Understanding Ovarian Cancer: Symptoms, Risk Factors, and Early Detection

Ovarian cancer is a serious gynecologic malignancy that affects thousands of women worldwide. While it can be challenging to detect in its early stages, understanding the signs and symptoms is crucial for timely diagnosis and treatment.

This blog post aims to provide a comprehensive overview of ovarian cancer, including its potential warning signs, ovarian cancer risk factors, and the importance of early detection. By educating ourselves about this disease, we can be better equipped to advocate for our health and well-being.

We will explore the subtle symptoms that are often mistaken for common ailments, such as bloating, pelvic pain, and changes in bowel habits. Additionally, we will discuss the various factors that may increase a woman’s risk of developing ovarian cancer, including age, family history, and genetic predisposition.

Throughout this post, we will emphasize the significance of open communication with healthcare providers and the value of regular check-ups and screenings. By staying informed and proactive, women can take an active role in their health and work towards early detection and improved outcomes.

Join us as we delve into the details of ovarian cancer and empower ourselves with the knowledge needed to confront this disease head-on.

What is Ovarian Cancer?

The ovary is an essential reproductive organ in females, typically existing as a pair of almond-shaped structures situated on each side of the uterus within the pelvic cavity. They serve pivotal roles in a woman’s menstrual cycle, fertility, and hormone production. Each ovary contains follicles housing immature eggs, with one follicle releasing a mature egg during ovulation for potential fertilization. These eggs then travel through the fallopian tubes towards the uterus. Usually, there is one ovary and one fallopian tube on each side of the uterus. Following fertilization, the egg attaches to the uterine wall, initiating embryo development and subsequent fetal growth.

Ovarian cancer is a complex and aggressive disease that originates in the ovaries or the fallopian tubes. Cancer, in general, is characterized by uncontrolled growth and division of cells, which can lead to the formation of tumors. When cancer cells break away from the primary tumor and spread to other parts of the body through the bloodstream or lymphatic system, it is called metastasis.

• Ovarian cancer ranks 5th in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. (Two Onc Docs)
• Projections indicate nearly 12 million women will be diagnosed and 8 million will die from ovarian cancer by 2050. (2024 World Ovarian Cancer Coalition Ovarian Cancer Data Briefing)

Types of Ovarian Cancer

The ovaries house three main types of cells: epithelial, stromal, and germ cells, with tumor development varying based on the cell type involved:

Epithelial Tumors

Epithelial tumors arise from the outer surface cells of the ovary. These are the most prevalent ovarian tumors, constituting around 90% of malignant ovarian cancers. They are categorized into subtypes according to microscopic variances:  

Serous carcinomas (52%) can be classified into three types.

• High-grade serous carcinoma (HGSOC): About 90% of serous carcinomas are high-grade, with poorly differentiated or undifferentiated cancer cells. 
• Low-grade serous carcinoma (LGSOC): About 10% of serous carcinomas are low-grade, with well-differentiated cells that resemble normal cells. These grow slowly, spread less easily, are less sensitive to chemotherapy, and often affect younger women. 
• Borderline ovarian tumor (BOT): Also called low malignant potential tumors, BOTs (also called borderline ovarian cancer) are noninvasive with low-grade cytology, commonly found in young women (aged between 20-40) with good outcomes. However, some can progress to low-grade serous carcinomas. Approximately 60% of low-grade serous carcinomas have co-existing borderline tumors, and 10% of women with advanced borderline tumors may develop low-grade serous carcinoma.

Endometrioid carcinoma (10%) resembles endometrial tissue and is often associated with endometriosis or concurrent endometrial carcinoma. They typically present at an earlier stage and have a more favorable prognosis compared to high-grade serous carcinomas. 

Clear cell carcinoma (6%) is characterized by cells with clear cytoplasm and is often associated with endometriosis. This is more commonly diagnosed at an early stage but can be resistant to conventional platinum-based chemotherapy.

Mucinous carcinoma (6%) is characterized by cells that produce mucin and often has a multicystic appearance. Mucinous carcinomas are usually diagnosed at an early stage and have a better prognosis compared to high-grade serous carcinomas, but advanced-stage tumors can be resistant to platinum-based chemotherapy.

Stromal Tumors 

Stromal tumors originate from the cells responsible for hormone production and structural support of the ovary. Only 1% of ovarian cancers stem from stromal cell tumors. While most ovarian cancer cases occur in women aged 50 or older, 1 in 20 instances arises in young girls. 

Stromal tumors are frequently detected in their early stages and typically carry a favorable prognosis, with over 75% of patients experiencing long-term survival. 

Germ Cell Tumors

Germ cell tumors originate from the egg-producing cells and comprise only 2% of ovarian cancers, with the majority being benign. Even malignant germ cell tumors exhibit a favorable prognosis, with over 90% of patients surviving at least 5 years post-diagnosis.

Recognizing the Signs: Common Ovarian Cancer Symptoms

Although it bears the enduring label of “silent killer,” ovarian cancer isn’t entirely silent. Symptoms do exist; it’s just important not to overlook them, particularly if they persist, intensify, or occur more frequently. 

It’s always prudent to seek medical attention for any concerning symptoms as a precautionary step. Timely diagnosis significantly improves the chances of successful treatment. The most common ovarian cancer symptoms include:

• Abdominal bloating: persistent bloating or a feeling of fullness.
• Pelvic or abdominal pain: unexplained pain in the pelvic area or lower abdomen
• Difficulty eating or feeling full quickly: changes in appetite or an early feeling of fullness while eating.
• Abnormal vaginal bleeding  
• Menstrual changes
• Unexplained weight loss or weight gain  
• Nausea, diarrhea, constipation, frequent urination
• Pain during sex
• Loss of appetite
• Fatigue
• Back pain

These symptoms are not exclusive to ovarian cancer, but if they are new, frequent, and persistent – especially if they occur almost daily – seeking medical attention is crucial.

