Epithelial Ovarian Cancer: Symptoms, Causes, Treatment

What are the symptoms of epithelial ovarian cancer?

Epithelial ovarian cancer is the most common type of ovarian cancer, and its symptoms can be vague and nonspecific, especially in the early stages. Some common symptoms of epithelial ovarian cancer may include:

Abdominal or Pelvic Pain: Pain in the abdomen or pelvis that may be persistent or frequent.
Bloating: Persistent bloating or feeling of fullness in the abdomen.
Changes in Appetite: Significant changes in appetite, such as feeling full quickly or difficulty eating.
Urinary Symptoms: Increased urgency or frequency of urination, or discomfort while urinating.
Changes in Bowel Habits: Changes in bowel habits, such as constipation or diarrhea.
Fatigue: Persistent fatigue or low energy levels.
Unexplained Weight Loss: Weight loss that occurs without dieting or explanation.
Abnormal Bleeding: Vaginal bleeding that is not related to menstruation, such as post-menopausal bleeding.

It’s important to note that these symptoms can also be caused by other conditions and may not necessarily indicate ovarian cancer. However, if you experience any of these symptoms, especially if they are persistent or severe, it’s important to consult a healthcare provider for evaluation. Early detection and treatment can improve the outlook for ovarian cancer.

What are the causes of epithelial ovarian cancer?

The exact cause of epithelial ovarian cancer is not well understood, but several factors may increase the risk of developing the disease. These risk factors include:

Age: The risk of ovarian cancer increases with age, with the highest incidence occurring in women over 60 years old.
Family History: Women with a family history of ovarian, breast, or colorectal cancer are at higher risk. Inherited genetic mutations, such as BRCA1 and BRCA2 mutations, can increase the risk of ovarian cancer.
Personal History: Women who have had breast, uterine, or colorectal cancer may have an increased risk of ovarian cancer.
Reproductive History: Factors that affect the number of times a woman ovulates, such as early onset of menstruation, late onset of menopause, and never having been pregnant, may increase the risk.
Hormone Replacement Therapy (HRT): Long-term use of HRT, especially estrogen-only therapy, may increase the risk of ovarian cancer.
Endometriosis: Women with endometriosis, a condition where the tissue that normally lines the uterus grows outside the uterus, may have an increased risk of ovarian cancer.
Obesity: Being overweight or obese may increase the risk of ovarian cancer.
Smoking: Smoking cigarettes may increase the risk of mucinous ovarian cancer, a subtype of epithelial ovarian cancer.

It’s important to note that having one or more risk factors does not mean that a woman will develop ovarian cancer. Many women with ovarian cancer have no known risk factors, and not all women with risk factors will develop the disease. Regular screenings and early detection can help improve outcomes for women at higher risk.

How is epithelial ovarian cancer diagnosed?

Epithelial ovarian cancer is typically diagnosed through a combination of medical history, physical examination, imaging tests, and laboratory tests. The diagnostic process may include:

Pelvic Examination: A pelvic examination may be performed to assess the size, shape, and texture of the ovaries and uterus.
Imaging Tests: Imaging tests such as transvaginal ultrasound, CT scan, or MRI may be used to visualize the ovaries and other pelvic organs and to determine the extent of the disease.
Blood Tests: Blood tests, such as CA-125 (cancer antigen 125) and HE4 (human epididymis protein 4), may be used to assess levels of certain proteins that can be elevated in ovarian cancer. However, these tests are not definitive and may also be elevated in other conditions.
Biopsy: A biopsy is the definitive way to diagnose ovarian cancer. This involves removing a sample of tissue from the ovary or other affected area and examining it under a microscope to look for cancer cells.
Surgery: In many cases, surgery is needed to confirm the diagnosis of ovarian cancer and to determine the stage of the disease. During surgery, a surgeon may remove one or both ovaries, as well as other affected tissues, for further examination.
Staging: If ovarian cancer is confirmed, further tests may be done to determine the stage of the disease, which helps guide treatment decisions. Staging may involve imaging tests, such as CT scan or MRI, as well as surgical exploration of the abdomen and pelvis.

The diagnosis and staging of ovarian cancer require a multidisciplinary approach involving gynecologic oncologists, radiologists, pathologists, and other specialists. Early detection and accurate staging are important for determining the most appropriate treatment and improving outcomes for women with ovarian cancer.

What is the treatment for epithelial ovarian cancer?

The treatment for epithelial ovarian cancer depends on the stage of the cancer, the overall health of the patient, and other factors. Treatment may include surgery, chemotherapy, and in some cases, targeted therapy or radiation therapy. The goals of treatment are to remove or destroy the cancer, prevent its spread or recurrence, and manage symptoms. Treatment options may include:

Surgery: Surgery is usually the first-line treatment for epithelial ovarian cancer. The goal of surgery is to remove as much of the cancerous tissue as possible. This may involve removing one or both ovaries, the fallopian tubes, the uterus, and nearby lymph nodes. In some cases, surgery may also involve removing parts of the omentum (a fatty tissue in the abdomen) or other affected tissues.
Chemotherapy: Chemotherapy is often used after surgery to kill any remaining cancer cells and reduce the risk of recurrence. Chemotherapy drugs may be given intravenously or directly into the abdominal cavity (intraperitoneal chemotherapy).
Targeted Therapy: Targeted therapy is a type of treatment that targets specific molecules involved in cancer cell growth and survival. It may be used in combination with chemotherapy for certain types of epithelial ovarian cancer.
Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells. It is sometimes used in combination with surgery and chemotherapy, particularly for advanced ovarian cancer.
Hormone Therapy: Hormone therapy is sometimes used for epithelial ovarian cancer that is hormone receptor-positive. It works by blocking the effects of hormones that stimulate cancer growth.
Clinical Trials: Clinical trials are research studies that test new treatments or treatment combinations. They may offer access to new treatments that are not yet widely available.

Treatment for epithelial ovarian cancer is often complex and may involve a combination of different approaches. The choice of treatment depends on the specific characteristics of the cancer and the individual patient. It’s important for patients to discuss their treatment options with a multidisciplinary team of healthcare providers, including gynecologic oncologists, medical oncologists, and other specialists, to determine the most appropriate treatment plan.

What is the survival rate for epithelial ovarian cancer?

The survival rate for epithelial ovarian cancer varies depending on several factors, including the stage of the cancer at diagnosis, the age and overall health of the patient, and the response to treatment.

According to the American Cancer Society, the relative 5-year survival rate for all stages of epithelial ovarian cancer combined is about 47%. This means that, on average, about 47% of people with epithelial ovarian cancer are alive 5 years after diagnosis. However, it’s important to note that survival rates are estimates and can vary widely based on individual factors.

The survival rates for epithelial ovarian cancer are generally higher when the cancer is diagnosed at an earlier stage and has not spread beyond the ovaries. For example, the 5-year relative survival rate for localized ovarian cancer (confined to the ovary) is about 92%. However, the majority of epithelial ovarian cancers are not diagnosed until they have reached an advanced stage, when the cancer has spread beyond the ovaries. In these cases, the 5-year relative survival rate is lower, ranging from about 29% to 33% depending on the extent of spread.

It’s important to keep in mind that survival rates are based on large groups of people and do not predict individual outcomes. Many factors can affect an individual’s prognosis, and survival rates are just one piece of information that can help guide treatment and provide a general outlook. Each person’s situation is unique, and it’s important to discuss prognosis and treatment options with a healthcare provider.