Ovarian Cancer Frequently Asked Questions
What is ovarian cancer?
Ovarian cancer begins in your ovaries, which are located on each side of the uterus and produce female hormones and eggs. There are three types of ovarian cancer:
- Epithelial tumors arise from cells that line or cover the ovaries.
- Germ cell tumors originate from cells that form eggs.
- Sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.
The American Cancer Society estimates that approximately 12,650 women are diagnosed with ovarian cancer and more than 15,500 die from the disease each year in the United States. Ovarian cancer is the fifth leading cause of cancer death among U.S. women and more women die from this disease than from all other gynecologic cancers combined. The majority of women are diagnosed when the disease has reached an advanced stage, however if detected early, the survival rate is more than 90%.
What are the risk factors?
There is no way to know for sure if you will get ovarian cancer. Most women with ovarian cancer are not at high risk. However, several factors may increase your risk for ovarian cancer, including if you:
- Are over 40. Ovarian cancer generally strikes after age 40, with the greatest number of cases occurring in women age 60 and older.
- Have close family members, such as your mother, sister, aunt, or grandmother, on either your mother's or your father's side, who have had ovarian cancer
- Have a genetic mutation (abnormality) called BRCA1 or BRCA2
- Have had breast, uterine, or colorectal (colon) cancer
- Have an Eastern European (Ashkenazi) Jewish background
- Have never given birth or have had trouble getting pregnant
- Have endometriosis, a condition in which tissue from the lining of the uterus grows elsewhere in the body
Ovarian cancer has a hereditary element that can be detected through genetic testing. Women who find they are genetically predisposed to ovarian cancer and who have other risk factors may choose to have their ovaries removed before cancer takes root (prophylactic oophorectomy). In high-risk women, this can greatly decrease the risk of developing ovarian cancer.
Is there anything I can do to prevent ovarian cancer?
There is no known way to prevent ovarian cancer. However, lower rates of ovarian cancer have been detected in women who:
- Have used birth control pills for more than five years.
- Have had their "tubes tied" (tubal ligation)
- Have had both ovaries removed
- Have had a hysterectomy
- Have given birth
What are the symptoms?
Ovarian cancer may cause one or more of these signs and symptoms:
- Vaginal bleeding or abnormal discharge from your vagina
- Pelvic or abdominal pain (the area below your stomach and between your hip bones)
- Back pain
- Feeling full quickly while eating
- A change in bathroom habits, such as having to pass urine very badly or very often, constipation, or diarrhea.
Pay attention to your body, and know what is normal for you. See a doctor if you have any of the signs for two weeks or longer and they are not normal for you. These symptoms may be caused by something other than cancer, but the only way to know is to see a doctor. The earlier ovarian cancer is found and treated, the more likely treatment will be effective.
How is ovarian cancer diagnosed?
There is no simple and reliable way to screen for ovarian cancer in women who do not have any signs or symptoms. However, early detection can lead to effective treatment. Diagnostic tests are used once you begin experiencing symptoms or if you are a high-risk patient who has not yet demonstrated symptoms.
Mount Sinai may perform the following tests and procedures to diagnose ovarian cancer:
- Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum..
- Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs to create echoes.
- CA 125 assay: A test that measures the level of CA 125 in the blood. An increased CA 125 level is sometimes a sign of cancer or another condition.
- Barium enema: A series of X-rays of the lower gastrointestinal tract.
- Intravenous pyelogram (IVP): A series of X-rays of the kidneys, ureters, and bladder to find out if your cancer has spread to these organs.
- CT scan (CAT scan): A procedure that creates a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an X-ray machine. A dye may be injected into a vein or given orally to help the organs or tissues show up more clearly.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue is removed in a procedure called a laparotomy (a surgical incision made in the wall of the abdomen).
The Pap test does not check for ovarian cancer. The only cancer the Pap test screens for is cervical cancer. Since there is no simple and reliable way to screen for any gynecologic cancers except for cervical cancer, it is especially important to recognize warning signs and see your doctor.
What is the prognosis?
The chance of recovery and treatment options depends on the following:
- The stage of the cancer
- The type and size of the tumor
- Patient age and general health
- Whether the cancer has just been diagnosed or has recurred (come back)
If your doctor says that you have ovarian cancer, ask to be referred to a gynecologic oncologist — a doctor who has been specially trained to treat cancers of a woman's reproductive system. This doctor will work with you to create a treatment plan.
What are the treatments for ovarian cancer?
Most patients have surgery to remove as much of the tumor as possible. Different types of surgery may include:
- Hysterectomy: A surgical procedure to remove the ovaries, uterus, cervix and fallopian tubes.
- Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
- Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
- Omentectomy: A surgical procedure to remove the omentum — a piece of the tissue lining the abdominal wall.
- Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
Depending on the stage of your cancer, Chemotherapy may be used after surgery. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by keeping them from dividing.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are conducted to find out if new cancer treatments are safe and effective or better than the standard treatment. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Your participation may help improve the way cancer is treated in the future.
What is the National Ovarian Cancer Early Detection Program?
Mount Sinai leads an international clinical and scientific effort to identify new screening methods for the early detection of epithelial ovarian cancer in high-risk women. Established in 1999, Mount Sinai is only NOCEDP site where gynecologic oncologists are working so closely with genetic counselors.
The hallmark of the program is the coordinated, multidisciplinary services we provide during each comprehensive clinic visit including evaluations by board certified specialists in cancer genetics, gynecologic oncology, ultrasound, and psychology. Participants receive a consultation with a board certified genetic counselor that reviews the family history of cancer in detail and provides an estimate of the likelihood of hereditary susceptibility.
We also provide women and their families the opportunity to discuss the numerous and complicated issues surrounding genetic testing. Women who participate in the program return every six months for follow-up, but remain with their own gynecologists for routine care.
What kind of support can I receive at Mount Sinai if I've been diagnosed with ovarian cancer?
Founded in 2003, you may participate in Woman to Woman, a unique network of trained volunteer survivors of gynecologic cancer who provide hope, one-on-one support, education and advocacy for women in treatment at Mount Sinai, their partners and families. From their first meeting with a woman to the end of treatment, our volunteers help patients adjust to their new lives as cancer survivors.
All women being treated at Mount Sinai for gynecologic cancer (ovarian cancer, uterine cancer, cervical cancer, vaginal or vulva cancer) are offered the opportunity to participate in the program by being matched with a survivor volunteer.
Male partners of women diagnosed with a gynecologic cancer are often overlooked by health care workers, family and friends resulting in confusion, anxiety, and anger. To help address the needs of this unique group, Woman to Woman created a "Guide for Male Partners" which contains information on gynecologic cancer, treatment and side effects, sexuality, finances, how to deal with family and friends, and resources for each topic. We also provide peer mentoring from men whose partners have already completed treatment at Mount Sinai for gynecologic cancer
For more information on ovarian cancer and the Mount Sinai Division of Gynecologic Oncology, please contact us at (212) 427-9898 or www.mountsinai.org/obgyn.