of ovarian cancer, including abdominal pain or bloating, nausea, vomiting, indigestion, and a change in bowel habits. Also, like ovarian cancer, PPC may elevate the blood level of a tumor marker called CA-125. Women with PPC usually receive the same treatment as those with widespread ovarian cancer, including surgery to remove as much of the cancer as possible (debulking), followed by chemotherapy. The outlook is likely similar to that of widespread ovarian cancer.

2.4.2. Fallopian Tube Cancer

Fallopian tube cancer is another rare cancer similar to epithelial ovarian cancer. It begins in the tube that carries an egg from the ovary to the uterus (the fallopian tube). Like PPC, fallopian tube cancer and ovarian cancer have similar symptoms. The treatment for fallopian tube cancer is much like that for ovarian cancer, but the outlook (prognosis) is slightly better.

3. Ovarian Germ Cell Tumors: Types and Outlook

Germ cells typically form the ova or eggs in females and the sperm in males. Most ovarian germ cell tumors are benign, but some are cancerous and may be life-threatening. Less than 2% of ovarian cancers are germ cell tumors. Overall, they have a good outlook, with more than 9 out of 10 patients surviving at least 5 years after diagnosis. Several subtypes of germ cell tumors exist, with the most common being teratomas, dysgerminomas, endodermal sinus tumors, and choriocarcinomas. Germ cell tumors can also be a mix of more than one subtype.

3.1. Teratoma

Teratomas are germ cell tumors with areas that, when seen under the microscope, look like each of the three layers of a developing embryo: the endoderm (innermost layer), mesoderm (middle layer), and ectoderm (outer layer). This germ cell tumor has a benign form called mature teratoma and a cancerous form called immature teratoma.

The mature teratoma is by far the most common ovarian germ cell tumor. It is a benign tumor that usually affects women of reproductive age (teens through forties). It is often called a dermoid cyst because its lining is made up of tissue similar to skin (dermis). These tumors or cysts can contain different kinds of benign tissues, including bone, hair, and teeth. The patient is cured by surgical removal of the cyst, but sometimes a new cyst develops later in the other ovary.

Immature teratomas are a type of cancer. They occur in girls and young women, usually younger than 18. These are rare cancers that contain cells that look like those from embryonic or fetal tissues such as connective tissue, respiratory passages, and brain. Tumors that are relatively more mature (grade 1 immature teratoma) and have not spread beyond the ovary are treated by surgical removal of the ovary. When they have spread beyond the ovary, and/or much of the tumor has a very immature appearance (grade 2 or 3 immature teratomas), chemotherapy is recommended in addition to surgery.

3.2. Dysgerminoma

Dysgerminoma is a rare type of cancer, but it is the most common ovarian germ cell cancer. It typically affects women in their teens and twenties. Dysgerminomas are considered malignant (cancerous), but most do not grow or spread very rapidly. When they are limited to the ovary, more than 75% of patients are cured by surgically removing the ovary, without any further treatment. Even when the tumor has spread further (or if it comes back later), surgery, radiation therapy, and/or chemotherapy are effective in controlling or curing the disease in about 90% of patients.

3.3. Endodermal Sinus Tumor (Yolk Sac Tumor) and Choriocarcinoma

These very rare tumors typically affect girls and young women. They tend to grow and spread rapidly but are usually very sensitive to chemotherapy. Choriocarcinoma that starts in the placenta (during pregnancy) is more common than the kind that starts in the ovary. Placental choriocarcinomas usually respond better to chemotherapy than ovarian choriocarcinomas do.

4. Ovarian Stromal Tumors: Characteristics and Symptoms

About 1% of ovarian cancers are ovarian stromal cell tumors. More than half of stromal tumors are found in women older than 50, but about 5% of stromal tumors occur in young girls. The most common symptom of these tumors is abnormal vaginal bleeding. This happens because many of these tumors produce female hormones (estrogen). These hormones can cause vaginal bleeding (like a period) to start again after menopause. In young girls, these tumors can also cause menstrual periods and breast development to occur before puberty.

