Ovarian Cancer

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Ovarian Cancer
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Overview

Source: In partnership with Genetic and Rare Diseases Information Center, funded by the National Center for Advancing Translational Sciences, and the National Human Genome Research Institute https://rarediseases.info.nih.gov/gard.

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Ovarian cancer

overview Question

What is ovarian cancer?

Ovarian cancer is a form of cancer that occurs due to abnormal and uncontrolled cell growth in the ovaries. Many people with early ovarian cancer have no signs or symptoms of the condition. When present, symptoms are often nonspecific and blamed on other, more common conditions. Most cases of ovarian cancer occur sporadically in people with little to no family history of the condition; however, approximately 10-25% of ovarian cancers are thought to be "hereditary." Although the underlying genetic cause of some hereditary cases is unknown, many are part of a hereditary cancer syndrome (such as BRCA1 or BRCA2 hereditary breast and ovarian cancer syndrome, Lynch syndrome and Peutz-Jeghers syndrome) and are inherited in an autosomal dominant manner. The best treatment options for ovarian cancer depend on many factors including the subtype and stage of the condition, but may include surgery, chemotherapy, radiation therapy, and/or targeted therapy (such as monoclonal antibody therapy).

Date Modified: 2015-03-30T13:39:00

basic Questions

What are the signs and symptoms of ovarian cancer?

Many people with early ovarian cancer have no signs or symptoms of the condition. When present, symptoms are often nonspecific and blamed on other, more common conditions. Some people with ovarian cancer may experience the following:

Date Modified: 2015-03-27T15:02:00

What causes ovarian cancer?

Most cases of ovarian cancer occur sporadically in people with little to no family history of the condition. They are due to random changes (mutations) that occur only in the cells of the ovary. These mutations (called somatic mutations) accumulate during a person's lifetime and are not inherited or passed on to future generations.

However, approximately 10-25% of ovarian cancers are thought to be "hereditary." These cases are caused by an inherited predisposition to ovarian cancer that is passed down through a family. In some of these families, the underlying genetic cause is not known. However, many of these cases are part of a hereditary cancer syndrome. For example, the following cancer syndromes are associated with an elevated risk of ovarian cancer and several other types of cancer:


Of note, some research suggests that inherited mutations in several other genes (including BARD1, BRIP1, MRE11A, NBN, RAD51, RAD50, CHEK2, and PALB2) may also be associated with an increased risk for ovarian cancer. However, the risk associated with many of these genes is not well understood. Most are termed "moderate- or low-penetrant" genes which means that, on their own, they would be expected to have a relatively small effect on ovarian cancer risk. However, in combination with other genes and/or environmental factors, these genes may lead to a significant risk of ovarian cancer.

Date Modified: 2015-03-27T15:45:00

Is ovarian cancer inherited?

Most cases of ovarian cancer occur sporadically in people with little to no family history of the condition. However, approximately 10-25% of ovarian cancer is thought to be inherited. In some of these families, the underlying genetic cause is not known. However, many of these cases are part of a hereditary cancer syndrome such as BRCA1 or BRCA2 hereditary breast and ovarian cancer syndrome, Lynch syndrome and Peutz-Jeghers syndrome, which are inherited in an autosomal dominant manner. This means that a person only needs a change (mutation) in one copy of the responsible gene in each cell to have a hereditary predisposition to ovarian cancer and other cancers associated with these syndromes. In some cases, an affected person inherits the mutation from an affected parent. Other cases may result from new (de novo) mutations in the gene. A person with one of these syndromes has a 50% chance with each pregnancy of passing along the altered gene to his or her child.

Date Modified: 2015-03-29T15:34:00

How is ovarian cancer diagnosed?

