Ovarian Cancer
 |
 |
 |
 |
 |
Only 24 percent of ovarian cancers are diagnosed at an early stage, when the cancer is confined to the ovary. Most cases are diagnosed after the cancer has spread to other parts of the body, making it difficult to treat successfully. A major risk factor for getting ovarian cancer is a personal history of breast, endometrial or colon cancer.
If you have experience with any type of cancer then we would like your opinion. Please submit your comment and we will post your comments in applicable sections.
All Rights Reserved
Click on a form of Cancer
Ovarian Cancer Facts to Know
Ovarian Cancer Fact 1. Ovarian cancer is the leading cause of gynecologic cancer deaths among American women.
Ovarian Cancer Fact 2. Only 24 percent of ovarian cancers are diagnosed at an early stage, when the cancer is confined to the ovary. Most cases are diagnosed after the cancer has spread to other parts of the body, making it difficult to treat successfully.
Ovarian Cancer Fact 3. One woman out of every 55 (approximately 1.8 percent) will develop ovarian cancer at some point in her lifetime.
Ovarian Cancer Fact 4. Ovarian cancer is most common in women who have already gone through menopause. The average age for developing ovarian cancer is 61 years old.
Ovarian Cancer Fact 5. For the small number of women who are fortunate enough to have their cancer diagnosed before it has spread beyond the ovary, the chance for recovery is 85 to 90 percent.
Ovarian Cancer Fact 6. For the majority of women in whom the disease has spread beyond the ovary, the chance of living for five years after the diagnosis is 20 to 25 percent.
Ovarian Cancer Fact 7. A major risk factor for getting ovarian cancer is a personal history of breast, endometrial or colon cancer.
Ovarian Cancer Fact 8. The only sure way to diagnose ovarian cancer is through microscopic examination of abnormal fluid or tissue, obtained by needle aspiration (withdrawal of fluid or tissue from a suspicious area though a special, wide needle) or surgery.
Ovarian Cancer Fact 9. Hycamtin is one of the first of a new kind of anti-cancer drugs that kills cancer cells by inhibiting an enzyme essential to the replication of human DNA.
_________________________
What is ovarian cancer?
Cancer is a disease in which certain body cells don't function right, divide very fast, and produce too much tissue that forms a tumor. Ovarian cancer is cancer in the ovaries, the female reproductive organs located in the pelvis. The ovaries make female hormones and store eggs that, if fertilized by sperm, can develop into a baby. Women have two ovaries, one on each side of the uterus. Tumors found in the ovaries may be non-cancerous tissue growths (cysts) or cancerous growths that may spread to other parts of the body.
Why should I be concerned about ovarian cancer?
About 1 in every 57 women in the United States will develop ovarian cancer. Most cases occur in women over the age of 50, but this disease can also affect younger women. Ovarian cancer causes more deaths than any other cancer of the female reproductive system. The sooner ovarian cancer is found and treated, the better a woman's chance for recovery. But ovarian cancer is hard to detect early. Many times, women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage. Scientists are studying ways to detect ovarian cancer before symptoms develop.
_______________
Types of Ovarian Cancer
There are several types of ovarian cancer, but this report discusses only epithelial ovarian tumors. If you need information about the less common types of ovarian cancer, please contact the American Cancer Society.
Benign epithelial ovarian tumors:
Most epithelial ovarian tumors are benign, do not spread, and usually do not lead to serious illness. There are several types of benign epithelial tumors, including serous adenomas, mucinous adenomas, and Brenner tumors.
Tumors of low malignant potential:
When viewed under the microscope, some ovarian epithelial tumors do not clearly appear to be cancerous. These are called tumors of low malignant potential (LMP tumors). They are also known as borderline epithelial ovarian cancers. These tumors differ from typical ovarian cancers, because they do not invade the ovarian stroma (the supporting tissue of the ovary). Likewise, if they spread outside the ovary (for example, into the abdominal cavity), they do not usually grow into the lining of the abdomen.
