ovaries, part of the female reproductive organs, are located on either
side of the lower pelvis. Some women may develop cysts on the ovary which
can be felt on a pelvic exam or seen on special x-rays. A cyst is a small
growth on the ovary which is filled with fluid. Pure cysts are rarely
cancerous. Some will go away on their own, and others must be removed
surgically. Some may be cancerous. Evaluation by a cancer specialist is
Ovarian cancer comes from cells of the ovary that grow and divide. The
cells may grow to form a tumor on the ovary, and they can also break off
from the main tumor and spread to other parts of the body. Ovarian cancer
can spread throughout the entire body but, in most cases, it stays in
the abdomen and affects organs such as the intestines, liver, and stomach.
There are many different types of ovarian cancer. Most cancers of the
ovary come from the cells that make up the outer lining of the ovary and
are called epithelial ovarian cancers. Epithelial ovarian cancers occur
in women who do or who do not have a family history of the disease. Ovarian
cancer may affect women of any age group.
Are the Key Statistics About Ovarian Cancer?
cancer is often referred to as the silent killer
because by the time a woman has symptoms, the disease may
have already spread through her abdomen and beyond.
associated with ovarian cancer include: feeling bloated,
vague abdominal and pelvic discomfort, gastrointestinal
symptoms such as gas, back pain, and fatigue.
cancer is the sixth most common cancer among women, excluding
non-melanoma skin cancers. The American Cancer Society estimates
that about 23,400 new cases of ovarian cancer will be diagnosed
in the United States during 2001. Ovarian cancer accounts
for 4% of all cancers in women.
good news is that the ovarian cancer incidence rate has
been slowly decreasing since 1991. The incidence rate is
a precise way for scientists to describe how common or rare
a disease is. The ovarian cancer incidence rate is defined
as the number of new cases diagnosed each year per 10,000
cancer ranks fifth in cancer deaths among women, accounting
for more deaths than any other cancer of the female reproductive
system. It is estimated that there will be about 13,900
deaths from ovarian cancer in the United States during 2001.
five-year survival rate is used to provide a standard way
of discussing prognosis. It refers to the percentage of
patients who live at least five years after their cancer
is diagnosed, although many of these patients live much
longer than five years after diagnosis. Five-year relative
survival rates exclude from the calculations patients dying
of other diseases, and are considered to be a more accurate
way to describe the prognosis for patients with a particular
type and stage of cancer. Of course, five-year survival
rates are based on patients diagnosed and initially treated
more than five years ago.
78% of all ovarian cancer patients survive one year after
diagnosis and over 50% survive longer than five years after
diagnosis. If diagnosed and treated before the cancer spreads
to areas outside of the ovary, the five-year survival rate
is between 80% and 95%..
only 30% of all ovarian cancers are found at this early
stage. Older women with ovarian cancer tend to have a poorer
prognosis than younger ones. For example, the five-year
survival rate is 64% in women under 65 years of age and
30% in women over 65.
Types of Ovarian Tumors
are many types of tumors that can affect the ovaries. Some
are benign (noncancerous) and never spread beyond the ovary.
These patients can be treated successfully by surgically removing
one ovary or the part of an ovary containing a tumor. Other
types of ovarian tumors are malignant (cancerous) and may
spread to other parts of the body. Their treatment is more
complex, and is discussed later in this document.
general, ovarian tumors are named according to the kind of
cells the tumor started from and whether the tumor is benign
or cancerous. There are three main types of ovarian tumors:
tumors start from the cells that cover the outer surface
of the ovary.
cell tumors start from the cells that produce the ova
tumors start from the connective tissue cells that hold
the ovary together and produce the female hormones estrogen
Major Risk Factors for Epithelial Ovarian Cancer
or not having children until late in life
history of ovarian or breast cancer
which are associated with lower risk of ovarian cancer
include a history of birth control pill use, pregnancy,
tubal litigation (female sterilization), or breast feeding.
Patients are diagnosed by pelvic exam, ultrasound, and/or
surgical procedure called laparotomy. Once diagnosed surgery
for the removal of the ovaries, fallopian tubes, and uterus
(hysterectomy) is performed. If the cancer has spread
beyond the ovaries an attempt is made to remove as much
tumor as possible. After surgery and recuperation, chemotherapy
would be recommended for most.
The Stages of Ovarian Cancer
of ovarian cancer is described using the FIGO system. FIGO
stands for International Federation of Gynecologists and Obstetricians.
I - The cancer is still contained within the ovary.
IA - Cancer has developed in one ovary and the
tumor is confined to the inside of the ovary. There is
no cancer on the outer surface of the ovary. Laboratory
examination of washings from the abdomen and pelvis did
not find any cancer cells.
IB - Cancer has developed within both ovaries without
any tumor on their outer surfaces. Laboratory examination
of washings from the abdomen and pelvis did not find any
IC - The tumor is present in one or both ovaries
and one or more of the following are present: (1) cancer
on the outer surface of at least on the ovaries, (2) in
the case of cystic tumors (fluid-filled tumors), the capsule
(outer wall of the tumor) has ruptured (burst), (3) laboratory
examination found cancer cells in fluid or washings from
II - The cancer involves one or both ovaries and
has involved other organs (such as the uterus, fallopian
tubes, bladder, the sigmoid colon, or the rectum) within
IIA - The cancer has extended to, or has actually
invaded the uterus or the fallopian tubes, or both. Laboratory
examination of washings from the abdomen did not find
any cancer cells.
IIB - The cancer has extended to other nearby pelvic
organs such as the bladder, the sigmoid colon, or the
rectum. Laboratory examination of fluid from the abdomen
did not find any cancer cells.
IIC - The cancer involves pelvic organs as in stages
2A or 2B and one or more of the following are present:
(1) cancer on the outer surface of at least one of the
ovaries, (2) in the case of cystic tumors (fluid-filled
tumors), the capsule (outer wall of the tumor) has ruptured
(burst), (3) laboratory examination found cancer cells
in fluid or washings from the abdomen.
III - The cancer involves one or both ovaries, and
one or both of the following are present: (1) cancer has
spread beyond the pelvis to the lining of the abdomen, (2)
cancer has spread to lymph nodes (glands that fight infection
and produce some types of blood cells.)
IIIA - During the staging operation, the surgeon
can see cancer involving the ovary or ovaries, but no
cancer is visible to the naked eye in the abdomen and
the cancer has not spread to lymph nodes. However, when
biopsies are checked under a microscope, tiny deposits
of cancer are found in the lining of the upper abdomen.
IIIB - There is cancer in one or both ovaries,
and deposits of cancer are present in the abdomen which
are large enough for the surgeon to see but smaller than
2cm (about 3/4 inch) across. Cancer has not spread to
the lymph nodes.
IIIC - The tumor is in one or both ovaries, and
one or both of the following is present: (1) cancer has
spread to lymph nodes, (2) deposits of cancer larger than
2cm (about 3/4 inch) across are seen in the abdomen.
IV - This is the most advanced stage of ovarian cancer.
The tumor is on one or both ovaries. Distant metastasis
(spread of the cancer to the inside of the liver, the lungs,
or to other organs located outside of the peritoneal cavity)
has occurred. Finding ovarian cancer cells in pleural fluid
(from the cavity that surrounds the lungs) is also evidence
of stage 4 disease.
means that the disease has recurred (come back) after completion
Use these resources to find more information:
Some of the above information has been made available through the American
Cancer Society's Web site.