Ovarian Cancer

What are the ovaries?

The ovaries are female reproductive organs located in the pelvis. There are two of them – one on each side of the uterus. The ovaries produce eggs and the female hormones estrogen and progesterone. Estrogen and progesterone control the development of female body characteristics (i.e., breasts, body shape and body hair) and regulate the menstrual cycle and pregnancy.

What are risk factors for ovarian cancer?

The cause of ovarian cancer is unknown, but there are certain risk factors that indicate an increase in a woman’s chance of developing ovarian cancer. The following have been suggested as risk factors for ovarian cancer:

• early menarche – starting monthly periods early – before the age of 12
• late menopause (after the age of 52)
• age – over the age of 55
• obesity
• hormone replacement therapy

Some studies have suggested that women who use hormone replacement therapy after menopause may have a slightly increased risk of ovarian cancer.

• infertility (inability to become pregnant)
• personal history of breast or colon cancer
• family history

First-degree relatives (such as mother, daughter, sister) of a woman who has had ovarian cancer are at risk for developing the disease. The risk increases if two or more first-degree relatives have had ovarian cancer. A family history of breast or colon cancer is also associated with an increased risk of developing ovarian cancer.

• certain fertility drugs

Treatment for ovarian cancer:

Specific treatment for ovarian cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Ovarian cancer may be treated with surgery, chemotherapy, radiation therapy, or a combination of treatments.

• surgery

Surgery for ovarian cancer may include:

• salpingo-oophorectomy – surgery to remove the fallopian tubes and ovaries.
• hysterectomy – surgical removal of the uterus.
• pelvic lymph node dissection – removal of some lymph nodes from the pelvis.
• chemotherapy – the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual.
• radiation therapy – the use of high-energy radiation to kill cancer cells and to shrink tumors. There are two ways to deliver radiation therapy, including the following:
• external radiation (external beam therapy) – a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
• internal radiation (brachytherapy, implant radiation) – radiation is given inside the body as close to the cancer as possible. In some cases, a treatment called intraperitoneal radiation therapy is used. A radioactive liquid is given through a catheter into the abdomen.

Another treatment for ovarian cancer is intraperitoneal (IP) chemotherapy. This type of chemotherapy is given directly into the abdomen through a catheter (a long, thin tube). While several clinical trials have shown a benefit for this type of chemotherapy treatment, it is not widely used.