Ovarian Cancer
On this page:
Ovarian Epithelial
Cancer
Ovarian Germ Cell Tumors
Ovarian Epithelial
Cancer
Ovarian epithelial cancer is a disease in which malignant (cancer) cells form
in the tissue covering the ovary.
The ovaries are a pair of organs in the female reproductive system.
They are located in the pelvis, one on each side of the uterus (the hollow,
pear-shaped organ where a fetus grows). Each ovary is about the size and shape
of an almond. The ovaries produce eggs and female hormones (chemicals that
control the way certain cells or organs function).
Ovarian epithelial cancer is one type of cancer that affects the
ovary.
Women who have a family history of ovarian cancer are at an increased risk
of developing ovarian cancer.
Women who have one first-degree relative (mother, daughter, or
sister) with ovarian cancer are at an increased risk of developing ovarian
cancer. This risk is higher in women who have one first-degree relative and
one second-degree relative (grandmother or aunt) with ovarian cancer. This
risk is even higher in women who have two or more first-degree relatives with
ovarian cancer.
Some ovarian cancers are caused by inherited gene mutations (changes).
The genes in cells carry the hereditary information that is received
from a personfs parents. Hereditary ovarian cancer makes up approximately 5%
to 10% of all cases of ovarian cancer. Three hereditary patterns have been
identified: ovarian cancer alone, ovarian and breast cancers, and ovarian and colon cancers.
Tests that can detect altered genes have been developed. These genetic
tests are sometimes done for members of families with a high risk of cancer.
Women with an increased risk of ovarian cancer may consider surgery to prevent
it.
Some women who have an increased risk of ovarian cancer may choose
to have a prophylactic oophorectomy (the removal of healthy ovaries so that
cancer cannot grow in them). It is not known if this procedure prevents ovarian
cancer.
Ovarian cancer is hard to detect (find) early because usually there are no
symptoms.
Some women who have early stage ovarian cancer may have symptoms such
as vague gastrointestinal (GI) discomfort, pressure in the pelvis, pain, swelling
of the abdomen, and shortness of breath. Most of the time, there are no symptoms
or they are very mild. By the time symptoms do appear, the cancer is usually
advanced.
When found in its early stages, ovarian epithelial cancer can
be cured in many patients. Women with any stage of ovarian epithelial cancer
should consider taking part in a clinical trial.
Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are
used to detect (find) and diagnose ovarian cancer.
- Pelvic exam: An exam of the vagina, cervix, uterus, fallopian
tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated,
gloved fingers of one hand into the vagina and the other hand is placed over
the lower abdomen to feel the size, shape, and position of the uterus and
ovaries. A speculum is also inserted into the vagina and the doctor or nurse
looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of
the cervix is usually done. The doctor or nurse also inserts a lubricated,
gloved finger into the rectum to feel for lumps or abnormal areas.
- Ultrasound: A procedure in which high-energy sound waves
(ultrasound) are bounced off internal tissues or organs and make echoes.
The echoes form a picture of body tissues called a sonogram.
- CA 125 assay: A test that measures the level of CA 125
in the blood. CA 125 is a substance released by cells into the bloodstream.
An increased CA 125 level is sometimes a sign of cancer or other condition.
- Barium enema (lower GI series): A series of x-rays of
the lower gastrointestinal tract. A liquid that contains barium (a silver-white
metallic compound) is put into the rectum. The barium coats the lower gastrointestinal
tract and x-rays are taken. This procedure is also called a lower GI series.
- Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters,
and bladder to find out if cancer is present in these organs. A contrast
dye is injected into a vein. As the contrast dye moves through the kidneys,
ureters, and bladder, x-rays are taken to see if there are any blockages.
- CT scan (CAT scan): A procedure that makes 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 swallowed to help the organs or tissues show up
more clearly. This procedure is also called computed tomography, computerized
tomography, or computerized axial tomography.
- Biopsy: The removal of cells or tissues so they can be
viewed under a microscope 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).
