Ovarian Cancer

Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the female sex hormones estrogen and progesterone. Ovarian cancer occurs when cells grow in an uncontrolled, abnormal manner and produce tumors in one or both ovaries.

Ovarian cancer is the fifth most common cancer in women. It's diagnosed in more than 25,000 women in the United States each year, and about 16,000 women die of the disease annually.

Your chances of surviving ovarian cancer are better if the cancer is found early. But because the disease is difficult to detect in its early stage, only about 29 percent of ovarian cancers are found before tumor growth has spread into tissues and organs beyond the ovaries. Most of the time, the disease has already advanced before it's diagnosed.

Until recently, doctors thought that early-stage ovarian cancer rarely produced any symptoms. But new evidence has shown that many women do have signs and symptoms before the disease has spread. Being aware of them may lead to earlier detection.

Signs and symptoms

The symptoms of ovarian cancer tend to mimic those of other conditions, including digestive disorders, and it's not unusual for a woman with ovarian cancer to be diagnosed with another condition before finally learning she has cancer. The key seems to be persistent or worsening signs and symptoms. With a digestive disorder, they tend to come and go, or they occur in certain situations or after eating certain foods. With ovarian cancer, there's typically little fluctuation — signs and symptoms are constant and will gradually worsen.

Recent studies have shown that women with ovarian cancer are more likely than are other women to consistently experience the following symptoms:

• Abdominal pressure, fullness, swelling or bloating
• Urinary urgency
• Pelvic discomfort or pain

Additional signs and symptoms that women with ovarian cancer may experience include:

• Persistent indigestion, gas or nausea
• Unexplained changes in bowel habits, including diarrhea or constipation
• Changes in bladder habits, including a frequent need to urinate
• Loss of appetite
• Unexplained weight loss or gain
• Increased abdominal girth or clothes fitting tighter around your waist
• Pain during intercourse (dyspareunia)
• A persistent lack of energy
• Low back pain

Causes of Ovarian Cancer

An ovarian tumor is a growth of abnormal cells that may be either noncancerous (benign) or cancerous (malignant). Although benign tumors are made up of abnormal cells, these cells don't spread to other body tissues (metastasize). Ovarian cancer cells metastasize in one of two ways. Most often, they spread directly to other organs in the pelvis and abdomen. Rarely, they can spread through your bloodstream or lymph nodes to other parts of your body.

The causes of ovarian cancer remain unknown. Some researchers believe it has to do with the tissue-repair process that follows the monthly release of an egg through a tiny tear in an ovarian follicle (ovulation) during a woman's reproductive years. The formation and division of new cells at the rupture site may set up a situation in which genetic errors can occur. Others propose that the increased hormone levels before and during ovulation may stimulate the growth of abnormal cells.

Three basic types of ovarian tumors exist, designated by where they form in the ovary. They include:

• Epithelial tumors. About 90 percent of ovarian cancers develop in the epithelium, the thin layer of tissue that covers the ovaries. This form of ovarian cancer generally occurs in postmenopausal women.
• Germ cell tumors. These tumors occur in the egg-producing cells of the ovary and generally occur in younger women.
• Stromal tumors. These tumors develop in the estrogen- and progesterone-producing tissue that holds the ovary together.

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