More than 90% ovarian cancers are classified as “epithelial” and are believed to arise from the surface (epithelium) of the ovary. However, some evidence suggests that the fallopian tube could also be the source of some ovarian cancers. Since the ovaries and tubes are closely related to each other, it is thought that these fallopian cancer cells can mimic ovarian cancer. Other types may arise from the egg cells (germ cell tumor) or supporting cells. These cancers are grouped into the category of gynecologic cancer.
Tests & Diagnostics
(A ) Physical examination may reveal a swollen abdomen and fluid in the abdominal cavity (ascites). A pelvic examination may reveal an ovarian or abdominal mass.
(B) Lab tests that may be carried out include:
- Alpha fetoprotein
- Blood chemistry
- CA125 (may be done if ovarian cancer is strongly suspected or has been diagnosed, and to monitor the cancer during or after treatment)
- Quantitative serum HCG (blood pregnancy test)
(C ) Imaging tests that may be done include:
- Abdominal CT scan or MRI of abdomen
- GI series
(D) Pelvic laparoscopy or exploratory laparotomy may be done to evaluate symptoms and get a biopsy to help make the diagnosis.
Surgery is part of the treatment for all stages of ovarian cancer. For earlier stages, it may be the only treatment. Surgery involves:
- Removal of the uterus (total hysterectomy)
- Removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy)
- Partial or complete removal of the omentum, the fatty layer that covers and pads organs in the abdomen
- Examination, biopsy, or removal of the lymph nodes and other tissues in the pelvis and abdomen
Studies have shown that surgery performed by a specialist in gynecologic oncology results in a higher success rate.
Chemotherapy is used after surgery to treat any remaining disease. It can also be used if the cancer comes back.
Radiation therapy is rarely used.
NOTE: After surgery and chemotherapy, patients should have:
(A) A physical exam (including pelvic exam) every 2 – 4 months for the first 2 years, followed by every 6 months for 3 years, and then annually
(B) A CA-125 blood test at each visit if the level was initially high
(C ) Your doctor may also order a computed tomography (CT) scan of your chest, abdomen, and pelvic area and a chest x-ray.