Certain factors affect treatment options and prognosis (chance of recovery).
The prognosis (chance of recovery) and treatment options depend
on the following:
- The stage of the cancer.
- The type and size of the tumor.
- The patientfs age and general health.
- Whether the cancer has just been diagnosed or has recurred (come
back).
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After ovarian epithelial cancer has been diagnosed, tests are done to find
out if cancer cells have spread within the ovaries or to other parts of the
body.
The process used to find out if cancer has spread within the ovary or
to other parts of the body is called staging. The information gathered from
the staging process determines the stage of the disease. It is important to
know the stage in order to plan treatment.
An operation called a laparotomy is usually done to find out the
stage of the disease. A doctor must cut into the abdomen and carefully look
at all the organs to see if they contain cancer. The doctor will also perform
a biopsy (cut out small pieces of tissue so they can be looked at under a microscope
to see whether they contain cancer). Usually the doctor will remove the cancer
and organs that contain cancer during the laparotomy.
In stage I, cancer is found in one or both of the ovaries and
has not spread. Stage I is divided into stage IA, stage IB, and stage IC.
- Stage IA: Cancer is found in a single ovary.
- Stage IB: Cancer is found in both ovaries.
- Stage IC: Cancer is found in one or both ovaries and one of the following
is true:
- cancer is found on the outside surface of one or both ovaries; or
- the capsule (outer covering) of the tumor has ruptured (broken open);
or
- cancer cells are found in the fluid of the peritoneal cavity (the body
cavity that contains most of the organs in the abdomen) or in washings
of the peritoneum (tissue lining the peritoneal cavity).
In stage II, cancer is found in one or both ovaries and has spread
into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB,
and stage IIC.
- Stage IIA: Cancer has spread to the uterus and/or the fallopian tubes (the
long slender tubes through which eggs pass from the ovaries to the uterus).
- Stage IIB: Cancer has spread to other tissue within the pelvis.
- Stage IIC: Cancer has spread to the uterus and/or fallopian tubes and/or
other tissue within the pelvis and cancer cells are found in the fluid of
the peritoneal cavity (the body cavity that contains most of the organs in
the abdomen) or in washings of the peritoneum (tissue lining the peritoneal
cavity).
In stage III, cancer is found in one or both ovaries and has spread
to other parts of the abdomen. Stage III is divided into stage IIIA, stage
IIIB, and stage IIIC.
- Stage IIIA: The tumor is found only in the pelvis, but cancer cells have
spread to the surface of the peritoneum (tissue that lines the abdominal wall
and covers most of the organs in the abdomen).
- Stage IIIB: Cancer has spread to the peritoneum but is 2 centimeters or
smaller in diameter.
- Stage IIIC: Cancer has spread to the peritoneum and is larger than 2 centimeters in
diameter and/or has spread to lymph nodes in the abdomen.
Cancer that has spread to the surface of the liver is also considered
stage III disease.
In stage IV, cancer is found in one or both ovaries and has metastasized (spread)
beyond the abdomen to other parts of the body. Cancer is found in the tissues
of the liver.
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Recurrent
ovarian
epithelial cancer is cancer
that has recurred (come back) after it has been treated.
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There are different types of treatment for patients with ovarian epithelial
cancer.
Different types of treatment are available for patients with ovarian
epithelial cancer. Some treatments are standard, and some are being tested
in clinical trials. Before starting treatment, patients may want to think about
taking part in a clinical trial. A treatment clinical trial is a research study
meant to help improve current treatments or obtain information on new treatments
for patients with cancer. When clinical trials show that a new treatment is
better than the treatment currently used as standard treatment, the new treatment
may become the standard treatment.
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 uterus and cervix. If
the uterus and cervix are taken out through the vagina, the operation is
called a vaginal hysterectomy. If the uterus and cervix are taken out through
a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy.
