Ovarian cancer, an abnormal growth of cells in the ovaries, affects roughly 21,000 women in the United States annually. Understanding this disease is critical because early symptoms can be subtle, leading to delayed diagnosis and treatment. This guide breaks down the key facts about ovarian cancer: what it is, why it matters, how it develops, and what options exist for those affected.
Understanding the Ovaries and Cancer Development
The ovaries, located on either side of the uterus, produce eggs and hormones like estrogen and progesterone. Cancer can originate in these organs, often starting in the fallopian tubes—a key discovery that informs prevention strategies. Ovarian cancer isn’t a single disease; it manifests in different forms depending on the type of cell affected.
There are three primary types of ovarian tumors:
- Epithelial Ovarian Tumors: The most common and frequently malignant, accounting for 85-90% of cases. These develop from cells covering the ovary’s surface.
- Ovarian Germ Cell Tumors: Usually benign, these originate in egg cells and make up only 5% of cases.
- Ovarian Stromal Tumors: Rare, developing in structural cells responsible for hormone production, representing roughly 1% of diagnoses.
Recognizing the Signs: Why Early Detection Matters
Ovarian cancer is notoriously difficult to detect early because initial symptoms are often vague and easily dismissed. The disease frequently progresses before becoming noticeable, making early diagnosis vital. Common signs include:
- Persistent bloating: Beyond normal digestive discomfort.
- Pelvic or abdominal pain: Unexplained and ongoing.
- Difficulty eating or feeling full quickly: Significant changes in appetite.
- Urinary urgency or frequency: Sudden, unexplained bladder changes.
Other potential symptoms include fatigue, back pain, and changes in menstruation. If you experience these symptoms frequently (more than 12 times a month), consult a doctor promptly.
Risk Factors: Who Is Most Vulnerable?
While the exact causes of ovarian cancer remain unknown, several factors increase risk:
- Age: Risk increases with age, most cases diagnosed after menopause.
- Weight: Obesity is linked to higher risk, though not necessarily the most aggressive forms.
- Pregnancy History: Having your first child after age 35 or never carrying a pregnancy to term raises risk.
- Hormone Therapy: Prolonged use of estrogen-only hormone therapy may increase risk.
- Family History: A family history of ovarian, breast, or colorectal cancer is a significant risk factor.
- Genetic Mutations: Inherited mutations in BRCA1 and BRCA2 genes are among the most serious risk factors, accounting for 10-15% of cases.
Smoking has also been linked to an uncommon type of ovarian tumor.
Diagnosis and Staging: From Exam to Biopsy
Diagnosing ovarian cancer typically starts with a pelvic exam, but smaller tumors may not be detectable this way. Imaging tests—ultrasound, CT scans, and PET scans—can help locate tumors. A definitive diagnosis requires a biopsy: surgically removing tissue for laboratory analysis.
Staging the cancer (from 1 to 4) determines its extent and guides treatment. This involves evaluating tumor size and spread to lymph nodes or other organs. Genetic testing confirms if inherited mutations like BRCA1/2 are present, informing treatment decisions.
Treatment Options: Surgery, Chemotherapy, and Beyond
Treatment usually combines surgery to remove tumors, chemotherapy to kill cancer cells, and targeted therapies to disrupt cancer growth. The specific approach depends on the cancer’s stage and type.
Palliative care may be necessary for advanced cases to manage symptoms and improve quality of life.
Disparities and Prognosis: Why Outcomes Vary
Ovarian cancer survival rates depend heavily on diagnosis stage. Early-stage cancers have a 93% five-year survival rate, while overall survival is about 50%. However, disparities exist: survival rates for white women have improved, but have decreased among Black women over the same period, potentially due to socioeconomic factors and healthcare access.
The Bottom Line
Ovarian cancer is a serious disease requiring vigilance, early detection, and informed treatment. While risk factors exist, awareness of symptoms and proactive healthcare are critical for improving outcomes. If you experience persistent changes in your body, don’t hesitate to seek medical advice.