Less often, stromal tumors make male hormones (like testosterone). If male hormones are produced, the tumors can cause normal menstrual periods to stop. They can also make facial and body hair grow. If the stromal tumor starts to bleed, it can cause sudden, severe abdominal pain.

Types of malignant (cancerous) stromal tumors include granulosa cell tumors (the most common type), granulosa-theca tumors, and Sertoli-Leydig cell tumors, which are usually considered low-grade cancers. Thecomas and fibromas are benign stromal tumors. Cancerous stromal tumors are often found at an early stage and have a good outlook, with more than 75% of patients surviving long-term.

5. Ovarian Cysts: Understanding and Management

An ovarian cyst is a collection of fluid inside an ovary. Most ovarian cysts occur as a normal part of the process of ovulation (egg release) — these are called functional cysts. These cysts usually go away within a few months without any treatment. If you develop a cyst, your doctor may want to check it again after your next menstrual cycle (period) to see if it has gotten smaller.

An ovarian cyst can be more concerning in a female who is not ovulating (like a woman after menopause or a girl who has not started her periods), and the doctor may want to do more tests. The doctor may also order other tests if the cyst is large or if it does not go away in a few months. Even though most of these cysts are benign (not cancer), a small number of them could be cancer. Sometimes the only way to know for sure if the cyst is cancer is to take it out with surgery. Cysts that appear to be benign (based on how they look on imaging tests) can be observed (with repeated physical exams and imaging tests) or removed with surgery.

6. Ovarian Cancer: Understanding the risk factors

Several factors can increase the risk of developing ovarian cancer. While having these factors does not guarantee the development of the disease, being aware of them can help with early detection and proactive health management.

Age: The risk of ovarian cancer increases with age, with most cases occurring after menopause.
Family History: A family history of ovarian, breast, or colorectal cancer can increase the risk. Specific genetic mutations, such as BRCA1 and BRCA2, are associated with a higher likelihood of developing ovarian cancer.
Obesity: Women who are obese have a higher risk of developing ovarian cancer compared to those with a healthy weight.
Hormone Therapy: Long-term hormone replacement therapy after menopause may slightly increase the risk.
Reproductive History: Women who have never been pregnant or who had their first pregnancy after age 35 may have a higher risk.
Fertility Treatments: Some studies suggest that fertility treatments may slightly increase the risk of ovarian cancer.

7. Ovarian Cancer: Recognizing the symptoms

Ovarian cancer symptoms can be vague and easily mistaken for other common conditions. This often leads to late diagnosis, which can impact treatment outcomes. Being aware of these symptoms and seeking prompt medical attention can improve the chances of early detection and effective management.

Abdominal Bloating: Persistent bloating that is not related to menstruation or dietary changes.
Pelvic or Abdominal Pain: Discomfort or pain in the pelvic or abdominal area that does not go away.
Difficulty Eating or Feeling Full Quickly: Feeling full after eating only a small amount of food.
Frequent Urination: An increased need to urinate.
Changes in Bowel Habits: Changes in bowel habits such as constipation or diarrhea.
Fatigue: Persistent and unexplained fatigue.
Pain During Intercourse: Discomfort or pain during sexual intercourse.
Unexplained Weight Loss or Gain: Significant weight loss or gain without intentional dietary changes.

8. Ovarian Cancer: How is it diagnosed?

Diagnosing ovarian cancer typically involves a combination of physical exams, imaging tests, and blood tests. Early detection is crucial for improving treatment outcomes.

