Is it Ovarian Cancer and if so, what type have I got?
Ovaries
The ovaries are two small organs, the size of walnuts, which are part of the female reproductive system. They are buried deep in the abdomen. Each month, under the direction of several hormones, an egg matures and is released from the ovaries in to the fallopian tubes.
If it is fertilized by sperm the egg will attached itself to the lining of the womb and an embryo will form. If not, the lining of the womb, called the endometrium, will be shed by the woman as part of her monthly cycle or period. The ovaries also produce the hormones oestrogen and progesterone throughout a woman's reproductive years. During the menopause, production of these hormones decreases and gradually the monthly cycle stops.
What is cancer?
The organs and tissue of the body are made from cells, the basic structural building block. All of the cells in the body have defined and tightly regulated roles essential for the well being of the body as a whole. Cancer is a disease of these cells and can occur in any organ. It is characterized by abnormal and uncontrolled cell growth and division. The resulting tumour can invade the surrounding normal tissue for no reason and serving no purpose which causes tissue destruction. Cancer cells can spread from the original site via the blood stream or lymph system to start new cancers in other parts of the body. Cancer can be fatal.
Diagnosis
Cysts and benign growths on the ovaries are not uncommon and often have no symptoms. They are sometimes only discovered when tests are being carried out for other reasons. If you are approaching the menopause and have any of the symptoms of ovarian cancer that are persistent and have been ongoing for several weeks, you should draw the attention of your doctor to this disease, and request an internal examination by a gynaecologist. You may find it useful to use our symptom diary, which you can download here, along with tips on using it and talking to your doctor. Women with a family history of ovarian cancer may wish to consult a specialist for advice.
Diagnosis can involve the following techniques:
A tumour can be detected by internal ultrasound scan/CT/MRI scan
Blood test (CA125)
Physical examination
Abdominal fluid aspiration
Laparoscopy
Surgery, which if ovarian cancer is suspected, should be performed by a gynaecologic oncology surgeon if at all possible.
Malignant or not?
Most ovarian tumours are benign and as they do not spread they do not usually lead to serious illness. Only about a fifth of masses found in women who are still having periods are cancerous whereas almost 50% of masses found in post-menopausal women are.
There are several types of benign ovarian tumours such as serous adenomas, mucinous adenomas, and Brenner tumours. These are epithelial in origin (see below).
Type
It is important to realise that ovarian cancer is not a single disease, there are many types each with their own characteristics and behaviour. The disease is grouped into three major categories relating to the area of the ovary it started in.
By clicking on each type you will be able to access further information, but this may contain information about the aggressiveness of the particular type of ovarian cancer.
epithelial tumours
Borderline tumours
germ cell
sex cord-stromal cell
There is also a type of ovarian cancer known as primary peritoneal carcinoma, or extra-ovarian primary peritoneal carcinoma (EOPCC) and serous surface papillary carcinoma. This develops from the cells that form the lining of the pelvis, and is closely related to epithelial ovarian cancer. Although it is rare, it is possible that women who have had their ovaries removed can develop this type of cancer.
Staging and Grading
The staging and grading of ovarian cancer gives doctors important information about the disease and which kind of treatment would be best. It is also an indicator of prognosis. The stage relates to how far the cancer has spread and the grade indicates how much the tumour resembles normal tissue in appearance. Click here to find out more.