Ovarian Cancer FAQs - Mount Sinai Hospital

Ovarian Cancer Frequently Asked QuestionsWhat is ovarian cancer?Ovarian cancer begins in your ovaries, which are located on each side of the uterus and produce femalehormones and eggs. There are three types of ovarian cancer:• Epithelial tumors arise from cells that line or cover the ovaries.• Germ cell tumors originate from cells that form eggs.• Sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together andproduce female hormones.The American Cancer Society estimates that approximately 12,650 women are diagnosed with ovariancancer and more than 15,500 die from the disease each year in the United States. Ovarian cancer is thefifth leading cause of cancer death among U.S. women and more women die from this disease than fromall other gynecologic cancers combined. The majority of women are diagnosed when the disease hasreached an advanced stage, however if detected early, the survival rate is more than 90%.What are the risk factors?There is no way to know for sure if you will get ovarian cancer. Most women with ovarian cancer are notat high risk. However, several factors may increase your risk for ovarian cancer, including if you:• Are over 40. Ovarian cancer generally strikes after age 40, with the greatest number of casesoccurring in women age 60 and older.• Have close family members, such as your mother, sister, aunt, or grandmother, on either yourmother's or your father's side, who have had ovarian cancer• Have a genetic mutation (abnormality) called BRCA1 or BRCA2• Have had breast, uterine, or colorectal (colon) cancer• Have an Eastern European (Ashkenazi) Jewish background• Have never given birth or have had trouble getting pregnant• Have endometriosis, a condition in which tissue from the lining of the uterus grows elsewhere inthe bodyOvarian cancer has a hereditary element that can be detected through genetic testing. Women who findthey are genetically predisposed to ovarian cancer and who have other risk factors may choose to havetheir ovaries removed before cancer takes root (prophylactic oophorectomy). In high-risk women, thiscan greatly decrease the risk of developing ovarian cancer.Is there anything I can do to prevent ovarian cancer?There is no known way to prevent ovarian cancer. However, lower rates of ovarian cancer have beendetected in women who:• Have used birth control pills for more than five years.• Have had their "tubes tied" (tubal ligation)• Have had both ovaries removed• Have had a hysterectomy• Have given birth

What are the symptoms?Ovarian cancer may cause one or more of these signs and symptoms:• Vaginal bleeding or abnormal discharge from your vagina• Pelvic or abdominal pain (the area below your stomach and between your hip bones)• Back pain• Bloating• Feeling full quickly while eating• A change in bathroom habits, such as having to pass urine very badly or very often, constipation,or diarrhea.Pay attention to your body, and know what is normal for you. See a doctor if you have any of the signsfor two weeks or longer and they are not normal for you. These symptoms may be caused by somethingother than cancer, but the only way to know is to see a doctor. The earlier ovarian cancer is found andtreated, the more likely treatment will be effective.How is ovarian cancer diagnosed?There is no simple and reliable way to screen for ovarian cancer in women who do not have any signs orsymptoms. However, early detection can lead to effective treatment. Diagnostic tests are used once youbegin experiencing symptoms or if you are a high-risk patient who has not yet demonstrated symptoms.Mount Sinai may perform the following tests and procedures to diagnose ovarian cancer:• Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum..• Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced offinternal tissues or organs to create echoes.• CA 125 assay: A test that measures the level of CA 125 in the blood. An increased CA 125 level issometimes a sign of cancer or another condition.• Barium enema: A series of X-rays of the lower gastrointestinal tract.• Intravenous pyelogram (IVP): A series of X-rays of the kidneys, ureters, and bladder to find outif your cancer has spread to these organs.• CT scan (CAT scan): A procedure that creates a series of detailed pictures of areas inside thebody, taken from different angles. The pictures are made by a computer linked to an X-raymachine. A dye may be injected into a vein or given orally to help the organs or tissues show upmore clearly.• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by apathologist to check for signs of cancer. The tissue is removed in a procedure called alaparotomy (a surgical incision made in the wall of the abdomen).The Pap test does not check for ovarian cancer. The only cancer the Pap test screens for is cervicalcancer. Since there is no simple and reliable way to screen for any gynecologic cancers except forcervical cancer, it is especially important to recognize warning signs and see your doctor.

What is the prognosis?The chance of recovery and treatment options depends on the following:• The stage of the cancer• The type and size of the tumor• Patient age and general health• Whether the cancer has just been diagnosed or has recurred (come back)If your doctor says that you have ovarian cancer, ask to be referred to a gynecologic oncologist — adoctor who has been specially trained to treat cancers of a woman's reproductive system. This doctorwill work with you to create a treatment plan.What are the treatments for ovarian cancer?Most patients have surgery to remove as much of the tumor as possible. Different types of surgery mayinclude:• Hysterectomy: A surgical procedure to remove the ovaries, uterus, cervix and fallopian tubes.• Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopiantube.• Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and bothfallopian tubes.• Omentectomy: A surgical procedure to remove the omentum — a piece of the tissue lining theabdominal wall.• Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissueunder a microscope to look for cancer cells.Depending on the stage of your cancer, Chemotherapy may be used after surgery. Chemotherapy usesdrugs to stop the growth of cancer cells, either by killing the cells or by keeping them from dividing.For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials areconducted to find out if new cancer treatments are safe and effective or better than the standardtreatment. Patients who take part in a clinical trial may receive the standard treatment or be among thefirst to receive a new treatment. Your participation may help improve the way cancer is treated in thefuture.What kind of support can I receive at Mount Sinai if I've been diagnosed with ovarian cancer?You may participate in Woman to Woman, a unique network of trained volunteer survivors ofgynecologic cancer who provide hope, one-on-one support, education and advocacy for women intreatment at Mount Sinai, their partners and families. From their first meeting with a woman to the endof treatment, our volunteers help patients adjust to their new lives as cancer survivors. All womenbeing treated at Mount Sinai for gynecologic cancer (ovarian cancer, uterine cancer, cervical cancer,vaginal or vulva cancer) are offered the opportunity to participate in this free program by being matchedwith a survivor volunteer.

Male partners of women diagnosed with a gynecologic cancer are often overlooked by health careworkers, family and friends resulting in confusion, anxiety, and anger. To help address the needs of thisunique group, Woman to Woman created a "Guide for Male Partners" which contains information ongynecologic cancer, treatment and side effects, sexuality, finances, how to deal with family and friends,and resources for each topic. We also provide peer mentoring from men whose partners have alreadycompleted treatment at Mount Sinai for gynecologic cancer.For more information on ovarian cancer and the Mount Sinai Division of Gynecologic Oncology, pleasecontact us at (212) 427-9898 or www.mountsinai.org/obgyn.