Pelvic Exam: A physical examination to check for any abnormalities in the ovaries and uterus.
Imaging Tests:
- Ultrasound: To visualize the ovaries and identify any masses or cysts.
- CT Scan: Provides detailed images of the abdominal and pelvic areas to assess the extent of the cancer.
- MRI: Offers more detailed images than CT scans and can help determine if the cancer has spread.
Blood Tests:
- CA-125 Assay: Measures the level of CA-125, a protein that is often elevated in women with ovarian cancer. However, CA-125 levels can also be elevated due to other conditions.
- Other Tumor Markers: Additional blood tests may be done to measure other tumor markers that can be associated with ovarian cancer.
Biopsy: A tissue sample is taken from the ovary and examined under a microscope to confirm the presence of cancer cells. This is often done during surgery.

9. Ovarian Cancer: What are the treatment options?

Ovarian cancer treatment depends on several factors, including the type and stage of the cancer, the patient’s overall health, and personal preferences. The primary treatment options include surgery, chemotherapy, and targeted therapy.

Surgery:
- Debulking Surgery: Aims to remove as much of the cancer as possible. This may involve removing one or both ovaries, the fallopian tubes, the uterus, and nearby lymph nodes.
- Staging Surgery: Determines the extent of the cancer and whether it has spread to other parts of the body.
Chemotherapy:
- Uses drugs to kill cancer cells. Chemotherapy is often given after surgery to eliminate any remaining cancer cells. It can also be used as the primary treatment for advanced-stage ovarian cancer.
Targeted Therapy:
- Uses drugs that target specific molecules involved in cancer cell growth and survival. Examples include PARP inhibitors and angiogenesis inhibitors.
Hormone Therapy:
- May be used for certain types of ovarian cancer, such as stromal tumors, that are sensitive to hormones.
Radiation Therapy:
- Uses high-energy rays to kill cancer cells. Radiation therapy is less commonly used for ovarian cancer but may be an option in certain cases.

10. Frequently Asked Questions About Ovarian Cancer

Question	Answer
What are the early warning signs of ovarian cancer?	Early warning signs can be vague and include abdominal bloating, pelvic pain, difficulty eating, frequent urination, and changes in bowel habits.
Is ovarian cancer hereditary?	Family history and genetic mutations (like BRCA1 and BRCA2) can increase the risk.
How is ovarian cancer staged?	Ovarian cancer is staged using the FIGO system, which considers the extent of the tumor, spread to lymph nodes, and distant metastasis.
Can ovarian cysts turn into cancer?	Most ovarian cysts are benign and do not turn into cancer. However, some cysts, particularly those that are complex or persistent, may require further evaluation.
What is the role of CA-125 in ovarian cancer diagnosis?	CA-125 is a tumor marker that can be elevated in women with ovarian cancer. However, it is not specific to ovarian cancer and can be elevated in other conditions.
What is debulking surgery?	Debulking surgery aims to remove as much of the cancer as possible, improving the effectiveness of subsequent treatments like chemotherapy.
How effective is chemotherapy for ovarian cancer?	Chemotherapy is a primary treatment for ovarian cancer and can be very effective, particularly for certain types and stages of the disease.
What are PARP inhibitors, and how do they help treat ovarian cancer?	PARP inhibitors are targeted therapy drugs that block PARP enzymes, which help cancer cells repair damaged DNA. They are effective in treating ovarian cancers with BRCA mutations.
What is the prognosis for women with ovarian cancer?	The prognosis varies depending on the stage, type, and grade of the cancer, as well as the patient’s overall health. Early detection and treatment can improve outcomes.
What can I do to reduce my risk of ovarian cancer?	Risk-reducing strategies include maintaining a healthy weight, avoiding hormone therapy after menopause, and considering prophylactic surgery if you have a high risk due to family history or genetic mutations.

11. Need More Answers? Contact WHAT.EDU.VN Today

Navigating the complexities of ovarian cancer can be overwhelming. At WHAT.EDU.VN, we are committed to providing you with the information and support you need. Whether you have questions about symptoms, diagnosis, treatment options, or anything else related to ovarian cancer, our team is here to help.

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