These cancers affect women at a younger age than the typical epithelial ovarian cancers. LMP tumors grow slowly and are also a less life-threatening disease than most ovarian cancers. Because of this, LMP tumors are treated differently, and a separate treatment pathway is presented in this report.
Epithelial ovarian cancers:
Cancerous epithelial tumors are called carcinomas. About 85% to 90% of ovarian cancers are epithelial ovarian carcinomas. Epithelial ovarian carcinoma cells have several features that can be seen under the microscope. These features are used to classify epithelial ovarian carcinomas into serous, mucinous, endometrioid, and clear cell types. Undifferentiated epithelial ovarian carcinomas don’t look like any of these 4 subtypes, and they also tend to grow and spread more quickly. Although all of these cancers may grow differently, they are all treated the same way.
Along with their classification by cell type, epithelial ovarian carcinomas are also given gradeand a stage. The tumor stage describes how far the tumor has spread from where it started in the ovary. The staging system is described in the staging section of this report.
_________________________________
Ovarian Cancer Stages
Staging is the process of finding out how far a cancer has spread. Most ovarian cancers that are not obviously widespread are staged at the time of surgery. Although your doctor may try to estimate the stage of your cancer from the exam and imaging tests, this estimate (called the clinical stage), this is not always accurate. The pathologic stage, which is assessed during and after surgery, is much more accurate.
During surgery, samples of tissues are taken from different parts of the pelvis and abdomen and looked at under the microscope. Staging is very important, because ovarian cancers are treated differently depending on stage. Each stage also has a different outlook (prognosis) for cure and survival. If the cancer is not properly staged, cancer that has spread outside the ovary may be missed and not treated. Once a stage has been assigned, it does not change, even if the cancer comes back or spreads to new locations in the body. The cancer is also assigned a grade, which describes how abnormal the individual cells look under the microscope. The stage and grade of the tumor are required for choosing the best treatment options.
Ask your cancer care team to explain the staging that will be done. Also ask them if they will be able to perform a thorough staging procedure. After surgery, ask about the stage of your cancer so that you can take part in making informed decisions about your treatment. The stages described below are pathologic stages. They are developed from the pathologist’s report of the findings from your surgery.
What the Stages of Ovarian Cancer Mean
Ovarian cancer is staged using the AJCC and FIGO system. AJCC stands for “American Joint Committee on Cancer,” and FIGO stands for “International Federation of Gynecologists and Obstetricians.”
Stage I: The cancer is still contained within the ovary (or ovaries).
Stage IA: Cancer has developed in one ovary and has not spread onto the outer surface of the ovary. Cancer cells were not found in washings from the abdomen and pelvis when the fluids were looked at under a microscope.
Stage IB: Cancer has developed within both ovaries and has not spread onto their outer surfaces. Cancer cells were not found in washings from the abdomen and pelvis when the fluids were looked at under a microscope.
Stage IC: The cancer is present in one or both ovaries, and one or more of the following are present:
* Cancer is found on the outer surface of at least one of the ovaries.
* In the case of cystic (fluid-filled) tumors, the capsule (outer wall of the tumor) has ruptured (opened).
* Cancer cells are found in fluid or washings from the abdomen when the fluids are looked at under a microscope.
Stage II: The cancer is in one or both ovaries and has grown onto or into other organs in the pelvis (such as the uterus, fallopian tubes, bladder, sigmoid colon, or the rectum).
Stage IIA: The cancer has spread onto or has grown into the uterus or the fallopian tubes, or both. Cancer cells are not found when washings from the abdomen are looked at under a microscope.
Stage IIB: The cancer has spread onto or grown into other nearby pelvic organs, such as the bladder, sigmoid colon, or rectum. Cancer cells are not found when washings from the abdomen are looked at under a microscope.
Stage IIC: The cancer has spread onto or grown into pelvic organs as in stages IIA or IIB, and cancer cells were found in fluid or washings from the abdomen.
Stage III: The cancer involves one or both ovaries, and one or both of the following are present:
* Cancer has spread beyond the pelvis to the lining of the abdomen.
* Cancer has spread to lymph nodes.
