Ovarian cancer originates in the cells of the ovaries, including surface epithelial cells, germ cells and the sex cord-stromal cells.
Ovarian tumors include:
- Germ Cell Tumors — Ovarian germ cell tumors develop from cells that produce the ova or eggs. Most germ cell tumors are benign, although some are cancerous and may be life-threatening. The most common germ cell malignancies are maturing teratomas, dysgerminomas and endodermal sinus tumors. Teenagers and women in their 20s are most often diagnosed with germ cell malignancies.
- Stromal Tumors — Ovarian stromal tumors develop from connective tissue cells that hold the ovary together and those that produce the hormones estrogen and progesterone. The most common types are granulosa-theca tumors and Sertoli-Leydig cell tumors. These tumors are fairly rare and usually are considered low-grade cancers.
- Epithelial Tumors — Epithelial ovarian cancer develops from the thin layer of cells, called the epithelium, that covers the ovary. Most epithelial ovarian tumors are benign, including serous adenomas, mucinous adenomas and Brenner tumors. Cancerous epithelial tumors are the most common and the most serious of ovarian cancers, accounting for 85 percent to 90 percent of all ovarian cancer. Some ovarian epithelial tumors don’t appear clearly cancerous under the microscope and are called borderline tumors or tumors of low malignant potential (LMP tumors).
When cancer is diagnosed early while the tumor is limited to the ovary, the cure rate is better than 90 percent. Unfortunately, about two-thirds of women with ovarian cancer initially seek medical attention when the tumor is already advanced and has spread outside of the ovary. In these instances, the five-year survival rate is significantly lower.
Ovarian cancer often does not have signs or symptoms until later in its development. Symptoms may include:
- Abdominal bloating or swelling
- Abdominal or pelvic pain
- Difficulty eating or feeling full quickly
- Frequent urination or feeling a need to urinate
If these symptoms are persistent and a change from the norm, you should see a gynecologist.
Others symptoms of ovarian cancer can include:
- Back pain
- Constipation
- Fatigue
- Menstrual changes
- Pain during sex
- Upset stomach
These symptoms, however, may be caused by other conditions and aren’t necessarily signs of ovarian cancer.
Surgery is the preferred treatment for ovarian cancer. Surgical treatment alone is often sufficient for malignant tumors that are well-differentiated and confined to the ovary.
The addition of chemotherapy may be required for more aggressive tumors that are confined to the ovary. For patients with advanced disease a combination of surgical reduction with a combination chemotherapy regimen is standard.
Borderline tumors, even following spread outside of the ovary, are managed well with surgery, and chemotherapy is not seen as useful.