Understanding Ovarian Cancer

What is Ovarian Cancer?

Ovarian Cancer is a disease in which malignant or cancerous cells are found in the ovaries. An ovary is one of two small, almond shaped organs located on each side of the uterus that store eggs or germ cells and produce female hormones estrogen and progesterone.

What is the outlook for women diagnosed with Ovarian Cancer?

In women age 35-74, ovarian cancer is the 5th leading cause of cancer related deaths. If diagnosed and treated early, when the cancer is confined to the ovary, the five year survival rate is over 90%. Unfortunatly due to ovarian cancer's non-specific systoms and lack of early detection tests, the only 19% of all cases are found in this early stage. If caught in stage III or higher the five year survival rate can be as low as 29%. (American Cancer Society)

Types of Ovarian Cancer

There are more than 30 different types of Ovarian cancer.

Cancerous tumors can start from three common cell types:

-Surface epithelium- cells covering the lining of the ovaries

-Germ Cells- cells that are destined to form eggs

-Cord-Stromal Cells- cells that release hormones and connect the different structures of the ovaries

Stages of Ovarian Cancer

Once diagnosed with ovarian cancer, the stage of a tumor can be determined during surgery, when the doctor can tell if the cancer has spread outside the ovaries. There are four stages of ovarian cancer - Stage I (early disease) to Stage IV (advanced disease). Your treatment plan and prognosis (the probable course and outcome of your disease) will be determined by the stage of cancer you have.

Following is a description of the various stages of ovarian cancer:

Stage IA—Growth is limited to one ovary and the tumor is confined to the inside of the ovary. There is no cancer on the outer surface of the ovary. There are no ascites present containing malignant cells. The capsule is intact.

Stage IB—Growth is limited to both ovaries without any tumor on their outer surfaces. There are no ascites present containing malignant cells. The capsule is intact.

Stage IC—The tumor is classified as either Stage IA or IB and one or more of the following are present: (1) tumor is present on the outer surface of one or both ovaries; (2) the capsule has ruptured; and (3) there are ascites containing malignant cells or with positive peritoneal washings.

Stage IIA—The cancer has extended to and/or involves the uterus or the fallopian tubes, or both.

Stage IIB—The cancer has extended to other pelvic organs.

Stage IIC—The tumor is classified as either Stage IIA or IIB and one or more of the following are present: (1) tumor is present on the outer surface of one or both ovaries;
(2) the capsule has ruptured; and (3) there are ascites containing malignant cells or with positive peritoneal washings.

Stage IIIA—During the staging operation, the practitioner can see cancer involving one or both of the ovaries, but no cancer is grossly visible in the abdomen and it has not spread to lymph nodes. However, when biopsies are checked under a microscope, very small deposits of cancer are found in the abdominal peritoneal surfaces.

Stage IIIB—The tumor is in one or both ovaries, and deposits of cancer are present in the abdomen that are large enough for the surgeon to see but not exceeding 2 cm in diameter. The cancer has not spread to the lymph nodes.

Stage IIIC—The tumor is in one or both ovaries, and one or both of the following is present: (1) the cancer has spread to lymph nodes; and/or (2) the deposits of cancer exceed 2 cm in diameter and are found in the abdomen.

Stage I—Growth of the cancer is limited to the ovary or ovaries.

Stage II—Growth of the cancer involves one or both ovaries with pelvic extension.

Stage III—Growth of the cancer involves one or both ovaries, and one or both of the following are present: (1) the cancer has spread beyond the pelvis to the lining of the abdomen; and (2) the cancer has spread to lymph nodes. The tumor is limited to the true pelvis but with histologically proven malignant extension to the small bowel or omentum.

Stage IV— This is the most advanced stage of ovarian cancer. Growth of the cancer involves one or both ovaries and distant metastases (spread of the cancer to organs located outside of the peritoneal cavity) have occurred. Finding ovarian cancer cells in pleural fluid (from the cavity which surrounds the lungs) is also evidence of stage IV disease.