Ovarian Cancer
Ovarian Cancerinformation from the Alberta Cancer Board
Ovarian Cancer
About the disease
The ovaries are part of the female reproductive system. Women have two almond-sized ovaries, one on each side of the pelvis. They produce eggs and are the main source of the female hormones estrogen and progesterone.
Ovarian cancer is often deadly because the relatively mild symptoms often mask the disease until it is difficult to treat effectively.
Epithelial cancers are the most common form of the disease and occur in the cells lining the ovaries. Germ cell cancers start from cells that are destined to form within the ovaries. Sex cord cancers begin in the cells that produce female hormones.
About 175 Alberta women will be diagnosed with ovarian cancer every year.
Risk Factors
Risk factors are determined by analyzing the numbers of patients with cancer in a larger population and trying to find differences in the characteristics or behaviors between those individuals who develop cancer and those who do not. The Alberta Cancer Board’s Tomorrow Project, for instance, is tracking more than 50,000 Albertans over a fifty-year period to learn more about who develops cancer and why.
The cause of ovarian cancer is not known, but it is more common in developed countries.
Other factors that may increase the risk of developing ovarian cancer include:
- Infertility
- Early periods (before the age of 12)
- Late periods (after the age of 50)
- Having ovarian cysts
- Age – ovarian cancer can occur at any age, but is most commonly seen in ages between 60-75
- Medical History – having cancer of the breast, uterus, colon or rectum increases the chance of being diagnosed with ovarian cancer
- Ethnic background – Ashkenazi Jewish women are at increased risk
Factors that may decrease the risk of developing ovarian cancer include:
- Use of oral contraceptives
- Several pregnancies
- Breastfeeding
- Prophylactic oophorectomy is the removal of the ovaries before the development of cancer; this is recommended only for high risk patients
- Hysterectomies also reduce risk, but are not recommended exclusively to avoid ovarian cancer
- Tubal ligation is a surgery to tie the fallopian tubes to prevent pregnancy. If done after childbirth it decreases risk by more than half.
- Diet – some studies have shown a reduced rate of ovarian cancer when the diet includes large numbers of vegetables
Genetic Link
If a member of the family has had ovarian cancer there is an increased risk, especially if the cancer was diagnosed before the age of 50. Women who carry a gene associated with breast cancer (BRAC1 or BRAC2) are also at higher risk of getting ovarian cancer. However, the majority (almost 90 per cent) of ovarian cancer patients have not had a family history of the disease.
Detection and Diagnosis
There is no reliable test for ovarian cancer. However, the chances of early diagnosis increase with a yearly pelvic exam. If an abnormality is found, further blood tests and an ultrasound may be helpful. Ultimately the only way to confirm the presence of cancer is to do a bioposy, removing tissue from the pelvis and abdomen in a surgical procedure called a laparotomy. The tissue is examined under a microscope to check for the presence of cancer cells.
The symptoms of ovarian cancer are often overlooked because they can be subtle or confused with other diseases. Women may feel discomfort in the abdomen, pelvic pain or swelling, bloating or intestinal gas, constipation, frequent urination, vaginal bleeding, fatigue, nausea and fever.
Treatment
Treatment options for ovarian cancer include surgery, chemotherapy and radiation therapy, sometimes in combination depending on the progression of the disease.
Surgery is the standard treatment for ovarian cancer and involves removing as much of the tumour as possible. Ideally tumour nodules of less than one centimeter should be left because smaller masses respond more readily to chemotherapy. A laparotomy involves removing both of the ovaries and the fallopian tubes, the uterus or womb and nearby lymph nodes. A hysterectomy removes the uterus, both ovaries and the fallopian tubes.
Chemotherapy is usually used after surgery but is sometimes administered before the operation. The drugs can be injected directly into the abdomen through a catheter or a thin tube passing through the skin. They may also be taken orally or injected into a vein.
Radiation therapy, concentrated beams of high-energy X-rays, is used alone or in combination with chemotherapy or surgery, mostly to relieve pain and other symptoms. Radiation is not a common treatment for ovarian cancer.
Links:
 National Comprehensive Cancer Network (U.S.) guide to treatment decisions with links to other sites
(Canadian) National Ovarian Cancer Association
Factors Affecting Prognosis
Increasingly ovarian cancer is being treated like a chronic disease. The chance of survival depends in part on how early the disease is found and on the patient’s general health and age. If diagnosed early while the cancer is confined to the ovary the five year survival rate is more than 90 per cent. Unfortunately only about a fifth of ovarian cancer is discovered at this stage. For more advanced cases the five year survival rate drops below 30 per cent and overall about half of women diagnosed are still alive five years later.
Learn more
Support for ovarian cancer patients
- Psychosocial and spiritual support, Edmonton,
Cross Cancer Institute
- Phone: (780) 432-8703 or 8704
- Psychosocial and spiritual support, Calgary,
Holy Cross site of the Tom Baker Cancer Centre
- Compassion House
How you can help
Other Resources
National Ovarian Cancer Association (NOCA)
Canadian Cancer Society
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