If the uterus and cervix are taken out through a small incision (cut) in
the abdomen using a laparoscope, the operation is called a total laparoscopic
hysterectomy.
- 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.
Radiation therapy is a cancer treatment that uses high-energy x-rays or
other types of radiation to kill cancer cells. There are two types of radiation
therapy. External radiation therapy uses a machine outside the body to send
radiation toward the cancer. Internal radiation therapy uses a radioactive substance
sealed in needles, seeds, wires, or catheters that are placed directly into
or near the cancer. The way the radiation therapy is given depends on the type
and stage of the cancer being treated.
Some women receive a treatment called intraperitoneal radiation
therapy, in which radioactive liquid is put directly in the abdomen through
a catheter.
Chemotherapy is a cancer treatment that uses drugs to stop the
growth of cancer cells, either by killing the cells or by stopping the cells
from dividing. When chemotherapy is taken by mouth or injected into a vein
or muscle, the drugs enter the bloodstream and can reach cancer cells throughout
the body (systemic chemotherapy). When chemotherapy is placed directly into
the spinal column, an organ, or a body cavity such as the abdomen, the drugs
mainly affect cancer cells in those areas (regional chemotherapy). The way
the chemotherapy is given depends on the type and stage of the cancer being
treated.
Other types of treatment are being tested in clinical trials. These include
the following:
Biologic therapy is a treatment that uses the patientfs immune
system to fight cancer. Substances made by the body or made in a laboratory
are used to boost, direct, or restore the bodyfs natural defenses against cancer.
This type of cancer treatment is also called biotherapy or immunotherapy.
High-dose chemotherapy with stem cell transplantation is a method
of giving high doses of chemotherapy and replacing blood-forming cells destroyed
by the cancer treatment. Stem cells (immature blood cells) are removed from
the blood or bone marrow of the patient or a donor and are frozen and stored.
After the chemotherapy is completed, the stored stem cells are thawed and given
back to the patient through an infusion. These reinfused stem cells grow into
(and restore) the bodyfs blood cells.
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- Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and
other tissues in the pelvis and abdomen are removed and examined under the
microscope to look for cancer cells.
- Hysterectomy, unilateral salpingo-oophorectomy, and omentectomy. Lymph
nodes and other tissues in the pelvis and abdomen are removed and examined
under the microscope to look for cancer cells.
- Internal or external radiation therapy.
- Chemotherapy.
- Watchful waiting (closely monitoring a patientfs condition without giving
any treatment until symptoms appear or change).
- A clinical trial.
Treatment of stage II ovarian epithelial cancer may be surgery to
remove the tumor, hysterectomy, bilateral salpingo-oophorectomy, and omentectomy.
Lymph nodes and other tissues in the pelvis and abdomen are removed and examined
under the microscope to look for cancer cells.
After surgery, treatment may include the following:
- Combination chemotherapy and internal or external radiation therapy.
- Combination chemotherapy alone.
- A clinical trial.
Treatment of stage III and stage IV ovarian epithelial cancer
may be surgery to remove the tumor, hysterectomy, bilateral salpingo-oophorectomy,
and omentectomy.
After surgery, treatment may include the following:
- Combination chemotherapy.
- Combination chemotherapy followed by second-look surgery (surgery performed
after the initial surgery to determine whether tumor cells remain).
- A clinical trial.
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Treatment of recurrent ovarian epithelial cancer may include the
following:
- Chemotherapy with or without surgery.
- A clinical trial of chemotherapy or biologic therapy (treatment
to stimulate or restore the ability of the immune system to fight cancer).
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Ovarian germ cell tumor is a disease in which malignant (cancer)
cells form in the germ (egg) cells of the ovary.
Germ cell tumors begin in the reproductive cells (egg
or sperm) of the body. Ovarian germ cell tumors usually occur in
teenage girls or young women and most often affect just one ovary.
The ovaries are a pair of organs in the female reproductive
system. They are located in the pelvis, one on each side of the uterus (the
hollow, pear-shaped organ where a fetus grows). Each ovary is about
the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals
that control the way certain cells or organs function).
