Ovarian Cancer Quiz: Test Your Medical IQ

Ovarian cancer actually represents a group of different tumors that arise from diverse types of tissue contained within the ovary. The most common type of ovarian cancer arises from the epithelial cells (the outside layer of cells) of the surface of the ovary. Other less common types of ovarian cancer develop from the egg-forming germ cells or from the supporting tissue (stroma) of the organ. Benign (noncancerous) tumors and cysts are also found in the ovary and are much more common than ovarian cancers.

The majority of ovarian cancers are diagnosed late, after the cancers have spread. Only about 20% of women are diagnosed early, when the disease may be most curable. If ovarian cancer could be readily diagnosed in its earliest stages, more women would be cured.

The importance of early diagnosis is clear: About 90% of women live 5 years or more if ovarian cancer is detected early; the 5-year survival rate for all cases is only about 40%.

Note: Regular pelvic examinations, sometimes supplemented by ultrasound examinations or blood tests for cancer-related markers, have been routinely used for ovarian cancer screening, but none of these tests are specifically able to detect ovarian cancer.

Traditionally, it was believed that ovarian cancer does not produce any characteristic symptoms until the tumor is widespread, and that early symptoms of ovarian cancer were not recognizable.

However, the American Cancer Society released a consensus statement about possible early symptoms of ovarian cancer. This statement was based on research suggesting that some of the early symptoms of ovarian cancer can, in fact, be recognized. In particular, possible early ovarian cancer symptoms include the following:
- Bloating
- Pelvic or abdominal pain
- Urgent or frequent urination
- Difficulty eating or feeling full very quickly

The researchers note that women who have these problems should see a gynecologist for cancer screening if these problems are new, if the symptoms are severe, and if they have been present continuously for over 2 to 3 weeks.

Doctors do not know exactly what causes ovarian cancer. However, some factors and conditions may increase a woman's risk of developing this condition. The following are risk factors for the development of ovarian cancer:

- Women over 50 are more likely than younger women to get ovarian cancer, and the risk is even greater after age 60. About 50% of ovarian cancers occur in women over 60 years of age.

- Women who have never given birth have a greater risk of developing ovarian cancer than women who have had children. In fact, the number of childbirths correlates directly with a decrease in risk for developing ovarian cancer. Women who have had their first child after age 30 are also at an increased risk.

- The American Cancer society reports that obese women have a higher rate of death from ovarian cancer than women of normal weight.

Ovarian cancer can occur at any age, even in childhood, but is most common after menopause. The disease accounts for about 22,000 new cases and almost 15,000 deaths annually in the U.S.

Most ovarian cancers occur after menopause, between the ages of 50 and 75. The peak incidence of ovarian cancer is between the ages of 75 and 79, so its incidence clearly increases with age.

Ovarian cancers are classified in stages 1 through 4, depending upon the extent of spread.

Stage I: The cancer is confined to one or both ovaries.

Stage II: Cancer is found outside the ovary and has spread to the uterus or fallopian tubes or other areas in the pelvis. The tumor may involve the capsule of the ovary, or fluid in the abdomen may contain malignant cells.

Stage III: Cancer has spread to pelvic organs and possibly to lymph nodes.

Stage IV: Cancer has spread to the abdominal organs (liver, spleen), or malignant cells are in the fluid surrounding the lungs.

Surgery is the usual first treatment for ovarian cancer. Whenever possible, the surgery takes place at the time of exploratory laparotomy. The operation is paused while the pathologist rapidly reviews the biopsy tissues. The pathologist's report determines the structures affected by cancer and if they should be removed. This spares the woman from undergoing another surgery.

There is no definitive way to prevent ovarian cancer for women with ovaries. If a woman has surgically removed her ovaries she is no longer at risk for ovarian cancer.

There are steps a woman can take that may reduce the risk and detect the disease in its early stages, increasing chances of survival. They include:
- Getting routine pelvic exams
- Reporting any irregular vaginal bleeding or abdominal pain to a doctor
- For women who have close family members (mother, sister, or daughter) with ovarian cancer, discussing risk factors with their doctors
- Avoiding using excessive talcum powder on or near the vagina
- Eating a low-fat diet

Although it is not known for sure if eating a low-fat diet or one that is rich in vegetables can actually decrease the risk of developing ovarian cancer, eating a healthy diet can decrease the risk for many chronic diseases, including some other types of cancer.

The average woman has a 1 or 2 in 100 chance of getting ovarian cancer in her lifetime.

Note: These odds don't apply to women who have a strong family history of ovarian cancer. For women with a family history of ovarian cancer, the chances of getting ovarian cancer are much higher. A few of these women have also inherited a certain gene change, called a BRCA gene change (say "BRAH-kuh"). Their chances of getting ovarian cancer are very high.

Most ovarian cysts are not cancerous. Further, most ovarian cysts don't cause symptoms and generally go away on their own. Still, women should talk to their doctors if they notice changes in their periods, or have pain in the pelvic area.