What is ovarian cancer?

The ovary is a small organ in women that makes female hormones (estrogen and progesterone) and holds egg cells.

There are two ovaries: one located on the left side of the uterus (the hollow, pear-shaped organ where a baby can develop) and one located on the right.

Cancer of the ovary is a disease in which cancer cells grow in the ovary. Most commonly, the cancer begins in the lining (epithelium) of the ovary and is called germ cell tumor.

What are risk factors and how can ovarian cancer be prevented?

American Cancer Society estimates that there will be about 21,650 new cases of ovarian cancer in this country in 2008.

The disease accounts for 4 percent of all cancers in women and causes more deaths than any other cancer of the reproductive system.

There are several known or suspected risk factors for developing epithelial ovarian cancer, but the influence of these risk factors is not well understood. Women with no risk factors may develop the disease, and women who have risk factors do not necessarily develop the disease.

The risk factors include the following:

  • Age: Most ovarian cancer occurs in post-menopausal women.
  • Breast cancer: Women who have had breast cancer have an increased risk of developing ovarian cancer.
  • Heredity: If a woman's sisters, daughters, or mother has had ovarian cancer, she may have an increased risk of developing the disease. This risk can be inherited from either her mother's or her father's side of her family. Women with two or more close family members affected by ovarian cancer should be counseled by a qualified specialist regarding their individual risk.
  • Menstrual/reproductive history:A woman may have an increased of developing ovarian cancer if she started menstruating early, experienced menopause late, or had no children or a first child after the age of 30.

What are the symptoms and how is a diagnosis made?

Unfortunately, the majority of women with ovarian cancer are not diagnosed until they have advanced disease. Although some women with early ovarian cancer have symptoms, more often women have no symptoms or very mild and nonspecific symptoms.

A woman should see a doctor if she experiences symptoms such as:

  • Vague gastrointestinal discomfort
  • Pelvic pressure
  • Abdominal swelling
  • Pain in the abdomen, back, or legs

The symptoms may be indicative of a less serious problem, but it is important to get an accurate diagnosis. The chances of successful treatment for ovarian cancer are much better if the cancer is found early.

If cancer of the ovary has spread to the peritoneum (the sac inside the abdomen that holds the intestines, uterus, and ovaries), fluid may build up inside the peritoneum (called ascites) and a woman may experience swelling of the abdomen. If the cancer has spread to the diaphragm, the muscle under the lung that controls breathing, fluid may build up under the lungs and cause shortness of breath.

If a doctor suspects ovarian cancer, he or she may do a pelvic examination to check for any signs of tumors or abnormal tissue. Cancer may be difficult to feel, however, so the doctor will likely use imaging tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and ultrasound to look for abnormal masses in the pelvic. The only way the doctor can confirm the presence of a cancer is to perform a biopsy, a surgical procedure to remove a small sample of tissue for examination under a microscope.

The chance of recovery (prognosis) and choice of treatment for ovarian cancer depend on the patient's age and general state of health, the type and size of the tumor, and the stage of the cancer.

What clinical trials are available?

Another treatment option available to some patients is to participate in a study of a new cancer treatment.

Every successful cancer treatment being used today was first tested in a clinical trial, a three-step research process designed to evaluate the safety and effectiveness of new treatments for diseases. Clinical trials are conducted at the end of a much longer process of developing and testing new therapies in the laboratory. Patients who participate in successful trials are the first to benefit from the new therapy.

Doctors in many hospitals and cancer centers across the country conduct clinical trials as new drugs and other therapies become available for treating cancer patients. Each carefully planned study is designed to answer certain questions and to find out specific information about how well a new drug or treatment method works.

All new treatments must go through three steps or phases of clinical trials:

  • Phase I trials: These first studies in people evaluate how a new drug should be given (by mouth, injected into the blood, or injected into the muscle), how often, and in what dose. A Phase I trial usually involves only a small number of patients, sometimes as few as a dozen.
  • Phase II trials: A Phase II trial continues to test the safety of the drug and begins to evaluate how well the new drug works. Phase II studies usually focus on a particular type of cancer.
  • Phase III trials: These studies test a new drug, a new combination of drugs, or a new surgical procedure in comparison to the current standard for treatment. A participant will usually be assigned to the standard treatment group or the new treatment group at random (called randomization). Phase III trials often enroll large numbers of people and may be conducted at many doctors' offices, clinics, and cancer centers nationwide.

All clinical trial participants receive the best care possible, and their reactions to the treatment are watched very closely. If the treatment does not seem to be helping, a doctor can take a patient out of a study. A patient may choose to leave a trial at any time. If a patient leaves a research study for any reason, standard care and treatment are still available.

View more information about our clinical trials.