Know Your Risk: Factors That Increase Vulnerability

Certain factors can elevate a woman’s risk of developing ovarian cancer. Some key ovarian cancer risk factors include:

• Age. While ovarian cancer can occur at any age, it is predominantly prevalent in women over 50 years old. According to the American Cancer Society, half of ovarian cancer cases are diagnosed in women aged 63 or older. It’s important to note that menopause itself does not directly cause ovarian cancer, but the risk of developing it increases with age.
• Family history. Approximately 5% to 10% of ovarian cancers stem from inherited germline ovarian cancer mutations in susceptible genes, with roughly 90% of these cases linked to mutations in BRCA1 or BRCA2 genes. Mutation carriers face an elevated risk of ovarian cancer, estimated at 40% to 60% by the age of 70 years.
• Personal history. A history of breast, uterine, or colorectal cancer may also potentially increase the risk.
• Reproductive history. Women who have never been pregnant or who have had trouble getting pregnant may have a higher risk.
• Hormone replacement therapy. Long-term use of hormone replacement therapy may slightly increase the risk of ovarian cancer, particularly when combined with progesterone or dydrogesterone. 

The Role of Early Detection in the Fight Against Ovarian Cancer

Early detection is a game-changer in the fight against ovarian cancer. When diagnosed at an early stage, the chances of successful treatment and improved outcomes are significantly higher. This underscores the importance of regular check-ups and proactive healthcare.

• Only about 20% of ovarian cancers are found at an early stage. When ovarian cancer is detected early, about 94% of patients live longer than 5 years after diagnosis. (American Cancer Society)

Methods of Early Detection

Methods of early detection are unfortunately very limited, depending on the type of ovarian cancer. At Not These Ovaries, we are focused on funding research for early detection as one of our core areas of impact.

Several methods contribute to early detection:

• Regular pelvic exams: Routine pelvic examinations by a healthcare provider can aid in detecting any abnormalities or changes.
• Ultrasounds: This imaging technique allows for a closer look at the ovaries and may help identify any irregularities.
• CA-125 blood test: While it’s not specific to ovarian cancer and can be elevated in other conditions like endometriosis or pelvic inflammatory disease, monitoring CA-125 levels alongside other diagnostic tests can aid in the early detection of ovarian cancer.
• Possible investigational blood tests: Blood tests like Galleri are on the cutting edge of working to identify markers within a simple blood test that could potentially identify cancer. These tests are currently not covered by insurance as they are still in trials, but these tests can be purchased for $949 if you qualify.
• MRI: While most doctors would not recommend a whole body scan, new healthcare startups like Prenuvo could potentially catch tumors. They offer MRI for your entire body for $2,500. Keep in mind you have to keep still for the 1-2 hours of testing inside the MRI.

Ovarian Cancer Survival Rate

Important note: Ovarian cancer survival rates have been improving steadily over the years due to advancements in treatment. While these rates are based on large population studies and serve as a general guide, they don’t necessarily reflect individual situations and they do not definitively predict any one person’s journey with ovarian cancer. 

A gynecologic oncologist should be able to answer the patient’s questions and make a more accurate prognosis. They can also provide a more accurate assessment by taking into account personal circumstances and creating a tailored treatment plan. Factors such as the specific type of ovarian cancer, stage at diagnosis, overall health, and response to treatment all play a role in determining a person’s unique prognosis. With the support of a medical team and loved ones, individuals can navigate this challenging time with strength and resilience.

According to the American Cancer Society, the overall 5-year relative survival rate for all types and stages of ovarian cancer is 49%. However, when ovarian cancer is caught early at a localized stage, the 5-year relative survival rate is much higher at 93%.

Here is a breakdown of the 5-year relative survival rates by stage:

• Localized (Stage I): 93%. Stage I ovarian cancer is confined to the ovaries and has not spread to other parts of the body. This stage has the highest survival rate.
• Regional (Stage II and III): 75%. Stage II ovarian cancer has spread beyond the ovaries to nearby pelvic organs, while Stage III has spread to the abdominal lining or lymph nodes. These stages have a lower survival rate compared to Stage I. 
• Distant (Stage IV): 31%. Stage IV ovarian cancer has metastasized to distant organs, such as the liver or lungs. This advanced stage has the lowest survival rate. 
• All stages combined: 49%

Ovarian cancer research has been paramount for improving treatment options, patient outcomes, and overall survival rates. That’s why, at Not These Ovaries, we steadfastly dedicate ourselves to swiftly funding ovarian cancer research and trials, with a specific focus on the less common and more challenging subtype of ovarian cancer: the borderline (BOT) and low-grade serous types (LGSOC). By prioritizing these less explored subtypes, our goal is to ensure that more individuals receive the necessary treatment

Understanding the nuances of ovarian cancer — its symptoms, risk factors, and the critical role of early detection — empowers women to take control of their health. By recognizing the signs, knowing their risk factors, and participating in regular screenings, women can play a proactive role in their well-being.

Not These Ovaries is committed to furthering research and education to ensure a future where ovarian cancer can be prevented, treated, and ultimately conquered. Stay tuned for more insights and information on this vital journey.