Ovarian cancer refers to cancers that originate in the ovaries, fallopian tubes, and peritoneum. With ovarian cancers, abnormal cells within these organs grow out of control and consequentially invade and destroy healthy body tissues. Ovarian cancer is one that affects the female reproductive organs. Women have two ovaries that are located on either side of the uterus. A woman’s ovaries produce both eggs for reproduction and female hormones such as estrogen and progesterone. On either side of the uterus, women have two fallopian tubes. These slender, long tubes facilitate eggs passing from the ovaries to the uterus. The peritoneum is a tissue located in the abdomen that helps to cover and protect abdominal organs.

Ovarian cancer is the fifth ranking in leading cancer deaths in women. The risk of a woman being diagnosed with ovarian cancer during her lifetime is about 1 in 78. The American Cancer Society estimates that about 19,710 women will receive a new ovarian cancer diagnosis annually

The ovaries are comprised of three different types of cells, which each have the potential to develop into a different type of tumor:

• Epithelial tumors are the most common type of ovarian cancers. These cancers originate in the cells that cover the ovary’s outer surface. Common types of epithelial tumors include serous, mucinous, endometrioid, clear cell, transitional, and undifferentiated tumors. The risk of developing epithelial ovarian cancers typically increase with age and are most often found in women over the age of 50.
• Germ cell tumors originate in the cells that cells that produce the ova, or eggs, in the ovaries. Common forms of germ cell tumors include teratoma, dysgerminoma, and choriocarcinoma. Germ cells tumors are found in women of any age but are most often found in women under the age of 30.
• Stromal tumors originate in the cells that comprise structural tissue that help to hold the ovaries together. These cells also help to produce female hormones such as estrogen and progesterone. Common types of stromal tumors include granulosa, granulosa-theca and Sertoli-Leydig tumors.

Fallopian tube cancers are considerably rare cancers that begin in the fallopian tube. These cancers typically act like epithelial ovarian cancers, with similar symptoms and treatment plans.

Peritoneal ovarian cancers are also rare and begins in the lining of the abdomen and pelvis. This type of cancer can occur even after hysterectomies. Symptoms and treatment of peritoneal ovarian cancer are typically similar to epithelial ovarian cancers.

There has not yet been a cause identified for ovarian cancers. However, researchers have identified risk factors that would increase the chances of a woman developing epithelial ovarian cancer. We have considerably less information about risk factors for germ cell and stromal ovarian cancers. In recent years, scientists have found that ovarian cancers begin in the cells in the ends of the fallopian tubes, rather than in the ovaries themselves. These findings can aid in prevention and screening of ovarian cancers.

Genetic mutations have the potential to cause normal cells in the body to become cancerous. Inherited genetic mutations are the result of the genes we inherit from our family, especially immediate family like parents and grandparents. Some ovarian cancers occur in women that have inherited mutations that are linked to an increased risk of developing ovarian cancers. Genetic testing can detect such mutations. If you have a family of history with cancers, especially breast, ovarian, thyroid, ovarian, colorectal, and/or endometrial cancer, you may want to consult your doctor about the possibility of pursuing genetic testing and counseling.

Factors that increase your risk of developing ovarian cancer include:

Aging

Most ovarian cancers typically develop after menopause. About half of diagnosed ovarian cancers are found in women aged 63 or older.

Obesity and Being Overweight

Obesity is generally linked to an increased risk of developing different forms of cancers. Obese women generally have been found to have a higher risk of developing a form of ovarian cancer, and obesity can also negatively affect the changes of a survival for a woman diagnosed with ovarian cancer.

Hormone Therapies

Women who use hormone therapies after menopause have an increased risk of developing a form of ovarian cancer.

Family History

Ovarian cancers, as many other cancer types, have the potential to genetically run in families. A woman’s risk of developing ovarian cancer is considered to be increased if her mother, sister, or daughter is diagnosed with ovarian cancer. Additionally, the occurrence of colorectal and breast cancers is also linked to an increased risk of developing ovarian cancer. This is due to the fact that inherited genetic mutations can cause a family cancer syndrome that in turn increases the risk of these cancer types.

Waiting to Have or Never Having Children

Women who wait after the age of 35 to carry their first full-term pregnancy or never have children at all have higher risks of developing ovarian cancer.

Symptoms of ovarian cancer are typically vague and can often be confused for less serious conditions, such as aging or indigestion. These symptoms don’t usually mean that you definitively have ovarian cancer but are good to discuss with your primary health care provider if they persist or occur often.

The most common symptoms of ovarian cancer include:

• Abdominal discomfort and pain, including pressure, swelling, and cramps
• Bloating and a feeling of fullness
• Persistent nausea, diarrhea, or constipation
• Loss of appetite
• Frequent urination
• Unusual fatigue
• Unexplained weight fluctuations, either gains or losses
• Abnormal vaginal bleeding or notable changes in the menstrual cycle
• Back pain, especially in the lower back
• Pain during sex

If you present symptoms that potentially signal ovarian cancer, your doctor will ask you questions about your personal and family health history and will examine you. Common tests for ovarian cancer include pelvic exams, blood tests, biopsies, imaging, and/or genetic testing. The tests your physician pursues will depend on your symptoms.

Treatment for ovarian cancer varies depending on the type and stage of ovarian cancer you are diagnosed with. Additionally, treatment for ovarian cancer typically involved a combination of surgery and chemotherapy. Here are some of the leading treatments for ovarian cancer, all of which are available at South Texas Oncology and Hematology for Cancer Care:

Surgical Options

Common surgical options for ovarian cancer treatment include:

• Surgery to remove an ovary. For early-stage ovarian cancers that haven’t spread beyond the ovary, surgery can involve removing the ovary and its fallopian tube. This approach has the potential to preserve your ability to have children. If the cancer is present in both ovaries, your surgeon may remove both ovaries and their respective fallopian tubes. Because this option leaves your uterus intact, you could still become pregnant with frozen embryos or eggs from a donor.


• Surgery to remove both ovaries and the uterus. If your cancer has extended past your ovaries and fallopian tubes, your surgeon will likely elect to remove both ovaries, their fallopian tubes, the uterus, any nearby affected lymph nodes, and a small portion of omentum (the surrounding abdominal tissue).


• Surgery for Advanced Cancers. If your cancer is more advanced or has spread significantly, your doctor may pursue a surgery that will remove as much of the cancer as possible. In these cases, chemotherapy and other conventional treatments can be provided before or after surgery to ensure effectiveness.

Chemotherapy

Chemotherapy drugs look for cells that divide quickly (like cancer cells) and destroy them. It is particularly useful when treating cancer in later stages because it can kill cancer cells throughout the whole body. More than half of cancer treatments involve some kind of chemotherapy, sometimes to completely remove the cancer and sometimes to just slow symptoms. You might have heard of chemotherapy side effects such as hair loss, nausea, or damage to the skin and/or bones. These side effects occur because the tissues in your hair, intestines, skin, and bones are all fast-growing cells and thus might potentially be attacked by chemotherapy drugs.

Chemotherapy drugs can be taken orally or injected into your veins.

Targeted Therapy

Targeted therapies are better at attacking only cancer cells while sparing healthy body cells. In some cases, targeted therapies do not cause as many side effects as other treatments as they are more effective at targeting only cancer cells

In treating ovarian cancer with targeted therapy, your doctor will test your cancer cells to determine the most effective form of targeted therapy for your cancer.

Immunotherapy

Immunotherapy drugs boost your immune system’s natural ability to fight your tumor. Tumors are good at avoiding the body’s immune system, so to improve your body’s immune response, immunotherapies include a variety of strategies such as adding extra T-cells and antibodies that specifically recognize and attack your tumor, introducing vaccines, or blocking the signals that would normally tell the immune system to slow down.

Hormone Therapy

Research shows that abnormal hormone levels are the most significant cause of cancer. In treating ovarian cancer with hormone therapy, the aim is to block the effects of estrogen on ovarian cancer cells. Hormone therapy is often used in slow-growing ovarian cancers, or ovarian cancers that have returned after initial treatments.

Genetic Testing

Because every person is different, every cancer is different. Thus, your cancer treatment should be personalized for you. Since your time is precious as a cancer patient, getting the most effective drug early on in your treatment process is critical. South Texas Oncology and Hematology for Cancer Care is the first cancer care provider in South Texas to offer genetic testing of tumors to help you get the best medication for your cancer as fast as possible.

Genetic testing can help you determine your risk for cancer based on your genes. It can also help your doctor know the best medication for you. Each of your cells, including your cancerous cells, contains a copy of your DNA. By sequencing the DNA in your tumor, the cancer specialists at START can use a series of tests to identify which anti-cancer drugs are most likely to help fight your cancer. This can save you weeks to months of treatment and unnecessary side effects

Anti-Cancer Drug

Some ovarian cancer treatments can include taking medication. South Texas Oncology and Hematology for Cancer Care provides comprehensive on-site pharmacy services including medication pick-up, counseling, financial aid, prior authorization processing for insurance claims, and even home delivery.

START Center oncologists are leaders in international cancer research and conduct the world’s largest oncology program in Phase I clinical trials for anti-cancer medications. (Phase I trials are in the first round of research trials for new medications. These types of trials use just a few participants). The researchers at START have access to the very latest promising new anti-cancer mediations.

There is no guaranteed way to prevent ovarian cancer. However, the following actions are associated with a lower chance of developing ovarian cancer:

• Having taken oral contraceptives (birth control pills) for longer than five years.


• Having a surgical removal of the ovaries, a tubal ligation (tying of the fallopian tubes), or a hysterectomy (surgical procedure in which the uterus is removed).


• Having given birth.


• Breastfeeding. There is some evidence to suggest that women who have breastfed for one year or more may have a reduced risk of developing ovarian cancer.

If you’re concerned about your risk of developing ovarian cancer, it is advised to talk to your physician about ways to reduce your risk.