Ovarian Cancer

What is cancer of the ovary (ovarian cancer)?

Ovarian cancer is the growth of abnormal cells in a woman's ovaries. The ovaries are glands on either side of the uterus (womb) in the lower belly. They are about the size and shape of an almond. They are part of the reproductive system and the main source of the female hormones estrogen and progesterone. Before menopause they produce eggs.

What is the cause?

The cause of ovarian cancer is not known. Most often it occurs in women over age 50. You may have an increased risk of ovarian cancer if:

• Your mother, sister, or daughter had ovarian cancer.
• You or members of your family have had breast or colon cancer.
• You have never given birth to a child.

Some studies suggest that women who use birth control pills, have a tubal sterilization, or breast-feed have a lower risk of getting ovarian cancer. Also, the more children you have had, the less likely it is you will have ovarian cancer.

What are the symptoms?

Ovarian cancer is very hard to detect in its early stages because at first there are often no clear symptoms. When symptoms do appear, they may include:

• an ongoing feeling of abdominal discomfort or pain (gas, indigestion, bloating, swelling, cramps)
• nausea, diarrhea, constipation
• loss of appetite
• feeling full even after a light meal
• unexplained weight loss or gain
• frequent urination or leaking of urine
• abnormal vaginal bleeding
• tiredness
• pelvic or back pain
• pain with sex

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history. You will have a physical exam, including a pelvic exam. Other exams and tests you may have are:

• ultrasound scan of the ovaries
• blood tests
• a special X-ray exam of the colon and rectum called a lower GI series or barium enema
• CT scan, another special type of X-ray exam

A small sample of tissue may need to be examined under a microscope to confirm the diagnosis. This is called a biopsy. It requires surgery with anesthesia. A sample may be taken through a viewing tube (laparoscope) inserted through a small cut in your belly. Another option is to remove the affected ovary for examination. Samples of nearby lymph nodes can be taken at the same time to check for spread of cancer beyond the ovary.

How is it treated?

You will have one or more of the following treatments:

• surgery
• radiation therapy
• chemotherapy

Usually both ovaries, the uterus, the fallopian tubes and nearby lymph nodes are removed. (The fallopian tubes carry eggs from the ovaries to the uterus.) After surgery, you may have radiation or anticancer drugs (chemotherapy) to kill the cancer cells. Chemotherapy may also be given to relieve cancer symptoms.

Sometimes anticancer medicine is put into your belly when you have surgery. Also, a tube may be placed in the belly at the time of surgery so that anticancer medicine can be injected into the belly after surgery.

How long will the effects last?

Cancer may start in the ovary and then spread to other parts of the body, such as the liver or lungs. The earlier ovarian cancer is found and treated, the better the chances for your long-term survival. The 5-year survival rate is over 90% when the cancer is found and treated early. If the cancer has spread beyond the ovaries, the survival rate is much lower.

Women who have had ovarian cancer may have a higher risk of breast or colon cancer. Also, treatment with certain anticancer drugs may increase the risk of other cancers, such as leukemia.

How can I take care of myself?

Make sure that you keep all follow-up appointments with your healthcare provider. Follow-up exams to check for the return or spread of cancer are very important.

Eat a balanced diet, get plenty of rest, and follow your provider's advice.

Joining a cancer support group can be very helpful. The support group can help you learn a lot about your care, treatment, and the cancer. Your local chapter of the American Cancer Society (ACS) may offer support groups. Look in the phone book for your local chapter.

For more information on cancer, you can contact:

• American Cancer Society, Inc.
  Phone: 800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org
• AMC Cancer Research Center and Foundation
  Phone: 800-525-3777
  Web site: http://www.amc.org
• NCI’s Cancer Information Service
  Phone: 800-4-CANCER (800-422-6237)
  Web site: http://www.cancer.gov/aboutnci/cis/

How can help prevent ovarian cancer?

At this time there is no known way of preventing ovarian cancer. However, if the cancer can be found and treated early, there is a good chance of survival. Be sure to:

• Have a pelvic exam every year, or as often as your healthcare provider recommends, so that your ovaries are checked regularly.
• Tell your provider as soon as possible if you have any ongoing abdominal discomfort or pain.
• Tell your provider if you lose or gain weight without a known reason.
• See your provider right away if you have unusual vaginal bleeding, including bleeding after menopause.

Some women who have an increased risk of ovarian cancer may choose to have their healthy ovaries removed so that cancer cannot grow in them. This is called prophylactic oophorectomy. The pros and cons of this surgery should be discussed with your healthcare provider.