Ovarian Cancer

Ovarian cancer is a relatively common and very dangerous cancer. It is a gynecological cancer that is often found in advanced stages when the therapeutic outcome is poor.


The ovary is a paired gonad of women. It produces female sex hormones and it contains millions of eggs. Both ovaries are located in the abdominal cavity in the pelvic area. They are located closely to the uterus and fallopian tubes. The right ovary can be found near the appendix.


The occurrence of ovarian cancer is related to age. The higher is the age, the higher is the risk of developing this disease. The lifestyle is also to blame as the cancer risk increases with smoking and in unhealthy diet with excessive intake of fats. Many women with ovarian cancer are reportedly obese. Genetic factors may have a role as well, because the incidence is higher in women with positive familial occurrence of ovarian cancer or breast cancer in close relatives. On the contrary, hormonal contraception is reported to be a clear protective factor that decreases the risk of ovarian cancer.


The great danger of ovarian cancer is its long absolutely asymptomatic period. The tumor can grow to surrounding tissues relatively unnoticed as there is enough place in the abdominal cavity. Late symptoms include abdominal pain and appearance of abdominal fluid produced by the tumor cells. This is usually perceived as enlarged abdomen with increased body weight. Symptoms of a metastatically spread tumor correspond to the general scheme of cancer symptoms.


The ideal diagnostic method is ultrasound, which can diagnose an enlarged ovary. The size, local extent of the tumor and presence of distant metastases may be evaluated by computed tomography. Blood tests may be used to measure concentration of a tumor marker known as CA-125. The concentration of this substance is usually significantly elevated in patients with ovarian cancer. A sample of the abdominal fluid (ascites) may be taken by a fine needle, which is used to puncture the abdominal wall. Cytological examination of the ascitic fluid can confirm the presence of tumor cells.


The only possible prevention is a healthy lifestyle including avoidance of smoking. Healthy diet with plenty of physical exercise is necessary in preventing obesity.


The treatment of choice is surgery. However, the tumor is frequently found in late stages when it is inoperable, or when it requires extensive surgical interventions. In case of an accidental finding of a small tumor, it may be enough to only remove the affected ovary. Extensive surgeries include removal of surrounding organs and it is no exception to remove ovaries, uterus, fallopian tubes, appendix and local lymph nodes in the pelvis.


Chemotherapy is often used as a complementary therapy to surgical intervention. The ovarian cancer is relatively sensitive to chemotherapeutic agents, yet the chemotherapy alone would be unable to successfully cure the disease.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources