Ovarian cancer is known as the silent killer because it is so tough to diagnose. Nevertheless, it is curable, depending on what type you have and its stage when diagnosed. If you are aware of your risk factors and any symptoms that you might be attributing to other causes, you can take proactive steps to prevent ovarian cancer or, at worst, catch the disease before it has time to progress.
Types and Stages
According to the MD Anderson Cancer Center, over 30 types of ovarian cancer have been placed into three categories: epithelial, germ cell, and sex cord stromal. Approximately 90 percent of ovarian tumors are epithelial - about half of which are classified as serous carcinomas, which are usually diagnosed at a later stage and therefore carry the poorest prognosis. Germ cell and sex cord stromal tumors tend to be diagnosed earlier, making them more curable. Treatments also vary somewhat by type.
Staging of ovarian tumors is critical to determining the treatment and ultimate prognosis. According to oncologists at Johns Hopkins University, treatment may also need to be modified depending on your overall health and whether you plan to become pregnant. Your doctor will work with you to determine a personalized treatment strategy.
In stage 1, the cancer is confined to one or both ovaries. For most women, treatment begins with surgery to remove the tumor and the affected ovaries. Sometimes women who have finished childbearing will undergo a hysterectomy. In most cases, chemotherapy is not needed unless a biopsy shows a lot of grossly abnormal cells. About 25% of ovarian cancers are found at stage 1. These women have a 90% or greater chance of surviving longer than five years.
In stage 2, the cancer has spread (metastasized) to the uterus and possibly the fallopian tubes or other pelvic tissue. Treatment is almost always hysterectomy and removal of both ovaries and fallopian tubes. Other tissues and lymph nodes are sampled for cancer, and chemotherapy (and possibly radiation therapy) may be necessary. At stage 2, the tumor type begins to have greater influence on survival; only two thirds of women with stage 2 epithelial tumors may survive longer than five years, but nearly 80% of women with stage 2 germ cell tumors can expect to live that long.
In stage 3, the cancer has spread to the abdominal lining outside the pelvis. Metastases may consist of only a few cells or form tumors measuring 2 centimeters or more. As with stage 2 tumors, the tumor and affected organs are surgically removed. After surgery, the patient often undergoes chemotherapy and radiation treatments, possibly followed by another surgery to remove any remaining cancer. Most cases of ovarian cancer are diagnosed in this stage, and most are of the invasive epithelial type. Consequently, only about half of women receiving their diagnosis at this stage survive longer than five years. Fortunately, germ cell and stromal tumors carry far better prognoses.
In stage 4, the cancer has spread to the liver or distant sites outside the abdomen. Again, surgery is typically performed, followed by chemotherapy. Fewer than 20% of women receiving their diagnosis at this stage can look forward to surviving longer than five years.
Future Treatment Options
Because ovarian cancer is difficult to detect and treat, researchers at the National Cancer Institute are always conducting studies. In one trial for patients with advanced-stage disease, anticancer drugs are being put directly into the abdominal cavity through a thin tube. Results are showing that this treatment may help women survive an average of 5 and a half years.