Organ Cancer Assignment: Ovaries
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Introduction
The ovaries are one of the vital organs that make up the female reproductive system. They are
essential in the production of hormones and formation of oocytes. These hormones affect a
female’s fertility, ability to become pregnant, and changes in the body. Oocytes are small germ
cells that are stored in the ovaries until they are ready to begin formation as embryos and release
them.
It is possible for cancer to occur in the ovaries due to a rapid growth of cancer cells that
quickly multiply and invade the healthy body tissue.7 It is hard to detect the cancer in its
beginning stages because the symptoms often mimic other common conditions. Symptoms
include abdominal bloating or swelling, loss of appetite, weight loss, discomfort in the pelvic
area, fatigue, back pain, constipation, or a frequent need to urinate. For ovarian cancer treatment,
surgery or chemotherapy are possible options.7
Types/Forms
The various types of ovarian cancer are dependent on the type of cell where the cancer
begins.3 The three main types of ovarian cancer are epithelial ovarian cancer, stromal tumors,
and germ cell tumors. Epithelial ovarian cancer is developed in the epithelial cell tissue and is
considered the most common type of ovarian cancer. It also includes serous and mucinous
carcinomas.3 Stromal tumors develop on the tissues that hold ovaries together. The diagnosis for
this tumor is earlier than other ovarian cancers.14 Germ cell tumors occur in the germ cells of the
ovary. This occurs at a younger age than the other ovarian cancers.11
Epidemiology
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According to the CDC, Ovarian cancer is considered the second most common
gynecologic cancer in the United States. It’s also stated that ovarian cancer causes more deaths
than any other cancer of the female reproductive system. The rates of ovarian cancer is also
different in various countries and races, which can also be contributed to genetic and economic
factors.5
Risk Factors
There are many risk factors that may increase the risk of ovarian cancer. These risk
factors may include older age, inherited gene changes, family history, obesity, hormone
replacement therapy, endometriosis, age of menstruation when it started and ended, or never
having been pregnant.13 As a female individual becomes older, the risk of ovarian cancer
increases. Inherited gene changes and family history are also risk factors due to gene changes
that can be inherited form parents or blood relatives that have previously been diagnosed with
ovarian cancer. If a female individual is overweight or obese, this will also increase the chance of
potential ovarian cancer. Postmenopausal hormone replacement therapy is taken to control
menopause symptoms that are experienced, however this can increase the risk of ovarian cancer.
Endometriosis is also another risk factor due to the tissue lining growing outside the uterus. Of
beginning menstruation at an early age or if menopause is started at an older age, either or both
can increase the risk of ovarian cancer.13 Finally, never having been pregnant also increases the
risk of ovarian cancer.
Pathobiology
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The majority of tumors in the ovary can be categorized in three major groups: the surface
epithelial-stromal tumors, sex cord-stromal tumors, and germ cell tumors.12 There are two coding
systems present that used to code the histology and morphology of tumors. These coding systems
were created by the World Health Organization and College of American Pathologists to be able
to easily identity the ovarian tumors.12
Molecular Basis of the Cancer
The genes associated with ovarian cancer are the BRCA1 and BRCA2 genes. Other gene
changes include the BRIP1, RAD51C, and RAD51D genes.4 Scientists are still trying to learn
about the molecular basis of ovarian cancer. They have found some evidence linking multiple
oncogenes and tumor suppressor genes such are HER-2neu oncogene, K-ras, p53, and various
tumor suppressor genes on Chromosome 17.4 There is also strong evidence linking the majority
of inherited ovarian cancers due to the mutations in the BRCA gene.
Clinical Manifestation
According to the American Cancer Society, the most common symptoms of ovarian
cancer include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, or
urinary urges to go often.13
Biomarkers and Cytogenic Laboratory Features
In a study conducted by Coticchia et al., scientists have discovered high levels of the
serum CA125 in women before they have been diagnosed with a type of ovarian cancer.2 This
biomarker may potentially help with early detection of ovarian cancer and help with preventative
treatment measures.
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Metastasis
Metastatic ovarian cancer is advanced stage of malignancy that from the ovary cells to
other areas of the body.15 The cancer can spread to the liver, lungs, spleen, intestines, brain, skin
or lymph nodes.
Staging
To indicate the progression of the ovarian cancer, there are stages that determine this
ranging from stage 1 to stage four. Stage 1 is that the cancer has been limited to either one or
both the ovaries. In stage 2, the cancer has spread to the uterus or other neighboring organs. In
the stage 3, the cancer has spread to the lymph nodes or abdominal lining. In stage 4, the cancer
has spread to the distant organs such as the lungs or liver.8 Within these stages, there are also sub
sections of each stage to determine at what size the cancer is measurable to. They range from
stage 1 to 4 (I, IA, IB, IC, II, IIA, IIB, IIIA1, IIIA2, IIIB, IIIC, IVA, IVB).8
Screening/Prevention
In terms of ovarian cancer prevention, there are not sure ways to prevent it but there are
ways to reduce the risk. To screen for ovarian cancer, there are two exams that can be
administered to detect ovarian cancer. The transvaginal ultrasound is a test that uses sound waves
to look at the uterus, fallopian tubes, and ovaries.6 It may help find a tumor within the ovary,
although it is hard to determine it is benign or cancer. The other screening test is the CA-125
blood test. In this test, the protein CA-125 is being measured.6 If there are high levels of this
protein, it is typically considered ovarian cancer may be detected. However, a 2nd screening may
be needed to confirm this with a transvaginal ultrasound because high levels of CA-125 can also
Organ Cancer Assignment: Ovaries
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be due to endometriosis or pelvic inflammatory disease.6 A pelvic exam is also another way to
determine possible ovarian cancer by feeling the ovaries.
