Ovarian cancer is the fifth leading cause of cancer deaths in women.  One out of 40 to 60 women have a lifetime chance of developing ovarian cancer.

There are different types of ovarian cancer:

• Surface epithelial-stromal tumour, also known as ovarian epithelial carcinoma, is the most common type of ovarian cancer. It includes serous tumour, endometrioid tumor and mucinous cystadenocarcinoma.

• Sex cord-stromal tumor, including estrogen-producing granulosa cell tumor and virilizing Sertoli-Leydig cell tumor or arrhenoblastoma, accounts for 8% of ovarian cancers.

• Germ cell tumor accounts for approximately 30% of ovarian tumors but only 5% of ovarian cancers.

• Mixed tumors (two or more of the above types)

Symptoms

The most common signs are:

• Bloating

• Pelvic or abdominal pain

• Difficulty eating or feeling full quickly

• Urinary symptoms (urgency or frequency)

 

These rather non-specific signs make early diagnosis difficult to make.  When suspected a doctor should always order a complete blood count (CBC) and serum electrolyte test. When pregnancy is suspected the serum BHCG level should be measured. Younger girls and adolescents have a higer risk at developing a malignant germ cell tumor and should be tested for serum alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH).

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Staging

Here are the stages used to characterize ovarian cancer development:

Stage I - limited to one or both ovaries

• IA - involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings

• IB - involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings

• IC - tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings

Stage II - pelvic extension or implants

• IIA - extension or implants onto uterus or fallopian tube; negative washings

• IIB - extension or implants onto other pelvic structures; negative washings

• IIC - pelvic extension or implants with positive peritoneal washings

Stage III - microscopic peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum

• IIIA - microscopic peritoneal metastases beyond pelvis

• IIIB - macroscopic peritoneal metastases beyond pelvis less than 2 cm in size

• IIIC - peritoneal metastases beyond pelvis > 2 cm or lymph node metastases

Stage IV - distant metastases to the liver or outside the peritoneal cavity

• Para-aortic lymph node metastases are considered regional lymph nodes (Stage IIIC).

 

Grading

Description

1  Low grade – slow growing, less likely to spread

2  Moderate grade

3  High grade – tend to grow quickly, more likely to spread

 

Treatment:

As with many cancers the choice of treatment is usually based on a number of factors and may include any of the following or combination thereof:

• surgery

• radiation therapy

• chemotherapy