Stage IIIA: During the staging operation, the surgeon can see cancer in the ovary or ovaries but no other sites of disease outside the ovaries are visible. However, when biopsies (tissue samples) are checked under a microscope, tiny deposits of cancer are found in the lining of the abdomen. The cancer has not spread to lymph nodes.
Stage IIIB: There is cancer in one or both ovaries, and deposits of cancer large enough for the surgeon to see but smaller than 2 cm (about 3/4-inch) across are present in the abdomen. Cancer has not spread to the lymph nodes.
Stage IIIC: The cancer is in one or both ovaries, and one or both of the following are present:
* Cancer has spread to lymph nodes.
*
Deposits of cancer larger than 2 cm (about 3/4-inch) across are seen in the abdomen.
Stage IV: This is the most advanced stage of ovarian cancer. The cancer has spread to distant sites such as the inside of the liver (if it is only on the outside, the cancer can still be stage III), the lungs, or to other organs located outside of the pelvis or abdomen. Finding ovarian cancer cells in pleural fluid (from around the lungs) is also evidence of stage IV disease.
Grade
The grade is on a scale of 1, 2, or 3 and is based on how the cells look under the microscope. Grade 1 epithelial ovarian carcinomas look more like normal tissue and grow more slowly. Patients with grade 1 carcinomas tend to have a better prognosis (which means that these patients usually live longer). Grade 3 epithelial ovarian carcinomas look less like normal tissue, are more aggressive, and usually have a worse outlook.
Recurrent ovarian cancer
This means that the disease has recurred (come back) after treatment was completed.
________________________
Ovarian cancer has long troubled specialists
BOULDER, Colo. -- Standing before a full-length mirror in her swimsuit on the Fourth of July, Deandra Trevino could no longer overlook it: There was something terribly wrong.
She had first noticed it a few weeks earlier -- an unusual swelling in her typically lean tummy -- but the fit 27-year-old quickly dismissed it as bloating, or maybe a few extra pounds. This was different.
"It literally just hit me," says Trevino, a Boulder native and hair salon owner. "Suddenly, I looked like I was seven months pregnant."
Trevino immediately scratched her holiday swimming plans and went straight to a local urgent care clinic, where she began a nine-day odyssey during which many of her care providers downplayed her condition just as she had initially. One doctor told her she was suffering from irritable bowel syndrome and should go home and eat some fiber. A radiologist noted that her uterus "could not be identified," on the ultrasound, then suggested she had endometriosis and told her to come back for more tests in a few weeks.
Now riddled with pelvic pain and increased swelling, Trevino instead insisted on more tests immediately, and soon she had her answer: Her uterus was "unidentifiable" because a mass 7.5 inches across had consumed it. She, like 22,430 other women in 2007, was diagnosed with ovarian cancer.
"I did not even suspect for a minute that it was cancer," says Trevino, who is now both fighting for her life and fighting to raise awareness about the disease.
Dubbed the "whispering cancer," ovarian cancer has long exasperated cancer specialists, because it is both tricky to diagnose and difficult to treat once it gets past a certain stage. The good news: In cases where the cancer is caught before it spreads past the ovaries, 93 percent of women will live beyond five more years. The bad news: Only 20 percent of cases are caught that early.
When diagnosed in advanced stages, as more than 55 percent of patients are, five-year survival rates drop below 30 percent.
"By the time the patient has symptoms, they are usually symptoms of metastatic disease," says Boulder oncologist John Fleagle, who is treating Trevino. "That's what's so frustrating."
Thus far, there is no routine diagnostic test (like a pap smear) to detect ovarian cancer at an early stage. Symptoms are subtle, such as bloating and weight gain, and often there are no symptoms at all.
In 2008, more than 15,000 women will die of ovarian cancer, making it the most deadly of all gynecological cancers and the fifth leading cause of cancer death among women.
Efforts are under way to improve those numbers. In January, Sen. Elizabeth Dole, R-N.C., and Sen. Barbara Boxer introduced legislation that would earmark $100 million for National Cancer Institute research grants and $20 million for a national clinical trial aimed at identifying biochemical indicators of ovarian cancer.
