Jane DoeWhat is ovarian cancer?
Ovarian cancer is cancer that begins in the ovaries. Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel through the fallopian tubes into the uterus where the fertilized egg implants and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is located on each side of the uterus in the pelvis.
The ovaries contain 3 main kinds of cells:
- Epithelial cells, which cover the ovary
- Germ cells, which are found inside the ovary. These cells develop into the eggs (ova) that are released into the fallopian tubes every month during the reproductive years.
- Stromal cells, which form the supporting or structural tissue holding the ovary together and which produce most of the female hormones estrogen and progesterone
- Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
- Germ cell tumors start from the cells that produce the eggs (ova).
- Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
Types of ovarian cancer
The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include:
- Cancer that begins in the cells on the outside of the ovaries. Called epithelial tumors, these cancers begin in the thin layer of tissue that covers the outside of the ovaries. Most ovarian cancers are epithelial tumors.
- Cancer that begins in the egg-producing cells. Called germ cell tumors, these ovarian cancers tend to occur in younger women.
- Cancer that begins in the hormone-producing cells. These cancers, called stromal tumors, begin in the ovarian tissue that produces the hormones estrogen, progesterone and testosterone.
Symptoms of Ovarian Cancer
Often, ovarian cysts don't cause any symptoms. You may not realize you have one until you visit your health care provider for a routine pelvic exam. Ovarian cysts can, however, cause problems if they twist, bleed, or rupture.
If you have any of the symptoms below, it's important to have them checked out. That's because they can also be symptoms of ovarian tumors. Ovarian cancer often spreads before it is detected.
Symptoms of ovarian cysts and tumors include:
- Pain or bloating in the abdomen
- Difficulty urinating, or frequent need to urinate
- Dull ache in the lower back
- Pain during sexual intercourse
- Painful menstruation and abnormal bleeding
- Weight gain
- Nausea or vomiting
- Loss of appetite, feeling full quickly
Causes of Ovarian Cancer
We don’t yet know exactly what causes most ovarian cancers. As discussed in the previous section, we do know some factors that make a woman more likely to develop epithelial ovarian cancer. Much less is known about risk factors for germ cell and stromal tumors of the ovaries.
Ovarian cancers causes are following:
Family history of cancer
Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer. If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.
Personal history of cancer
Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
Age over 55
Most women are over age 55 when diagnosed with ovarian cancer.
Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.
Menopausal hormone therapy
Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.
Treatment for Ovarian Cancer
Your doctor can describe your treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, radiation therapy is used.
Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body:
Local therapy
Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
Intraperitoneal chemotherapy
Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.
Systemic chemotherapy
When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.
Lifestyle changes after Ovarian Cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life -- making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it's really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. (For more information on dealing with fatigue, please see Fatigue in People With Cancer and Anemia in People With Cancer.)
Keep in mind exercise can improve your physical and emotional health.
- It improves your cardiovascular (heart and circulation) fitness.
- Along with a good diet, it will help you get to and stay at a healthy weight.
- It makes your muscles stronger.
- It reduces fatigue and helps you have more energy.
- It can help lower anxiety and depression.
- It can make you feel happier.
- It helps you feel better about yourself.
