Ovarian Cancer

Overview

Ovarian cancer originates in the ovaries, the two organs attached to the sides of the uterus that produce eggs and hormones needed for reproduction.

Epithelial ovarian cancer is the most common type of ovarian cancer. It begins in the epithelial cells, the cells that line the surface of the ovaries. Epithelial cancer constitutes about 85 to 90 percent of ovarian cancers.

The symptoms of ovarian cancer are not specific to cancer, and they may mimic those of many other conditions, including digestive and bladder disorders. If you have ovarian cancer, you may be diagnosed with another condition before finally learning you have cancer. Common misdiagnoses include irritable bowel syndrome, stress and depression.

Women with ovarian cancer are more likely than other women to consistently experience symptoms of abdominal pressure, fullness, swelling or bloating, urinary urgency and pelvic discomfort or pain. Other symptoms may include persistent indigestion, gas or nausea and unexplained changes in bowel habits, such as constipation.

If your doctor suspects you have ovarian cancer, he or she will take your medical history, give you a physical examination and perform various tests to aid in the diagnosis, including a Papanicolaou (Pap) smear.

Once ovarian cancer is diagnosed, surgery is usually the first treatment. You may be referred to a gynecologic oncologist for care. Research has shown that surgery by gynecologic oncologists results in higher survival rates than surgery by doctors without this type of specialty training, because gynecologic oncologists are more likely to remove all of the cancer at the time of surgery.

Usually the uterus, ovaries, fallopian tubes and nearby lymph nodes are removed for staging. Fatty tissue in the stomach area, called the omentum, also may be taken out, as well as any fluid in the abdominal area. If the cancer is more extensive, the surgeon may remove it from the intestines, liver and other affected areas. This procedure is called debulking.

Equally important is having surgery performed before chemotherapy, except for patients whose cancer has spread outside the abdomen or pelvis (such as to the liver, brain or lung) or patients who are too high a risk for surgery because of heart, lung or other severe medical conditions. In those cases, chemotherapy may be the first treatment.