Advanced Malignant Neoplasm of Ovary

Ovarian Cancer

Genitourinary

Written by the doctors and editors at UpToDate
What is ovarian cancer? — Ovarian cancer happens when normal cells in the ovary change into abnormal cells and grow out of control. The ovaries are organs that are part of a woman's reproductive system. A woman's eggs are in the ovaries (figure 1).
Ovarian cancer occurs most often in women ages 50 to 65, but can happen in younger or older women. Sometimes ovarian cancer runs in families.
What are the symptoms of ovarian cancer? — Symptoms of ovarian cancer can include:
Your stomach getting bigger or feeling bloated
Stomach pain
Feeling full or having trouble eating
Needing to urinate often or feeling like you suddenly need to urinate urgently
These symptoms are common feelings. They might also be caused by conditions that are not ovarian cancer. But if you start having these symptoms and they continue for more than a day or two, you should let your doctor or nurse know.
Many women have no symptoms of ovarian cancer, but learn they have it when a growth is found. This sometimes happens during a pelvic exam or an imaging test, like an ultrasound, that was done for another reason. If this happens, your doctor or nurse might then do more tests to check for ovarian cancer.
Is there a test for ovarian cancer? — Yes. If your doctor suspects you have ovarian cancer, he or she might order 1 or more of the following:
Ultrasound or other imaging tests – These tests create images of the inside of the body and can show abnormal growths.
Blood tests – There is no blood test that can tell for sure if a woman has ovarian cancer. The main test that is done when a doctor suspects ovarian cancer is called the "CA 125" blood test. CA 125 is a protein in the blood that can go up when a woman has ovarian cancer. The test is mostly helpful in women who have already gone through menopause. It can help find ovarian cancer in some women, but it does not clearly show whether or not the woman has it. Blood tests can also help doctors decide whether they need to do surgery to diagnose ovarian cancer.
Surgery – The only way to know for sure if a woman has ovarian cancer is for a doctor to do surgery and remove the ovary. While the surgery is going on, usually another doctor will look at cells from the ovary under a microscope to check for cancer. If cancer is present, the doctor will usually continue surgery and treat the cancer by removing as much of it as possible. Most of the time, this involves doing a surgery called "total hysterectomy with salpingo-oophorectomy" (figure 2). For this surgery, the doctor removes the ovaries, the tubes that connect the ovaries to the uterus (called the fallopian tubes), and the uterus. If the cancer has spread to other nearby organs, the doctor might remove parts of those, too.
What is cancer staging? — Cancer staging is a way in which doctors find out how far a cancer has spread.
How is ovarian cancer treated? — For most women, having surgery to remove the cancer is the first part of treatment. Further treatment will depend a lot on the stage of the cancer and her other medical problems. Some women might not need any further treatment after surgery. Other women might need further treatment that includes chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Usually, these medicines go into a vein. But sometimes they can go through a small tube into the lower part of the stomach.
What if I want to get pregnant one day? — If you want to have a baby one day, tell your doctor before having treatment. Treatment for ovarian cancer usually leaves a woman unable to get pregnant. But for some women it might be possible to plan treatment so that pregnancy is still possible.
What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Follow up tests usually include blood tests, exams, and imaging tests. You should also watch for the symptoms listed above, because having those symptoms could mean the cancer has come back. Tell your doctor or nurse if you have any symptoms.
What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, you might have more surgery or chemotherapy. You might also have a medicine called targeted therapy, which can help prevent cancer growth.
Can ovarian cancer be prevented? — If ovarian, breast, uterine, or colon cancer runs in your family, talk to your doctor. There might be things you can do to keep from getting cancer.
What else should I do? — It is important to follow all your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for ovarian cancer involves making many choices, such as what treatment to have.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15417 Version 10.0
Release: 28.2.2 - C28.105
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CA Ovaries,Cancer of the Ovaries,Carcinoma of the Ovaries,Malignant Neoplasm of Ovary,Ovarian CA,Ovarian Carcinoma

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