ovarian cancer
Meaning of ovarian cancer: Early symptoms are so ordinary, bloating and pelvic discomfort among them, that the disease is usually advanced when found.
Definition of ovarian cancer
Ovarian cancer is cancer arising in an ovary or, as is now recognized for the most common form, in the fallopian tube beside it. The ovaries are the paired organs that release eggs and produce hormones. Most cases are epithelial carcinomas, while smaller numbers begin in the egg-producing germ cells or in the supportive stromal tissue.
Where does it actually start?
The traditional account had these tumors arising from the cells covering the surface of the ovary. Careful examination of tissue removed from people at high inherited risk changed that picture. The most common and most aggressive epithelial subtype, high grade serous carcinoma, is now understood to begin in most cases at the fringed far end of the fallopian tube, where small precursor lesions are found, before spreading to the ovary and the surrounding lining of the abdomen. Cancers of the ovary, of the fallopian tube and of the abdominal lining are consequently grouped together and handled as one disease, and removing the tubes has become part of risk reducing surgery for that reason.
What are the main types?
| Type | Cell of origin | Notes |
|---|---|---|
| Epithelial | Surface lining cells, largely of tubal origin | The great majority; includes serous, endometrioid, clear cell and mucinous forms |
| Germ cell | The egg-producing cells | Uncommon, and mostly affects younger people |
| Sex cord stromal | The supporting, hormone-making tissue | Uncommon; may produce hormones and cause abnormal bleeding |
Inherited faults in the BRCA1 and BRCA2 genes account for a meaningful share of epithelial cases, and Lynch syndrome contributes as well, which is why a diagnosis often prompts genetic evaluation of the family.
Why is it found so late?
The ovaries sit deep in the pelvis with room around them, so a tumor can grow and shed cells across the abdominal lining before anything is felt. The symptoms that do appear, persistent bloating, pelvic or abdominal discomfort, feeling full quickly, and a change in urinary frequency, are the same complaints produced by far more common and far less serious conditions. There is also no screening test accurate enough for use in the general population; the blood marker used to follow known disease is raised in many benign conditions and normal in some early cancers, so it does not serve to find the disease in people without symptoms.
Used in a sentence
Imaging and tumor marker testing were ordered to further evaluate a mass suspicious for ovarian cancer.
Good to know
Symptoms of ovarian cancer overlap heavily with common digestive and gynecologic complaints, and no screening test is accurate enough for general use, which together account for the disease being identified later than many other cancers.