Cancer Therapy
For ovarian cancer therapy treatments, there may be radiation, surgery, or drugs
administered. Drugs that are given to treat ovarian cancer are determined as systematic therapies
since they are able to reach cancer cells anywhere in the body. The types of systematic
treatments are chemotherapy, hormone therapy, and targeted drug therapy.10
Prognosis
For invasive epithelial ovarian cancer, there is a 49% chance of survival rate within 5
years.9 For ovarian stromal cancers, there is a 93% chance of survival rate within 5 years.9 For
ovarian stromal tumors, there is a 90% chance of survival rate within 5 years.9 Although these
are the given statistics, each individual is different considering their health, age, and how well
they respond to the treatments.
Current/Future Research
Scientists have had positive discoveries in potential ovarian cancer treatments. They have
conducted vaccine trials that can make ovarian cancer cells more immunogenic.1 They also have
a frontline intraperitoneal gene GEN-1 trial that involves having interferons on the cell surface to
attract white cells.1 There is also another trial with the gene FLORA-5 that is ongoing trials with
oregovomab, an antibody that goes from the cell surface CA,125 to make it become
immunogenic.1
1
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References
1. Chad A. Hamilton, M. D., & Robert W. Holloway, M. D. (2022, February 16). The future of
Ovarian Cancer treatment. OncLive. from https://www.onclive.com/view/the-future-of-
ovarian-cancer-treatment
2. Coticchia CM, Yang J, Moses MA. Ovarian cancer biomarkers: current options and future
promise. J Natl Compr Canc Netw. 2008;6(8):795-802. doi:10.6004/jnccn.2008.0059
3. Epithelial ovarian cancer: Types, stages, symptoms & causes. Cleveland Clinic. (n.d.).
Retrieved from https://my.clevelandclinic.org/health/diseases/22250-epithelial-ovarian-
cancer
4. Gallion HH;Pieretti M;DePriest PD;van Nagell JR; (n.d.). The molecular basis of ovarian
cancer. Cancer. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8634990/
5. Gaona-Luviano, P., Medina-Gaona, L. A., & Magaña-Pérez, K. (2020, June 30). Epidemiology
of Ovarian Cancer. Chinese Clinical Oncology. Retrieved from
https://cco.amegroups.com/article/view/45941/html
6. How to check for ovarian cancer: Ovarian cancer screening. How to Check for Ovarian
Cancer | Ovarian Cancer Screening. (n.d.). Retrieved from
https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/detection.html
7. Mayo Foundation for Medical Education and Research. (2021, August 31). Ovarian cancer.
Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/ovarian-
cancer/symptoms-causes/syc-20375941
8. Ovarian cancer stages. Society of Gynecologic Oncology. (2020, June 25). Retrieved from
https://www.sgo.org/patient-resources/ovarian-cancer/ovarian-cancer-stages/
9. Ovarian cancer survival rates: Ovarian cancer prognosis. Ovarian Cancer Survival Rates |
Ovarian Cancer Prognosis. (n.d.). Retrieved from https://www.cancer.org/cancer/ovarian-
cancer/detection-diagnosis-staging/survival-rates.html
10. Ovarian cancer treatment: How to treat ovarian cancer. Ovarian Cancer Treatment | How to
Treat Ovarian Cancer. (n.d.). Retrieved from https://www.cancer.org/cancer/ovarian-
cancer/treating.html
11. Ovarian germ cell tumors treatment (PDQ®)–patient version. National Cancer Institute.
(n.d.). Retrieved from https://www.cancer.gov/types/ovarian/patient/ovarian-germ-cell-
treatment-pdq
12. Pathology and classification of ovarian tumors - wiley online library. (n.d.). Retrieved from
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.11345
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13. Signs and symptoms of ovarian cancer. Early Signs of Ovarian Cancer. (n.d.). Retrieved from
https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/signs-and-
symptoms.html
14. Stromal ovarian tumor. Mercy Health. (n.d.). Retrieved from https://www.mercy.com/health-
care-services/cancer-care-oncology/specialties/ovarian-uterine-cervical-
cancer/conditions/stromal-ovarian-tumor
15. Where does metastatic ovarian cancer spread to? Moffitt Cancer Center. (n.d.). Retrieved
March 9, 2023, from https://moffitt.org/cancers/ovarian-cancer/faqs/where-does-
metastatic-ovarian-cancer-spread-to/