If ovarian cancer is suspected based on the presence of certain signs and symptoms, the following tests and procedures may be recommended:

  • Physical evaluation and pelvic exam to check for signs of ovarian cancer (i.e. lumps or swelling) and to examine the size, shape and location of the ovaries
  • Ultrasound and other imaging studies to look for abnormal growths
  • Blood tests such as a CA-125 assay which may be elevated in people with ovarian cancer
  • A biopsy of the tumor is the only way to confirm a diagnosis of ovarian cancer

The National Cancer Institute offers more detailed information regarding the tests used to diagnose ovarian cancer. To access this resource, please click here.

Date Modified: 2015-03-30T10:56:00

How might ovarian cancer be treated?

The best treatment options for ovarian cancer depend on many factors including the subtype and stage of the condition. In general, treatment may include a combination of the following:

Unfortunately, research suggests that there are no benefits of ovarian cancer screening (using a CA-125 blood test and transvaginal ultrasound), even in women who are at an elevated risk due to their personal and/or family histories. Women who are at a high-risk for ovarian cancer may, therefore, want to discuss other preventative measures, such as prophylactic surgery, with their healthcare provider. In women with a known hereditary cancer syndrome, management should also include screening for the other component cancers. Please click on the following links for more information regarding the treatment and management of each condition:

 

Date Modified: 2015-03-29T15:58:00

What is the long-term outlook for people with ovarian cancer?

The long-term outlook (prognosis) for women with ovarian cancer depends on many factors including the subtype of cancer and the stage at which the cancer is diagnosed. In general, epithelial ovarian cancers (the most common subtype) are often associated with a worse prognosis than more rare subtypes such as germ cell and stromal ovarian tumors.

Because early stages of ovarian cancer are often not associated with any specific signs or symptoms, many cases are, unfortunately, diagnosed at a later and less treatable stage. Late stage ovarian cancers are generally associated with a poor prognosis. For example, 5-year survival rates for women diagnosed with stage I ovarian cancer range from 79-87%, while the 5-year survival rates for women diagnosed with stage IV ovarian cancer are approximately 11%.

Date Modified: 2015-03-29T16:33:00

Presentation(s)

Abnormality of metabolism/homeostasis

Autosomal dominant inheritance

Breast carcinoma

Dysgerminoma

Ovarian papillary adenocarcinoma

medical Products

Doxorubicin HCL liposome

Trade Name: Doxil®

Indication: Treatment of metastatic carcinoma of the ovary in patients with disease that is refractory to both paclitaxel- and platinium-based chemotherapy regimens. Refractory disease is defined as disease that has progressed while on treatment, or within 6 months

Amifostine

Trade Name: Ethyol®

Indication: To reduce the cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer.

Altretamine

Trade Name: Hexalen®

Indication: Single agent palliative treatment of patients with persistent or recurrent ovarian cancer following first-line therapy with a cisplatin and/or alkylating agent based combination.

olaparib

Trade Name: Lynparza

Indication: Use of as monotherapy for patients with deleterious or suspected deleterious germline BRCA mutated (as detected by an FDA-approved test) advanced ovarian cancer who have been treated with three or more prior lines of chemotherapy

Satumomab pendetide

Trade Name: Oncoscint CR/OV

Indication: For determining the extent and location of extraphepatic malignant disease in patients with known colorectal and ovarian cancer.

FDA Approved Medicines

  • FDA approved amifostine, sold as Ethyol, manufactured by Alza as a treatment to reduce renal toxicity associated with chemotherapy in subjects with advanced ovarian cancer ( Ovarian Cancer ) in year 1995.
  • FDA approved topotecan hydrochloride, sold as Hycamtin, manufactured by SmithKline Beecham for the treatment of metastatic ovarian cancer ( Glandular Neoplasm | Epithelial ovarian cancer | Male Genital Neoplasm | Ovarian Cancer ) in year 1996.
  • FDA approved doxorubicin HCl liposome injection, sold as Doxil, manufactured by Alza for the treatment of ovarian cancer that is refractory to other first-line therapies ( Ovarian Cancer ) in year 1999.
  • FDA approved olaparib, sold as Lynparza, manufactured by AstraZeneca for the treatment of previously treated BRCA mutated advanced ovarian cancer ( Ovarian Cancer ) in year 2014.