"Unlike common cancers such as breast, cervical, and prostate cancers, ovarian cancer -- the most common gynecological cancer -- has no biomarker," said Dole, in a prepared statement.
Ovarian Cancer Fact 1. Ovarian cancer is the leading cause of gynecologic cancer deaths among American women.
Ovarian Cancer Fact 2. Only 24 percent of ovarian cancers are diagnosed at an early stage, when the cancer is confined to the ovary. Most cases are diagnosed after the cancer has spread to other parts of the body, making it difficult to treat successfully.
Ovarian Cancer Fact 3. One woman out of every 55 (approximately 1.8 percent) will develop ovarian cancer at some point in her lifetime.
Ovarian Cancer Fact 4. Ovarian cancer is most common in women who have already gone through menopause. The average age for developing ovarian cancer is 61 years old.
Ovarian Cancer Fact 5. For the small number of women who are fortunate enough to have their cancer diagnosed before it has spread beyond the ovary, the chance for recovery is 85 to 90 percent.
Ovarian Cancer Fact 6. For the majority of women in whom the disease has spread beyond the ovary, the chance of living for five years after the diagnosis is 20 to 25 percent.
Ovarian Cancer Fact 7. A major risk factor for getting ovarian cancer is a personal history of breast, endometrial or colon cancer.
Ovarian Cancer Fact 8. The only sure way to diagnose ovarian cancer is through microscopic examination of abnormal fluid or tissue, obtained by needle aspiration (withdrawal of fluid or tissue from a suspicious area though a special, wide needle) or surgery.
Ovarian Cancer Fact 9. Hycamtin is one of the first of a new kind of anti-cancer drugs that kills cancer cells by inhibiting an enzyme essential to the replication of human DNA.
_________________________
What is ovarian cancer?
Cancer is a disease in which certain body cells don't function right, divide very fast, and produce too much tissue that forms a tumor. Ovarian cancer is cancer in the ovaries, the female reproductive organs located in the pelvis. The ovaries make female hormones and store eggs that, if fertilized by sperm, can develop into a baby. Women have two ovaries, one on each side of the uterus. Tumors found in the ovaries may be non-cancerous tissue growths (cysts) or cancerous growths that may spread to other parts of the body.
Why should I be concerned about ovarian cancer?
About 1 in every 57 women in the United States will develop ovarian cancer. Most cases occur in women over the age of 50, but this disease can also affect younger women. Ovarian cancer causes more deaths than any other cancer of the female reproductive system. The sooner ovarian cancer is found and treated, the better a woman's chance for recovery. But ovarian cancer is hard to detect early. Many times, women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage. Scientists are studying ways to detect ovarian cancer before symptoms develop.
_______________
Types of Ovarian Cancer
There are several types of ovarian cancer, but this report discusses only epithelial ovarian tumors. If you need information about the less common types of ovarian cancer, please contact the American Cancer Society.
Benign epithelial ovarian tumors:
Most epithelial ovarian tumors are benign, do not spread, and usually do not lead to serious illness. There are several types of benign epithelial tumors, including serous adenomas, mucinous adenomas, and Brenner tumors.
Tumors of low malignant potential:
When viewed under the microscope, some ovarian epithelial tumors do not clearly appear to be cancerous. These are called tumors of low malignant potential (LMP tumors). They are also known as borderline epithelial ovarian cancers. These tumors differ from typical ovarian cancers, because they do not invade the ovarian stroma (the supporting tissue of the ovary). Likewise, if they spread outside the ovary (for example, into the abdominal cavity), they do not usually grow into the lining of the abdomen.
These cancers affect women at a younger age than the typical epithelial ovarian cancers. LMP tumors grow slowly and are also a less life-threatening disease than most ovarian cancers. Because of this, LMP tumors are treated differently, and a separate treatment pathway is presented in this report.
