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Ovarian cancer - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of ovarian cancer..

Highlights:

Ovarian Cancer

Ovarian cancer is the eighth most common cancer in women, and the fifth leading cause of female cancer death. Unfortunately, most cases of ovarian cancer are discovered when the cancer is already advanced. Detection of ovarian cancer while it is in its early stages significantly improves prognosis.

Symptoms

Ovarian cancer grows quickly and can progress from early to advanced stages within a year. Paying attention to symptoms can help improve a woman's chances of being diagnosed and treated promptly. If you have the following symptoms on a daily basis for more than a few weeks, you should see your doctor (preferably a gynecologist):

Bloating
Pelvic or abdominal pain
Difficulty eating or feeling full quickly

Risk Factors for Ovarian Cancer

The main risk factors of ovarian cancer are:

Older age
Family history of ovarian, breast, or hereditary colorectal cancer
BRCA1 or BRCA2 genetic mutations
Obesity
Hormone replacement therapy use for 5 or more years
Not having had children

Preventive Factors for Ovarian Cancer

Factors that reduce the risk of ovarian cancer include:

Taking birth control pills
Giving birth to at least one child
Tubal ligation (tying fallopian tubes) or hysterectomy (removal of uterus) after childbearing

Treatment

Ovarian cancer is usually treated by surgery, followed by chemotherapy. Surgery involves removal of the ovaries, fallopian tubes, uterus, and the omentum (the fatty layer that covers organs in the abdomen).

Patients with ovarian cancer should seek care from a qualified gynecologic oncologist (a surgical specialist in female reproductive cancers) and a qualified medical oncologist with special expertise in the chemotherapeutic management of gynecologic cancer.

Resources

www.cancer.gov -- National Cancer Institute
www.cancer.org -- American Cancer Society
www.asco.org -- American Society of Clinical Oncology
www.cancernet.org -- Cancer.Net
www.ovarian.org -- National Ovarian Cancer Coalition
www.ovariancancer.org -- Ovarian Cancer National Alliance
www.sgo.org -- Society of Gynecologic Oncologists
www.wcn.org -- Women's Cancer Network
www.ovariancancer.com -- The Gilda Radner Familial Ovarian Cancer Registry
www.cancer.gov/clinicaltrials -- Find clinical trials

References

Aletti GD, Gallenberg MM, Cliby WA, Jatoi A, Hartmann LC. Current management strategies for ovarian cancer. Mayo Clin Proc. 2007 Jun;82(6):751-70.

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Management of adnexal masses. Obstet Gynecol. 2007; 110(1): 201-14.

Beral V; Million Women Study Collaborators; Bull D, Green J, Reeves G. Ovarian cancer and hormone replacement therapy in the Million Women Study. Lancet. 2007 May 19;369(9574):1703-10.

Burger, RA. Experience with bevacizumab in the management of epithelial ovarian cancer. J Clin Oncol. 2007; 25(20): 2902-8.

Chan JK, Tian C, Monk BJ, Herzog T, Kapp DS, Bell J, et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer. 2008; 112(10): 2202-10.

Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, Doll R, Hermon C, Peto R and Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008; 371(9609): 303-14.

Domchek SM and Rebbeck TR. Prophylactic oophorectomy in women at increased cancer risk. Curr Opin Obstet Gynecol. 2007; 19(1): 27-30.

Elit L, Oliver TK, Covens A, Kwon J, Fung MF, Hirte HW, et al. Intraperitoneal chemotherapy in the first-line treatment of women with stage III epithelial ovarian cancer: a systematic review with metaanalyses. Cancer. 2007; 109(4): 692-702.

Fader AN and Rose PG. Role of surgery in ovarian carcinoma. J Clin Oncol. 2007; 25(20): 2873-83.

Goff BA, Mandel LS, Drescher CW, Urban N, Gough S, Schurman KM, et al. Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer. 2007 Jan 15;109(2):221-7.

Goff BA, Matthews BJ, Larson EH, Andrilla CH, Wynn M, Lishner DM, et al. Predictors of comprehensive surgical treatment in patients with ovarian cancer. Cancer. 2007 May 15;109(10):2031-42.

Hogdall, E. Cancer antigen 125 and prognosis. Curr Opin Obstet Gynecol. 2008; 20(1): 4-8.

Lacey JV Jr, Brinton LA, Leitzmann MF, Mouw T, Hollenbeck A, Schatzkin A, et al. Menopausal hormone therapy and ovarian cancer risk in the National Institutes of Health-AARP Diet and Health Study Cohort. J Natl Cancer Inst. 2006 Oct 4;98(19):1397-405.

Lacey JV Jr, Greene MH, Buys SS, Reding D, RileyTL, Berg CD, et al. Ovarian cancer screening in women with a family history of breast or ovarian cancer. Obstet Gynecol. 2006; 108(5): 1176-84.

Larkin JM and Kaye SB. Potential clinical applications of epothilones: a review of phase II studies. Ann Oncol. 2007; 18 Suppl 5: v28-34.

Martin L and Schilder R. Novel approaches in advancing the treatment of epithelial ovarian cancer: the role of angiogenesis inhibition. J Clin Oncol. 2007; 25(20): 2894-901.

Morrison J, Swanton A, Collins S and Kehoe S. Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev. 2007; (4): CD005343.

National Comprehensive Cancer Network. NCCN Practice Guidelines in Oncology: Ovarian cancer. 2008; v.1.

Prentice RL, Thomson CA, Caan B, Hubbell FA, Anderson GL, Beresford SA, et al. Low-fat dietary pattern and cancer incidence in the Women's Health Initiative Dietary Modification Randomized Controlled Trial. J Natl Cancer Inst. 2007; 99(20): 1534-43.

Rao G, Crispens M and Rothenberg ML. Intraperitoneal chemotherapy for ovarian cancer: overview and perspective. J Clin Oncol. 2007; 25(20): 2867-72.

U.S. Preventive Services Task Force. Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: recommendation statement. Ann Intern Med. 2005 Sep 6;143(5):355-61.

Zhou B, Yang L, Wang L, Shi Y, Zhu H, Tang N, et al. The association of tea consumption with ovarian cancer risk: A metaanalysis. Am J Obstet Gynecol. 2007; 197(6): 594 e1-6.

Reviewed last on: 9/19/2008
Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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