What is Ovarian Cancer?

Cancer of the ovary is a disease in which some of the cells of the ovary undergo changes and develop into cancer. There are four different types of ovarian cancer, named after the part of the ovary that is affected. Ovarian Cancer may be shortened and referred to as "OvCa"(pronounced 'of-car')

Types of ovarian cancer

Epithelial ovarian cancer

Is a cancer that arises in the epithelium: the outer cells covering the ovary. Nine out of ten ovarian cancers are epithelial.

Germ cell and sex-cord stromal cell ovarian cancer

These two types of ovarian cancer are very uncommon. The germ cell cancers arise in the cells that mature into eggs and usually only affect women under 30 years of age. Sex cord stromal cell cancers arise in the cells, which release the female hormones. These cancers can occur at any age.

Germ cell and sex-cord stromal cell ovarian cancers usually respond very well to treatment and are often curable. If these cancers only affect one ovary, it may still be possible for women to have children after treatment.

Borderline tumours

Borderline tumours are a group of epithelial tumours, which are not as aggressive as other forms of ovarian cancer. Sometimes the words 'low malignant potential' are used to describe borderline tumours. The outlook for women with borderline tumours is generally good regardless of whether the disease is diagnosed early or late.

Diagnosis

If ovarian cancer is suspected there are a number of tests that can be performed to help the doctor decide whether symptoms are due to ovarian cancer or other causes. None of these tests can be relied upon on their own so it is essential to have both a blood test and an ultrasound to give your doctor the clearest picture.

Physical Examination

This will include an internal pelvic examination where the doctor checks for a mass or a lump in the lower abdomen and the pelvis.

Blood Tests

Blood can be tested for a particular protein or a tumour marker called CA 125. This protein is often higher than normal in women with ovarian cancer. Some women may have other tumour markers called 'Inhibin' or 'CEA'. The type of marker depends on the type of tumour. However some tumours will not have any of these tumour markers. Testing the blood for these tumour markers is one way to help diagnose cancer. These tests are also used later on to check the progress of the illness.

Ultrasound and other imaging tests

A trans-vaginal ultrasound (TVU) can assist with diagnosis. A TVU involves an ultrasound probe being inserted into the vagina to relay images of the ovaries to the radiologist. It is important that this type of ultrasound is used as it gives a much clearer picture of the ovaries than an abdominal or external ultrasound.

Routine chest and abdominal x-rays may be taken as well as an ultrasound scan of the lower abdomen. You may also have an X-ray of your bowel to make sure that the symptoms are not due to a bowel problem. This X-ray is called barium enema, a which is not painful but uncomfortable.