Ovarian germ cell tumor is a general name that is
used to describe several different types of cancer. The most common
ovarian germ cell tumor is called dysgerminoma.
Possible signs of ovarian germ cell tumor are swelling of the
abdomen or vaginal bleeding after menopause.
Ovarian germ cell tumors can be difficult to diagnose
(find) early. Often there are no symptoms in the early stages,
but tumors may be found during regular gynecologic examinations
(checkups). A woman who has swelling of the abdomen without weight
gain in other places should see a doctor. A woman who no longer
has menstrual periods (who has gone through menopause) should also
see a doctor if she has bleeding from the vagina.
Tests that examine the ovaries, pelvic area, blood, and ovarian
tissue are used to detect (find) and diagnose ovarian germ cell
tumor.
- Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries,
and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers
of one hand into the vagina and the other hand is placed over the lower abdomen
to feel the size, shape, and position of the uterus and ovaries. A speculum is
also inserted into the vagina and the doctor or nurse looks at the vagina
and cervix for signs of disease. A Pap test or Pap smear of the cervix is
usually done. The doctor or nurse also inserts a lubricated, gloved finger
into the rectum to feel for lumps or abnormal areas.
- Laparotomy: A surgical incision made in the wall of the abdomen
to check the inside of the abdomen for signs of disease and to
remove tissue and fluid for examination under a microscope.
- Lymphangiogram: A procedure used to x-ray the lymph system.
A dye is injected into the lymph vessels in the feet. The dye
travels upward through the lymph nodes and lymph vessels, and
x-rays are taken to see if there are any blockages. This test
helps find out whether cancer has spread to the lymph nodes.
- CT scan (CAT scan): A procedure that makes 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 swallowed to help the organs
or tissues show up more clearly. This procedure is also called
computed tomography, computerized tomography, or computerized
axial tomography.
- Blood tests: Tests to measure the levels of alpha fetoprotein (AFP)
and human chorionic gonadotropin (HCG) in the blood. AFP and
HCG are substances that may be signs of ovarian germ cell tumor
when found at increased levels.
Certain factors affect prognosis (chance of recovery and treatment
options.
- The type of cancer.
- The size of the tumor.
- The stage of cancer (whether it affects part of the ovary,
involves the whole ovary, or has spread to other places in the
body).
- The way the cancer cells look under a microscope.
- The patientfs general health.
Ovarian germ cell tumors are generally curable if
found and treated early.
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After ovarian
germ cell tumor has been diagnosed, tests are done to find out if
cancer cells have spread within the ovary or to other parts of the
body.
The process used to find out whether cancer
has spread within the ovary
or to other parts of the body is called staging.
The information gathered from the staging process determines the stage
of the disease. It is important to know the stage in order to plan
the best treatment. Certain tests are used in the staging process.
Many of the tests used to diagnose ovarian
germ
cell tumor are also used to determine the stage of the disease.
Unless a doctor is sure the cancer has spread from the ovaries to
other parts of the body, surgery
is required to determine the stage of cancer in an operation called
a laparotomy.
The doctor must cut into the abdomen
and carefully look at all the organs
to see if they contain cancer. The doctor will cut out small pieces
of tissue
and look at them under a microscope to see whether they contain
cancer. The doctor may also wash the abdominal
cavity with fluid and then look at the fluid under a microscope to
see if it contains cancer cells.
Usually the doctor will remove the cancer and other organs that
contain cancer during the laparotomy.
The following
stages are used for ovarian germ cell tumors:
Stage
I is divided into stage IA, stage IB, and stage IC as
follows:
- Stage IA: Cancer is limited to one ovary.
- Stage IB: Cancer is found in both ovaries.