Epithelial ovarian cancers:
Cancerous epithelial tumors are called carcinomas. About 85% to 90% of ovarian cancers are epithelial ovarian carcinomas. Epithelial ovarian carcinoma cells have several features that can be seen under the microscope. These features are used to classify epithelial ovarian carcinomas into serous, mucinous, endometrioid, and clear cell types. Undifferentiated epithelial ovarian carcinomas don’t look like any of these 4 subtypes, and they also tend to grow and spread more quickly. Although all of these cancers may grow differently, they are all treated the same way.
Along with their classification by cell type, epithelial ovarian carcinomas are also given gradeand a stage. The tumor stage describes how far the tumor has spread from where it started in the ovary. The staging system is described in the staging section of this report.
_________________________________
Ovarian Cancer Stages
Staging is the process of finding out how far a cancer has spread. Most ovarian cancers that are not obviously widespread are staged at the time of surgery. Although your doctor may try to estimate the stage of your cancer from the exam and imaging tests, this estimate (called the clinical stage), this is not always accurate. The pathologic stage, which is assessed during and after surgery, is much more accurate.
During surgery, samples of tissues are taken from different parts of the pelvis and abdomen and looked at under the microscope. Staging is very important, because ovarian cancers are treated differently depending on stage. Each stage also has a different outlook (prognosis) for cure and survival. If the cancer is not properly staged, cancer that has spread outside the ovary may be missed and not treated. Once a stage has been assigned, it does not change, even if the cancer comes back or spreads to new locations in the body. The cancer is also assigned a grade, which describes how abnormal the individual cells look under the microscope. The stage and grade of the tumor are required for choosing the best treatment options.
Ask your cancer care team to explain the staging that will be done. Also ask them if they will be able to perform a thorough staging procedure. After surgery, ask about the stage of your cancer so that you can take part in making informed decisions about your treatment. The stages described below are pathologic stages. They are developed from the pathologist’s report of the findings from your surgery.
What the Stages of Ovarian Cancer Mean
Ovarian cancer is staged using the AJCC and FIGO system. AJCC stands for “American Joint Committee on Cancer,” and FIGO stands for “International Federation of Gynecologists and Obstetricians.”
Stage I: The cancer is still contained within the ovary (or ovaries).
Stage IA: Cancer has developed in one ovary and has not spread onto the outer surface of the ovary. Cancer cells were not found in washings from the abdomen and pelvis when the fluids were looked at under a microscope.
Stage IB: Cancer has developed within both ovaries and has not spread onto their outer surfaces. Cancer cells were not found in washings from the abdomen and pelvis when the fluids were looked at under a microscope.
Stage IC: The cancer is present in one or both ovaries, and one or more of the following are present:
* Cancer is found on the outer surface of at least one of the ovaries.
* In the case of cystic (fluid-filled) tumors, the capsule (outer wall of the tumor) has ruptured (opened).
* Cancer cells are found in fluid or washings from the abdomen when the fluids are looked at under a microscope.
Stage II: The cancer is in one or both ovaries and has grown onto or into other organs in the pelvis (such as the uterus, fallopian tubes, bladder, sigmoid colon, or the rectum).
Stage IIA: The cancer has spread onto or has grown into the uterus or the fallopian tubes, or both. Cancer cells are not found when washings from the abdomen are looked at under a microscope.
Stage IIB: The cancer has spread onto or grown into other nearby pelvic organs, such as the bladder, sigmoid colon, or rectum. Cancer cells are not found when washings from the abdomen are looked at under a microscope.
Stage IIC: The cancer has spread onto or grown into pelvic organs as in stages IIA or IIB, and cancer cells were found in fluid or washings from the abdomen.
Stage III: The cancer involves one or both ovaries, and one or both of the following are present:
* Cancer has spread beyond the pelvis to the lining of the abdomen.
* Cancer has spread to lymph nodes.
Stage IIIA: During the staging operation, the surgeon can see cancer in the ovary or ovaries but no other sites of disease outside the ovaries are visible. However, when biopsies (tissue samples) are checked under a microscope, tiny deposits of cancer are found in the lining of the abdomen. The cancer has not spread to lymph nodes.
