#GCAM Diagnosis and Types and Stages of Ovarian Cancer

I spoke about how there are symptoms of ovarian cancer( gloating, freq urination etc) in my previous post. What happens when you go to your gynecologist or primary care physician with these symptoms? Your doctor may image your pelvis with an ultrasound. If something is abnormal you may have a CT or MRI. You also may have a blood test for a protein in the blood called CA-125. The marker is raised in most serous ovarian cancers ( I'll discuss the types a little later in the post) but it may not be elevated  in other types . It can  also be elevated if the women is still menstruating which is why the CA-125 is not used as a screening test for ovarian cancer. The Foundation for Women's Cancer has an informative book on CA-125 ( https://foundationforwomenscancer.org/wp-content/uploads/2023/07/FWC_CA-125-Levels-Your-Guide.pdf )

If these test come back abnormal it is important to see a specially trained gynecologic oncologist. Studies show that survival rates for women treated by a gyn onc are higher than those who have treatment.   

Staging OC 

It is important to know if the cancer has spread from the ovaries to other areas of the pelvis or abdomen. Two organizations the  International Federation of Gynecology and Obstetrics and the AJCC  (American Joint Committee on Cancer) have systems for staging called the FIGO and TNM staging systems.  Both look at the size of tumors,  Lymph node involvement and spread beyond the ovaries. 

The stage is determined by the amount of spread and size of  tumors. 

 Below is a diagram of the stages from FWC. 

 Types of OC 

 The most common type of ovarian cancer ( 85%) is Epithelial ovarian cancer. The develop on the Fallopian tubes or on the surface cells of the ovaries. These epithelial cancers can be from mutations in the BRCA1 or BRCA2 genes. Epithelial ovarian cancer can be high grade or low grade. Knowing the difference provided information to develop the best treatment. There are a number of histological ( structure at the cell level) subtypes of epithelial ovarian carcinomas :

Serous - most common type may be high grade or low grade 

Endometriod 

Clear Cell

Mucinous

Transitional Cell  

 

Germ cell cancers make up about 5% of OC diagnosis. Germ cell cancers start in cells that are found in the follicles or eggs in the ovary. Usually adolescents or young women develop this disease.   

Teratoma

Dysgerminoma

Immature Teratoma

Yolk Sac tumors 

Mix germ cell tumors 

Sex cord- Stromal Cell Cancers develop in the cells that produce female hormones ( such as estrogen). 

It is important when treating ovarian cancers that information about the histology, molecular structures and morphology be considered. 

 

Next week I'll share resources on Treatments. 

 

 

Dee

Every Day is a Blessing!  

  

 

Sources https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/ovarian-cancer-primary-peritoneal/ 

https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/staging.html

https://pmc.ncbi.nlm.nih.gov/articles/PMC8774015/ 

https://my.clevelandclinic.org/health/diseases/6186-ovarian-germ-cell-tumors 

https://www.mskcc.org/pediatrics/cancer-care/types/germ-cell-tumors-sex-cord-tumors

#GCAM Ovarian Cancer Risk Factors

Since there is no screening test for ovarian cancer understanding your risk for the disease is important. 

Family history is a strong risk factor for being diagnosed with ovarian cancer. 

Does your family - mother, sibling or daughter have ovarian cancer?  According to the American Cancer Society your risk is 4 times the general population. If your mother, sister or daughter has been diagnosed with breast cancer your risk is increased by 70%. This increased risk is due to mutations in the BRCA1 and BRCA2 genes. If you are of Ashkenazi Jewish ancestry you have a 1 in 40 chance of having a BRCA1 mutation placing you at risk for ovarian cancer and breast cancer. There are a number of online resources that can help you have that conversation with relatives about family history. The CDC has an app My Family Health Portrait: Cancer app you can use to collect family history.

