Ovarian cancer is the growth of malignant cells in one or both ovaries, and is often accompanied by the spread of malignant cells to surrounding organs in the abdominal cavity. Research suggests that many epithelial ovarian cancers start in the fallopian tubes. Whilst a small number of cases appear to have an underlying genetic component, in most instances the causes of ovarian cancer are unknown.
Over 50% of the community incorrectly believe a pap smear diagnoses ovarian cancer
There is no early detection test for ovarian cancer, which often means that diagnosis happens when the disease has already advanced. Consequently, only 20–25% of women diagnosed will survive beyond five years.
Women have two ovaries, located on either side of the uterus or womb, as part of their reproductive system. These almond-shaped glands are two to four centimetres in diameter and are responsible for producing ova or eggs, as well as hormones that are involved in the menstrual cycle and fertility.
Benign and malignant tumours
While cells in our body usually grow in a controlled and organised fashion, when they grow abnormally, they form a growth or a tumour, which can be benign or malignant.
A malignant tumour, known as a cancer or carcinoma, will continue to spread in an uncontrolled fashion through the body unless it is treated. The extent of this spread will determine the stage of ovarian cancer.
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Types of ovarian cancer
There are several different types of ovarian cancer. The treatment and likely outcome for a particular type of ovarian cancer will vary with each individual case and needs to be discussed with a gynaecological oncologist.
Epithelial ovarian cancers are derived from cells covering the surface of the ovary and comprise over 90% of cases. Epithelial ovarian cancer is further divided into subtypes, including serous, mucinous, endometrioid, clear cell, and undifferentiated. Epithelial ovarian cancer can also be divided into grades depending on how abnormal the cancer looks under the microscope.
Germ cell ovarian cancers arise from the eggs within the ovary and can also be classified into several subtypes. Germ cell cancers are uncommon, and tend to occur in women under 30. Generally, this type responds well to treatment, and young women may still have children afterwards if only one ovary is affected.
Sex-cord stromal ovarian cancers originate from the tissue that releases female hormones. These are uncommon and can occur at any age. They respond well to treatment, and young women may still have children if only one ovary is affected.
Borderline ovarian cancers are a group of epithelial tumours that are not as aggressive or malignant as the epithelial cancers. They generally have a better outcome, whether diagnosed early or late.
How does ovarian cancer spread?
Ovarian cancer spreads to the other parts of the body by shedding cancerous cells into the abdominal cavity which then attach to the abdominal lining and continue to grow. Because there are few physical barriers within the abdominal cavity, it can spread very quickly.
Organs, tissue and muscle
Cancerous (malignant) cells can spread to the bowel, bladder, liver, omentum (the fatty tissue hanging from the stomach and intestines), and diaphragm (a sheet of muscle beneath the lungs).
Ovarian cancer may also spread via the lymph glands which are part of the immune system and often swell when our bodies are fighting an infection. These glands are all over the body, but it is those in the pelvis, around the aorta and in the groin and neck that are usually affected by ovarian cancer.
Another way of spreading is via the bloodstream or through the diaphragm, affecting the lungs and causing fluid to collect.
Signs & Symptoms Diagnosing