Stage IIIB: There is cancer in one or both ovaries, and deposits of cancer large enough for the surgeon to see but smaller than 2 cm (about 3/4-inch) across are present in the abdomen. Cancer has not spread to the lymph nodes.
Stage IIIC: The cancer is in one or both ovaries, and one or both of the following are present:
* Cancer has spread to lymph nodes.
*
Deposits of cancer larger than 2 cm (about 3/4-inch) across are seen in the abdomen.
Stage IV: This is the most advanced stage of ovarian cancer. The cancer has spread to distant sites such as the inside of the liver (if it is only on the outside, the cancer can still be stage III), the lungs, or to other organs located outside of the pelvis or abdomen. Finding ovarian cancer cells in pleural fluid (from around the lungs) is also evidence of stage IV disease.
Grade
The grade is on a scale of 1, 2, or 3 and is based on how the cells look under the microscope. Grade 1 epithelial ovarian carcinomas look more like normal tissue and grow more slowly. Patients with grade 1 carcinomas tend to have a better prognosis (which means that these patients usually live longer). Grade 3 epithelial ovarian carcinomas look less like normal tissue, are more aggressive, and usually have a worse outlook.
Recurrent ovarian cancer
This means that the disease has recurred (come back) after treatment was completed.
________________________
Ovarian cancer has long troubled specialists
BOULDER, Colo. -- Standing before a full-length mirror in her swimsuit on the Fourth of July, Deandra Trevino could no longer overlook it: There was something terribly wrong.
She had first noticed it a few weeks earlier -- an unusual swelling in her typically lean tummy -- but the fit 27-year-old quickly dismissed it as bloating, or maybe a few extra pounds. This was different.
"It literally just hit me," says Trevino, a Boulder native and hair salon owner. "Suddenly, I looked like I was seven months pregnant."
Trevino immediately scratched her holiday swimming plans and went straight to a local urgent care clinic, where she began a nine-day odyssey during which many of her care providers downplayed her condition just as she had initially. One doctor told her she was suffering from irritable bowel syndrome and should go home and eat some fiber. A radiologist noted that her uterus "could not be identified," on the ultrasound, then suggested she had endometriosis and told her to come back for more tests in a few weeks.
Now riddled with pelvic pain and increased swelling, Trevino instead insisted on more tests immediately, and soon she had her answer: Her uterus was "unidentifiable" because a mass 7.5 inches across had consumed it. She, like 22,430 other women in 2007, was diagnosed with ovarian cancer.
"I did not even suspect for a minute that it was cancer," says Trevino, who is now both fighting for her life and fighting to raise awareness about the disease.
Dubbed the "whispering cancer," ovarian cancer has long exasperated cancer specialists, because it is both tricky to diagnose and difficult to treat once it gets past a certain stage. The good news: In cases where the cancer is caught before it spreads past the ovaries, 93 percent of women will live beyond five more years. The bad news: Only 20 percent of cases are caught that early.
When diagnosed in advanced stages, as more than 55 percent of patients are, five-year survival rates drop below 30 percent.
"By the time the patient has symptoms, they are usually symptoms of metastatic disease," says Boulder oncologist John Fleagle, who is treating Trevino. "That's what's so frustrating."
Thus far, there is no routine diagnostic test (like a pap smear) to detect ovarian cancer at an early stage. Symptoms are subtle, such as bloating and weight gain, and often there are no symptoms at all.
In 2008, more than 15,000 women will die of ovarian cancer, making it the most deadly of all gynecological cancers and the fifth leading cause of cancer death among women.
Efforts are under way to improve those numbers. In January, Sen. Elizabeth Dole, R-N.C., and Sen. Barbara Boxer introduced legislation that would earmark $100 million for National Cancer Institute research grants and $20 million for a national clinical trial aimed at identifying biochemical indicators of ovarian cancer.
"Unlike common cancers such as breast, cervical, and prostate cancers, ovarian cancer -- the most common gynecological cancer -- has no biomarker," said Dole, in a prepared statement.