- Stage IC: Cancer is found in one or both
ovaries and one of the following occurs:
- Cancer has spread to the outside surface
of one or both ovaries; or
- The outer covering of the tumor
has ruptured (broken open); or
- Cancer cells are found in the fluid of the
peritoneal
cavity or in washings of the peritoneum
(tissue that lines the abdominal wall and covers most of the
organs in the abdomen).
Stage
II is divided into stage IIA, stage IIB, and stage IIC as
follows:
- Stage IIA: Cancer is found in one or both
ovaries and has spread into the pelvis
and/or to the uterus
and/or fallopian
tubes.
- Stage IIB: Cancer is found in one or both
ovaries and has spread to other tissue within the pelvis.
- Stage IIC: Cancer is found in one or both
ovaries, has spread to the uterus, fallopian tubes, and/or to
other tissues in the pelvis, and one of the following occurs:
- Cancer is on the surface of one or both
ovaries; or
- The outer covering of the tumor has
ruptured (broken open); or
- Cancer cells are found in the fluid of the
peritoneal cavity or in washings of the peritoneum.
Stage
III is divided into stage IIIA, stage IIIB, and stage IIIC as
follows:
- Stage IIIA: Cancer is found in one or both
ovaries and the pelvis, and microscopic cancer cells are found in
the peritoneum.
- Stage IIIB: Cancer is found in one or both
ovaries and has spread to the peritoneum. The peritoneal tumors
are no larger than 2 centimeters (about 3/4 inch).
- Stage IIIC: Cancer is found in one or both
ovaries and has spread beyond the pelvis to the peritoneum. The
peritoneal tumors are larger than 2 centimeters and/or cancer is
found in lymph
nodes in the pelvis.
Cancer that has spread to the surface of the liver
or has spread to the small
bowel or omentum
(a fold of peritoneum that encloses the bowel) is also considered
stage III disease.
In stage
IV, cancer is found in one or both ovaries and has metastasized
(spread) not only to the pelvis and abdomen but also to other parts
of the body. Cancer is found in the tissues of the liver.
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Recurrent ovarian germ cell tumor is cancer that has recurred
(come back) after it has been treated. The cancer may come back in the other ovary or
in other parts of the body.
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Ovarian Germ Cell Tumors
There are different types of treatment for patients with ovarian
germ cell tumors.
Different types of treatment are available for patients
with ovarian germ cell tumor. Some treatments are standard (the
currently used treatment), and some are being tested in clinical
trials. Before starting treatment, patients may want to think
about taking part in a clinical trial. A treatment clinical trial
is a research study meant to help improve current treatments
or obtain information on new treatments for patients with cancer.
When clinical trials show that a new treatment is better than
the gstandardh treatment, the new treatment may become the standard
treatment.
Surgery is the most common treatment of ovarian
germ cell tumor. A doctor may take out the cancer using one of
the following types of surgery.
- Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and
one fallopian tube.
- Hysterectomy: A surgical procedure to remove the uterus and cervix.
If the uterus and cervix are taken out through the vagina,
the operation is called a vaginal hysterectomy. If the uterus
and cervix are taken out through a large incision (cut) in
the abdomen, the operation is called a total abdominal hysterectomy.
If the uterus and cervix are taken out through a small incision
(cut) in the abdomen using a laparoscope, the operation is
called a total laparoscopic hysterectomy.
- Bilateral salpingo-oophorectomy: A surgical procedure to
remove both ovaries and both fallopian tubes.
- Tumor debulking: A surgical procedure in which as much of
the tumor as possible is removed. Some tumors may not be able
to be completely removed.
Chemotherapy is a cancer treatment that uses drugs
to stop the growth of cancer cells, either by killing the cells
or by stopping the cells from dividing. When chemotherapy is
taken by mouth or injected into a vein or muscle, the drugs enter
the bloodstream and can reach cancer cells throughout the body
(systemic chemotherapy). When chemotherapy is placed directly
in the spinal column, a body cavity such as the abdomen, or an organ,
the drugs mainly affect cancer cells in those areas. The way
the chemotherapy is given depends on the type and stage of the
cancer being treated.
