Ovarian cancer begins in a woman's ovaries. The ovaries are part of a woman's reproductive system. There are two, located on each side of the uterus. They are almond-shaped and are about one-and-one-half inches long. Ovaries make eggs. Every month, during ovulation, an egg is released from an ovary and travels to the uterus via a fallopian tube.

Ovaries are the primary source of women's sex hormones, estrogen and progesterone, which influences female characteristics including breast growth, body shape and body hair. They also regulate the menstrual cycle and pregnancy.

There are three types of ovarian cancer:

Epithelial Carcinoma

Epithelial tumors make up 85% to 90% of ovarian cancers. They begin in cells on the outer surface of the ovary. Because it is difficult to diagnose, 70% of ovarian cancers are not found until the disease has reached an advanced stage and moved from the ovaries into another part of the body, most commonly the abdomen.

Germ Cell Tumors

This uncommon form of ovarian cancer develops in the egg-producing cells of the ovary.

Stromal Tumors

This rare form of ovarian cancer develops in the connective tissue cells that hold the ovaries together, as well as those that produce female hormones.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Ovarian epithelial cancer is a disease in which malignant (cancer) cells form in the tissue covering the ovary.

The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function).

Ovarian epithelial cancer is one type of cancer that affects the ovary. (Refer to the PDQ treatment summaries on Ovarian Germ Cell Tumors and Ovarian Low Malignant Potential Tumors for information about other types of ovarian cancer.)

Women who have a family history of ovarian cancer are at an increased risk of developing ovarian cancer.

Women who have one first-degree relative (mother, daughter, or sister) with ovarian cancer are at an increased risk of developing ovarian cancer. This risk is higher in women who have one first-degree relative and one second-degree relative (grandmother or aunt) with ovarian cancer. This risk is even higher in women who have two or more first-degree relatives with ovarian cancer.

Some ovarian cancers are caused by inherited gene mutations (changes).

The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary ovarian cancer makes up approximately 5% to 10% of all cases of ovarian cancer. Three hereditary patterns have been identified: ovarian cancer alone, ovarian and breast cancers, and ovarian and colon cancers.

Tests that can detect altered genes have been developed. These genetic tests are sometimes done for members of families with a high risk of cancer. (Refer to the PDQ summaries on Screening for Ovarian Cancer, Prevention of Ovarian Cancer, and Genetics of Breast and Ovarian Cancer for more information.)

Women with an increased risk of ovarian cancer may consider surgery to prevent it.

Some women who have an increased risk of ovarian cancer may choose to have a prophylactic oophorectomy (the removal of healthy ovaries so that cancer cannot grow in them). It is not known if this procedure prevents ovarian cancer.

Ovarian cancer is hard to detect (find) early because usually there are no symptoms.

Some women who have early stage ovarian cancer may have symptoms such as vague gastrointestinal (GI) discomfort, pressure in the pelvis, pain, swelling of the abdomen, and shortness of breath. Most of the time, there are no symptoms or they are very mild. By the time symptoms do appear, the cancer is usually advanced.
When found in its early stages, ovarian epithelial cancer can be cured in many patients. Women with any stage of ovarian epithelial cancer should consider taking part in a clinical trial.

Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect (find) and diagnose ovarian cancer.

The following tests and procedures may be used:

* Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and the other hand is placed over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

* Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

* CA 125 assay: A test that measures the level of CA 125 in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA 125 level is sometimes a sign of cancer or other condition.

* Barium enema (lower GI series): A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.

* Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.

* CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

* Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. The tissue is removed in a procedure called a laparotomy (a surgical incision made in the wall of the abdomen).

Certain factors affect treatment options and prognosis (chance of recovery).

The prognosis (chance of recovery) and treatment options depend on the following:

* The stage of the cancer.

* The type and size of the tumor.

* The patient’s age and general health.

* Whether the cancer has just been diagnosed or has recurred