The ovaries are the main female reproductive glands, responsible for producing most female sex hormones as well as ova, or eggs. Most women possess two ovaries, although in many cases fertility can be maintained with a single ovary. The ovaries are subject to developing both cysts and tumors of low malignant potential. Although often painful, these growths are usually not concerning for cancer.
There are three main types of malignant ovarian tumors: epithelial cell tumors, germ cell tumors, and stromal tumors. Epithelial cell tumors are by far the most common among ovarian cancers, while stromal tumors make up less than 1% of all ovarian cancer cases.
There are several risk factors that can increase the chance of developing ovarian cancer. These include both controllable factors and factors that are out of the patient’s hands. The first is age. Ovarian cancer is rare in women under 40, and roughly half of all cases of ovarian cancers occur in women age 63 or above.
There also seems to be a link between obesity and ovarian cancer, with overweight women being at a higher risk. Additionally, reproductive history plays a role as a risk factor. Women who carry a pregnancy to term before age 26 show a lower risk of ovarian cancer. Also, women who have never carried a pregnancy to term or have only done so after age 35 have a higher risk.
Other factors include taking birth control pills, undergoing tubal ligation (tubes tied) surgery, or a hysterectomy, all of which reduce ovarian cancer risk. However, having hormone replacement therapy seems to raise the risk. Also, as with many cancers, family history plays a role.
There are four main stages of ovarian cancer, along with many substages, classified according to the spread of the cancer. These stages are:
The cancer is only present within the ovary and has not invaded any lymph nodes or other organs.
The cancer has spread to at least one other pelvic organ, such as the bladder or uterus, but not the lymph nodes.
The cancer has invaded the abdominal lining, the lymph nodes located at the back of the abdomen, or both.
The cancer has spread outside the abdominal cavity to organs located elsewhere, such as the lungs.
Some signs and symptoms of ovarian cancer include:
- Abdominal pain and/or bloating and swelling
- Pelvic and/or back pain
- Nausea and vomiting
- Pain during sexual intercourse
- Urinary symptoms such as urgency and frequency
- Variable menstrual changes
A diagnosis of ovarian cancer is typically made with a combination of a physical examination and diagnostic imaging, like ultrasound, x-rays, MRI, and CT scans. Additionally, biopsies and exploratory surgery called a laparotomy may be used to confirm a diagnosis or determine cancer staging.
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