Radiation therapy is a cancer treatment that uses
high-energy x-rays or other types of radiation to kill cancer
cells. There are two types of radiation therapy. External radiation therapy
uses a machine outside the body to send radiation toward the
cancer. Internal radiation therapy uses a radioactive substance
sealed in needles, seeds, wires, or catheters that are placed
directly into or near the cancer. The way the radiation therapy
is given depends on the type and stage of the cancer being treated.
Even if the doctor removes all the cancer that can
be seen at the time of the operation, some patients may be offered
chemotherapy or radiation after surgery to kill any cancer cells
that are left. Treatment given after the surgery to increase
the chances of a cure is called adjuvant therapy.
Following radiation or chemotherapy, an operation
called a second-look laparotomy is sometimes done. This is similar
to the laparotomy that is done to determine the stage of the
cancer. During the second-look operation, the doctor will take
samples of lymph nodes and other tissues in the abdomen to see
if any cancer is left.
Other types of treatment are being tested in clinical trials.
These include the following:
High-dose chemotherapy with bone marrow transplantation
High-dose chemotherapy with bone marrow transplantation is
a method of giving very high doses of chemotherapy and replacing
blood-forming cells destroyed by the cancer treatment. Stem cells (immature
blood cells) are removed from the bone marrow of the patient
or a donor and are frozen for storage. After the chemotherapy
is completed, the stored stem cells are thawed and given back
to the patient through an infusion. Over a short time, these
reinfused stem cells grow into (and restore) the bodyfs blood
cells.
Combination chemotherapy (the use of more than one
chemotherapy drug to fight cancer) is being tested in clinical
trials.
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Treatment depends on whether the tumor is dysgerminoma or another
type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Unilateral salpingo-oophorectomy with or without lymphangiography (an x-ray study
of the lymph system, the tissues and organs that filter and destroy harmful
substances and help fight infection and disease) or CT scan (a series of
detailed pictures of areas inside the body, created by a computer linked
to an x-ray machine).
- Unilateral salpingo-oophorectomy followed by observation (closely monitoring
a patientfs condition without giving any treatment until symptoms appear
or change).
- Unilateral salpingo-oophorectomy followed by radiation therapy.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may be either:
- unilateral salpingo-oophorectomy followed by careful observation; or
- unilateral salpingo-oophorectomy, sometimes followed by combination chemotherapy.
Treatment depends on whether the tumor is dysgerminoma or another
type of germ cell tumor.
Treatment of dysgerminoma may be either:
- hysterectomy and bilateral salpingo-oophorectomy followed by radiation
therapy or combination chemotherapy; or
- unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Unilateral salpingo-oophorectomy followed by combination chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine
whether tumor cells remain).
- A clinical trial evaluating new treatment options.
Treatment depends on whether the tumor is dysgerminoma or another
type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Hysterectomy and bilateral salpingo-oophorectomy, with removal of as much
of the cancer in the pelvis and abdomen as possible.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Hysterectomy and bilateral salpingo-oophorectomy, with removal of as much
of the cancer in the pelvis and abdomen as possible. Chemotherapy will be
given before and/or after surgery.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine
whether tumor cells remain).
- A clinical trial evaluating new treatment options.
Treatment depends on whether the tumor is dysgerminoma or another
type of germ cell tumor.
Treatment of dysgerminoma may include the following:
- Hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy,
with removal of as much of the cancer in the pelvis and abdomen as possible.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
Treatment of other germ cell tumors may include the following:
- Hysterectomy and bilateral salpingo-oophorectomy, with removal of as much
of the cancer in the pelvis and abdomen as possible. Chemotherapy will be
given before and/or after surgery.
- Unilateral salpingo-oophorectomy followed by chemotherapy.
- Second-look surgery (surgery performed after primary treatment to determine
whether tumor cells remain).
- A clinical trial evaluating new treatment options.
