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What Is Ovarian Cancer?

Ovarian cancer broadly refers to cancer that starts in the ovaries, fallopian tubes, or, less commonly, the lining of the abdominal cavity, called the peritoneum. The ovaries are glands in females that produce eggs for reproduction. During reproduction, eggs travel from the ovaries through the fallopian tubes and into the uterus, where a fertilized egg can settle to develop into a fetus. The ovaries are also the primary source of the female hormones estrogen and progesterone. Most women have two ovaries, one on either side of the uterus.  

Often, ovarian cancer can go undetected until it starts to spread beyond the ovary and further into the abdomen and pelvis. At that point, the cancer is referred to as late-stage ovarian cancer and is generally more difficult to treat. Early-stage ovarian cancer describes disease that is confined to the ovary and is typically easier to treat and often has a better prognosis.

According to the American Cancer Society, there will be about 21,410 new cases and 13,770 deaths from ovarian cancer in 2021 in the United States. In Colorado, it is estimated that 320 people will be diagnosed with ovarian cancer and 180 will die from the disease.

Ovarian Cancer Prognosis and Survival Rates

Ovarian cancer is the fifth most common cause of cancer-related deaths in women in the U.S. The risk of a woman getting ovarian cancer during her lifetime is around one in 78, while the lifetime odds of a woman dying from ovarian cancer are around one in 108. 

Ovarian cancer develops primarily in older women. More than half of women diagnosed with ovarian cancer are 63 or older. Ovarian cancer is more common in white women than Hispanic, Asian/Pacific-Islander, African American, or American Indian/Alaska Native women.

The rates of ovarian cancer diagnoses have been falling slowly over the past two decades.

The five-year survival rate for ovarian cancer — the percentage of people who live at least five years after the disease is found —varies by the specific type of ovarian cancer and the stage at which it is discovered. It ranges from 18% for invasive epithelial ovarian cancer that has spread to distant parts of the body, such as the liver or lungs, to 98% for ovarian stromal tumors and germ cell tumors of the ovary that are discovered and treated before they can spread. 

Of all ovarian cancers, 90% to 95% fall within the category of “epithelial” ovarian carcinomas, which include the serous, mucinous, endometrioid, and clear cell subtypes, as well as borderline tumors of low malignant potential. The remaining 5% to 10% are germ cell and sex cord stromal tumors, which arise from the specialized gonadal stroma surrounding the oocytes, such as the granulosa, theca, Sertoli, and Leydig cells, and are more commonly seen in younger women. Of the epithelial carcinomas, 75% are serous.

Until recently, fallopian tube and peritoneal carcinomas were thought to be phenotypically related, but clinically distinct from ovarian cancer and were considered relatively rare. However, recent data suggest that most epithelial ovarian cancers originate in the fallopian tube, and given their similar behavior, these three are often treated as a single entity. 

Why Come to CU Cancer Center for Ovarian Cancer

As the only National Cancer Institute Designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region, the University of Colorado Cancer Center has doctors who provide cutting-edge, patient-centered ovarian cancer care, as well as researchers who are dedicated to finding cutting-edge diagnostic and treatment modalities. 

The Women’s Cancer Developmental Therapeutics Program (WCDTP) at the CU Cancer Center seeks to increase the development of novel cancer therapies in ovarian cancer and other gynecologic cancers with the goal of decreasing cancer-related morbidity and mortality for patients. Additionally, the WCTD seeks to increase access to phase I and II clinical trials of novel cancer therapies for patients with gynecologic and breast cancers.

There are numerous clinical trials ongoing at the CU Cancer Center at any one time, including trials that enroll ovarian cancer patients. These trials offer patients other options besides traditional ovarian cancer treatment. 

→ CU Researchers Come Together to Better Understand Ovarian Cancer Tumors and Treatment Outcomes

Types of Ovarian Cancer

Different types of cells in the ovaries can become cancerous, and the type of cell affected determines the type of ovarian cancer. Ovarian cancer type can be determined by looking at the cells under a microscope. Doctors use this information to understand and make predictions about the anticipated rate of growth and pattern of tumor spread, and to determine which treatments may work best.

There are three main types of ovarian cancer, named for the cells in which the tumors originate.

  • Epithelial tumors start in the cells covering the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
  • Germ cell tumors start in the cells that produce eggs. Less than 2% of ovarian tumors are germ cell tumors. 
  • Stromal tumors start in the structural connective tissue cells that hold the ovary together and produce the hormones estrogen and progesterone. Stromal tumors are rare and occur mostly in younger women.

Risk Factors for Ovarian Cancer 

Ovarian cancer has multiple risk factors, or behaviors or conditions that increase a person’s chances of getting the disease. Risk factors for ovarian cancer include:

  • Age: Ovarian cancer can occur at any age, but it is most common in women ages 50 to 60.
  • Inherited gene mutations: A small number of ovarian cancers are caused by gene mutations, which are inherited from your parents. Genes known to increase ovarian cancer risk are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer. Other gene mutations, including mutations associated with Lynch syndrome, can also increase the risk of ovarian cancer.
  • Family history of ovarian cancer: Women with two or more close relatives with a history of ovarian cancer are at increased risk for the disease.
  • Estrogen hormone replacement therapy: This is especially true for those with long-term use, or those who have received hormonal therapy at large doses.
  • Age when menstruation started and ended: Women who started menstruating at an early age or started menopause at a later age — or both — may be at increased risk for ovarian cancer.

Latest in Ovarian Cancer from the CU Cancer Center

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Information reviewed by Bradley Corr, MD, in October 2021.