Other risk factors for ovarian cancer include:

Lynch Syndrome ( 12% lifetime risk of ovarian cancer)  

Your history of other cancers( breast, uterine, colorectal) 

Your history of endometriosis ( Associated with Low-grade serous carcinoma, Clear cell carcinoma, Mucinous carcinoma, Endometrioid carcinoma)

Age ( the median age of diagnosis is 63)

Early menstruation, no childbirth,  child birth after 30 , no oral contraceptive use  and infertility 

Obesity

  

We may not be able to prevent cancer but there are ways to reduce your risk of ovarian cancer? 

If you use oral contraceptives for five years you can reduce your risk by 50%. Multiple pregnancies ( ovulating less)  and pregnancy before 26 years old can also reduce your risk. 

Another way to reduce risk is to have your Fallopian tubes removed. Many High grade serous ovarian cancers originates in the Fallopian tubes.  The surgery to remove the Fallopian tubes when done during another gynecologic surgery such as a hysterectomy is called opportunistic salpinectomy. This surgery leaves the ovaries intact. 

For women with a BRCA1 or 2 genetic mutations risk can be reduced by having a  bilateral  salpingo-oopherectomy where the fallopian tubes and ovaries are removed surgically. Primary peritoneal cancer may still occur after this surgery but it is rare. 

Sources : https://ocrahope.org/for-patients/prevention-risk/ , https://www.cancer.org , https://www.basser.org/brca/brca-ashkenazi-jewish-community

 In my next post I'll talk about diagnosis and types of ovarian cancer. 

 Dee

Every Day is a Blessing! 

#GCAM Symptoms of Ovarian Cancer

I follow the Foundation for Women's Cancer and loved the design of this graphic for #GCAM. I would change the hashtag #ASKHER to #ASKME. 

 

 

There is NO screening test for ovarian cancer. That is why it is so important for women to know the symptoms of the disease. If these symptoms last more than 2 weeks please see your gynecologist. 

bloating, 

urinary symptoms (urgency or frequency), 

pelvic or abdominal pain,

 difficulty eating or feeling full quickly

Mentioning the pain I was having on the left side of my pelvis to my gynecologist during my annual exam made a difference in my life. I thought it was nothing - a pulled muscle maybe. But she knew it didn't sound right and she sent me for a transvaginal ultrasound.  I was on my was to a diagnosis. 

Next post will be about Family History and Risk Factors for Ovarian Cancer. 

Dee

Every Day is a Blessing! 

September is OVARIAN CANCER AWARENESS MONTH

I am not sure where the month of August went and here we are starting September. If you have followed me for any period of time you are probably already aware that September is Ovarian Cancer Awareness Month. Teal is the awareness color for ovarian cancer. 

Teal Awareness Ribbon for Ovarian Cancer Awareness Month 

 Let me start with these important facts:

There is no screening test for ovarian cancer. 

Approximately 20,890 women will be diagnosed with ovarian cancer in the US in 2025. *

Approximately 12,730 women will die in the US in 2025 due to  ovarian cancer.* 

 

I have been an advocate for ovarian cancer research for 15+ years.  While we have made strides in treatments( VEGF inhibitors, Anti-body drug conjugates,  immunotherapies) there is no cure.  That is why raising funds for research is so important. 

This year due to NIH funding cuts raising awareness of ovarian cancer and more importantly funds for research take on a greater urgency. I will be posting symptom and risk information as well as other resources throughout the month in my small effort to raise awareness.  

I will be raising funds for research this year by walking on Sept 28, 2025 at the Kaleidoscope of Hope Ovarian Cancer Foundation walk at Loantaka Brook Park in Morristown. Join me, my family and friends as we walk as Team Determined. We are walking to honor the memory of a dear friend, Mary Lu, who passed away in July due to ovarian cancer. Donate to Team Determined at https://www.classy.org/team/766060. 

If you live in other areas of the country, check to see if there will be walks or other fundraising events being run by ovarian cancer organizations by you. Or donate to support research through OCRA or Foundation for Women's Cancer .

Thank you in advance. 

 Dee

Every Day is a Blessing!  

* https://www.cancer.org/cancer/types/ovarian-cancer/key-statistics.html