Is it Ovarian Cancer and if so, what type have I got?
Types in depth
Epithelial ovarian cancer
As with all cancers, the risk of developing epithelial ovarian cancer increases with age but all women can be affected by the disease. They are divided into subtypes bases on their histology, i.e. how they look under a microscope. An emphasis is placed on correct identification of the epithelial subtype as it indicates how aggressive a cancer might be and therefore has consequences for how that cancer is treated. The subtypes are as follows:
Serous tumours contain cells that look like the cells of the fallopian tubes and are the most widespread forms of ovarian cancer. They account for 25 - 40% of common epithelial tumours. About 50% of these tumours are malignant (cancerous), 33% are benign (non cancerous), and 17% are of borderline malignancy. Serous tumours occur most often in women who are between 40 and 60 years of age. Specialists are now looking to subdivide these tumours into serous carcinoma, which tends to be aggressive and micropapillary serous carcinoma, a low grade, slow growing cancer often not responsive to chemotherapy.
Endometrioid tumours account for approximately 20% of epithelial tumours and occur primarily in women aged 50 - 70 years of age. The cells in these tumours resemble those in endometrial carcinoma, a cancer that affects the lining of the womb. About a fifth of cases occur in women who also have endometrial carcinoma and 5% are linked with endometriosis, a disorder of the endometrium, the lining of the womb. The majority of these tumours are malignant.
Clear cell carcinomas make up 6% of epithelial tumours and are most common in women aged 40 to 80. Nearly all of these tumours are malignant and about 50% are associated with endometriosis. Clear cell carcinoma is considered to be aggressive in nature.
Mucinous tumour cells look like cells of the mucinous membrane of the cervical canal which connects the to the uterus. These cancers are most common in women between 30 and 50 years of age and make up roughly 1% of epithelial tumours.
Undifferentiated tumours are those that do not fit neatly into any category and account for about 15% of epithelial tumours.
Transitional cell tumours often have cells that look like the cells that line the urinary tract. They tend to be high grade tumours.
Other Epithelial Ovarian Tumours
An additionally category of tumour referred to as borderline tumours are of low malignant potential (LMP) and account for 10% to 15% of cases. They effect women aged 30-80 but usually affect younger women. These tumours tend to be found on the surface of the ovary, rarely invade the tissue and have a better cure rate than invasive epithelial cancers. Then can often be cured through surgery alone.
Germ Cell Tumours
These tumours account for approximately 5%-10% of ovarian cancer cases. Unlike epithelial ovarian cancer which usually affects middle aged and older women, germ cell tumours tend to be found in younger women, and the peak incidence is early 20’s. They arise from germ cells, which produce the eggs, and are normally very curable with 90% of cases successfully treated. This form of cancer is associated with specific proteins such as beta human chorionic gonadotrophin and alpha fetoprotein which are released into the blood and can be used to monitor the progress of treatment.
Sex cord stromal tumours
Sex cord stromal tumours begin in the connective cells that hold the ovaries together and produce female hormones, and can affect all age groups. The majority of tumours are either benign (non cancerous) or confined to the ovary at the time of diagnosis.