Understanding Ovarian Cancer

September is ovarian cancer awareness month. Ovarian cancer can begin in the ovaries, but research has shown it may also start in nearby tissues such as the far ends of the fallopian tubes.

Ovarian cancer affects the female reproductive system and can be difficult to recognize early. Understanding the symptoms, tumor types, and treatment options can help you feel more prepared to talk with your doctor.

What are Ovaries?

Ovaries are the reproductive glands for women, where the body produces eggs for reproduction. They are also the main source of estrogen and progesterone before menopause, hormones that regulate menstrual cycles and support pregnancy.

From the ovaries, eggs travel through the fallopian tubes to the uterus. If an egg is not fertilized, it breaks down, and the uterine lining is shed during a normal menstrual cycle.

Because the ovaries sit deep in the pelvis, changes related to ovarian cancer may cause symptoms that feel vague or similar to common digestive or urinary conditions.

Early Signs and Common Symptoms of Ovarian Cancer

Diagnosing ovarian cancer in early stages is difficult because the symptoms are also commonly caused by other diseases or occur often in women who do not have ovarian cancer. As a result, many women are diagnosed after the cancer has advanced.

Symptoms may include:

• Bloating
• Pelvic or abdominal pain
• Fatigue
• Back pain
• Constipation
• Changes in period
• Abdominal swelling
• Upset stomach
• Pain during sex
• Trouble eating
• Urinary urgency
• Urinary frequency

These symptoms do not automatically mean cancer. However, if they persist or worsen, they should be discussed with a healthcare professional.

When to Talk With a Doctor

When symptoms like these become persistent, it is important to see a doctor to discuss these conditions. While they may be caused by something less serious, they can also be signs of ovarian cancer and should be evaluated promptly.

Open communication with a healthcare provider can help determine whether testing or imaging is needed. Early evaluation may clarify what is happening and guide next steps.

Different Ovarian Tumors and Cysts

Ovarian tumors fall into different categories, and not all ovarian growths are cancerous. These tumors can be malignant (cancerous), borderline (low malignant potential), or benign (non-cancerous).

Major categories include:

• Epithelial tumors: Start in surface-lining cells
• Germ cell tumors: Begin in egg-forming cells
• Stromal tumors: Arise in hormone-producing support tissue
• Ovarian cysts : Often benign fluid-filled sacs

Understanding the type of growth helps guide treatment decisions.

Epithelial Ovarian Tumors

The majority of ovarian cancers are epithelial tumors. These tumors can be malignant, borderline, or benign.

Borderline epithelial tumors tend to grow slowly and may affect younger women more often than other ovarian cancers. Common malignant epithelial subtypes include serous, clear cell, mucinous, and endometrioid tumors.

Epithelial ovarian cancers are the most common form of ovarian cancer and are often diagnosed after symptoms have progressed.

Ovarian Germ Cell Tumors

Ovarian Germ Cell Tumors begin in the eggs located in the ovaries. Many germ cell tumors are benign, and malignant forms are rare compared with other ovarian cancers.

These tumors occur most often in teens and women in their twenties. Treatment can be highly effective in many cases, and in select situations, fertility-preserving approaches may be possible.

There are several different types of germ cell tumors, including teratomas, dysgerminomas, choriocarcinoma, and endodermal sinus tumors.

Ovarian Stromal Tumors

Ovarian Stromal Tumors begin in the cells that release hormones and connect different structures of the ovaries together. These tumors are rare compared with epithelial tumors.

They are often identified earlier than many other ovarian cancers, which can allow treatment to begin sooner. The most common types of stromal cell tumors are granulosa-theca and Sertoli-Leydig tumors.

Ovarian Cysts

Ovarian Cysts are a mass of fluid inside an ovary. They are usually benign and often occur naturally during ovulation.

These naturally occurring cysts, called functional cysts, often resolve within a few months without treatment. If a cyst does not resolve or causes concerning symptoms, a doctor may monitor it closely or recommend surgical removal.

Cysts that develop after menopause or outside typical ovulation patterns may require additional evaluation.

Stage, Grade, and Type of Ovarian Cancer

When diagnosed with ovarian cancer, many individuals are confused about what doctors mean when they discuss stage, grade, and type.

Stage refers to how far the cancer has spread in the body. Grade describes how the cancer cells look under a microscope and how quickly they may grow. Type identifies the kind of cells where the cancer began.

Understanding these terms can help you and your care team make informed decisions about treatment options.

Treatment Options for Ovarian Cancer

Treatment plans are individualized based on tumor type, stage, overall health, and personal goals. Surgery is the main course of action when dealing with the majority of ovarian cancers. During surgery, doctors determine where the cancer is located and whether it has spread.

The areas affected determine what needs to be removed. In some cases, especially for women of childbearing age, it may be possible to treat the cancer without removing both ovaries and the uterus, depending on the type and extent of disease.

A key part of surgery is known as debulking. Debulking is used to remove as much of the tumor as possible, which is especially important when ovarian cancer has spread within the abdomen.

Additional treatment options may include:

• Chemotherapy: Uses medication to kill or slow the growth of cancer cells
• Targeted therapy: Uses drugs designed to act on specific features of cancer cells
• Hormone therapy: Uses hormones or hormone-blocking drugs in select tumor types
• Radiation therapy: Uses high-energy X-rays or particles to treat cancer cells in certain situations

Radiation is not commonly used as the main treatment for ovarian cancer, but it may be considered in specific circumstances.

Support During Treatment

For those diagnosed with ovarian cancer, support is an important factor in their care. Family members, friends, and support groups can help individuals cope with the physical and emotional demands of treatment.

It is also important to maintain open communication with the cancer care team. Understanding a diagnosis and treatment options helps patients make informed decisions about their health.