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Treatment depends on whether the tumor is dysgerminoma
or another type of germ cell tumor.
- Chemotherapy with or without radiation therapy.
- Chemotherapy.
- Surgery with or without chemotherapy.
- A clinical trial of high-dose chemotherapy followed by bone
marrow transplantation.
- A clinical trial evaluating new treatment options.
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After ovarian
low malignant
potential tumor
has been diagnosed, tests are done to find out if cancer
cells
have spread within the ovary
or to other parts of the body. The process used to find out whether
cancer has spread within the ovary or to other parts of the body is
called staging.
The information gathered from the staging process determines the stage
of the disease. It is important to know the stage in order to plan
treatment. Certain tests or procedures are used to determine stage.
Staging laparotomy
(a surgical incision
made in the wall of the abdomen
to remove ovarian tissue)
may be used. Most patients are diagnosed with stage
I disease.
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Recurrent
ovarian
low malignant
potential tumor
is cancer
that has recurred (come back) after it has been treated. The cancer
may come back in the other ovary or in other parts of the body.
Return to top
There are different types of treatment for patients with ovarian low malignant
potential tumor.
Different types of treatment are available for patients with ovarian low malignant potential tumor.
Some treatments are standard (the currently used treatment), and some are being
tested in clinical trials. Before starting treatment, patients may want to
think about taking part in a clinical trial. A treatment clinical trial is
a research study meant to help improve current treatments or obtain information
on new treatments for patients with cancer. When clinical trials show that
a new treatment is better than the gstandardh treatment, the new treatment
may become the standard treatment.
The type of surgery (removing the tumor in an operation) depends
on the extent of the disease and the womanfs plans for having children. Surgery
may include the following:
- 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.
- Hysterectomy and bilateral salpingo-oophorectomy: A surgical procedure
to remove the uterus, cervix, and both ovaries and fallopian tubes. If the
uterus and cervix are taken out through the vagina, the operation is called
a vaginal hysterectomy. If the uterus and cervix are taken out through a
large incision (cut) in the abdomen, the operation is called a total abdominal
hysterectomy. If the uterus and cervix are taken out through a small incision
(cut) in the abdomen using a laparoscope, the operation is called a total
laparoscopic hysterectomy.
- Partial oophorectomy: A surgical procedure to remove part of one ovary
or part of both ovaries.
- Omentectomy: A surgical procedure to remove the omentum (a piece of the tissue lining
the abdominal wall).
Even if the doctor removes all disease that can be seen at the
time of the operation, the patient may be given chemotherapy after surgery
to kill any tumor cells that are left. Treatment given after the surgery to
increase the chances of a cure is called adjuvant therapy.
Chemotherapy is a cancer treatment that uses drugs to stop the
growth of cancer cells, either by killing the cells or by stopping the cells
from dividing. When chemotherapy is taken by mouth or injected into a vein
or muscle, the drugs enter the bloodstream and can reach cancer cells throughout
the body (systemic treatment). When chemotherapy is placed directly into the
spinal column, a body cavity such as the abdomen, or an organ, the drugs mainly
affect cancer cells in those areas. The way the chemotherapy is given depends
on the type and stage of the cancer being treated.
Other types of treatment are being tested in clinical trials.
Return to top
Surgery is the standard treatment for early stage ovarian low malignant potential tumor.
The type of surgery usually depends on whether a woman plans to have children.
- unilateral salpingo-oophorectomy; or
- partial oophorectomy.
To prevent recurrence of disease, most doctors recommend surgery
to remove the remaining ovarian tissue when a woman no longer plans to have
children.
- hysterectomy and bilateral salpingo-oophorectomy.
Late Stage Ovarian Low Malignant Potential Tumors (Stage III)
- hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. A lymph
node dissection may also be performed.
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Treatment for recurrent ovarian low malignant potential tumor may
include the following:
- Surgery.
- Surgery followed by chemotherapy.
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Abnormal Vaginal Bleeding
