Ovarian Cancer Types: What You Should Know

Ovarian cancer is a serious condition that affects thousands of women worldwide. It occurs when malignant cells develop in the ovaries, the reproductive glands responsible for producing eggs and female hormones. While the exact cause of ovarian cancer remains unknown, understanding the various types, symptoms, and risk factors can help women take proactive steps towards early detection and treatment.

With over 30 different types of ovarian cancer, each with its characteristics and prognosis, it is crucial for women to be informed about this complex disease. By familiarising themselves with the signs and symptoms, women can advocate for their health and work closely with their healthcare providers to receive the most appropriate care.

Every ovarian cancer patient experiences different signs and symptoms and needs a different treatment plan tailored to her health condition.

Here are some common signs linked to ovarian cancer:

• Abdominal bloating or swelling
• Feeling full even when not eating
• Weight loss
• Discomfort in the pelvic area
• Fatigue
• Back pain
• Changes in bowel habits, such as constipation/loose stools
• Nausea and vomiting
• A frequent urge to pass the urine
• Increased abdominal girth
• Abdominal pain or swelling
• Increased levels of the CA-125 protein

Types of ovarian cancer

Epithelial Ovarian Carcinomas

Epithelial ovarian carcinomas are the most common type of ovarian cancer, accounting for 85-90% of all cases. These cancers develop from the epithelial cells that cover the outer surface of the ovaries. If not detected and treated early, epithelial ovarian carcinomas can spread to the lining and organs of the pelvis and abdomen and later to other parts of the body, such as the liver, lungs, bones, skin, and brain.

It is crucial to note that nearly 70% of women with this type are diagnosed in advanced stages, emphasising the importance of early detection and awareness of symptoms. Epithelial ovarian carcinomas can be further classified into several subtypes:

1. Serous carcinoma:

   This is the most common subtype, developing in the serous membrane of the epithelial layer in the abdominopelvic cavity. Serous carcinomas can be either high-grade or low-grade, with high-grade tumours being more aggressive and fast-growing.

2. Endometrioid carcinoma:

   This subtype is linked to endometriosis, a condition where the tissue that usually lines the uterus grows outside of it. Women with endometriosis have an increased risk of developing endometrioid ovarian cancer.

3. Clear cell carcinoma:

   This is a rare subtype of epithelial ovarian cancer, also associated with endometriosis. Clear cell carcinomas are treated similarly to serous ovarian cancer and have a poorer prognosis compared to other subtypes when diagnosed at an advanced stage.

4. Mucinous carcinoma:

   They may originate in the ovary or spread from cancer elsewhere in the digestive system. Mucinous carcinomas tend to be diagnosed at an earlier stage than other subtypes.

5. Undifferentiated or unclassifiable carcinoma:

   In some cases, the cancer cells are not fully developed, making it difficult to determine the specific cell type from which the cancer originated. These tumours are classified as undifferentiated or unclassifiable epithelial ovarian carcinomas.

Germ Cell Tumors

Germ cell tumours are rare cancers that develop in the cells responsible for producing eggs (ova) in females. The most common type of germ cell tumour is called dysgerminoma, which typically affects women in their teens and twenties. Although dysgerminomas are malignant, they tend to grow and spread more slowly compared to other types of ovarian cancer.

When dysgerminomas are confined to the ovaries and have not spread to other organs, treatment usually involves surgical removal of one or both ovaries (oophorectomy). In many cases, this is sufficient to prevent cancer from spreading further, and no additional treatment may be necessary. However, if the tumor has advanced or relapsed, a combination of surgery and chemotherapy has proven to be highly effective in managing the disease, with a success rate of around 90%.

Germ cell tumours can also manifest in other parts of the body, including the central nervous system, although this is less common. Regular check-ups and awareness of potential symptoms are essential for early detection and successful treatment outcomes.

Stromal Cell Tumors

Stromal cell tumours are a rare type of ovarian cancer, accounting for about 1% of all cases. They develop in the connective tissue cells that support the ovaries and produce hormones such as estrogen and progesterone. Stromal cell tumours can be detected early and have a generally good prognosis.

More than half of stromal cell tumours occur in women over the age of 50, but approximately 5% of cases affect younger girls in their teens. The most common symptom associated with stromal cell tumours is abnormal vaginal bleeding, which can occur even after menopause or before puberty. This is because many of these tumours produce estrogen, leading to hormonal imbalances and irregular bleeding patterns.

Treatment for stromal cell tumours typically involves surgical removal of the affected ovary or ovaries, along with any nearby tissues to which cancer may have spread. In some cases, hormonal therapy or chemotherapy may be recommended to prevent recurrence and improve overall treatment outcomes.

Borderline Ovarian Tumors

Borderline ovarian tumours, also known as low malignant potential (LMP) tumours, are characterised by abnormal cell growth in the tissue covering the ovary. These tumours are not considered to be fully cancerous but may display some features of malignancy. Approximately 15% of all ovarian tumours are borderline tumours.

Borderline ovarian tumours are typically treated with surgery, which may involve removing the affected ovary and fallopian tube (unilateral salpingo-oophorectomy) or both ovaries and fallopian tubes (bilateral salpingo-oophorectomy). In some cases, a hysterectomy (removal of the uterus) may also be performed. The extent of surgery depends on factors such as the patient’s age, desire for future fertility, and the stage of the tumour.

The prognosis for borderline ovarian tumours is generally excellent, with a 5-year survival rate of over 95% when detected and treated early. However, regular follow-up appointments and monitoring are essential to detect any potential recurrences or progression to invasive cancer.

Rare Types

1. a. High-Grade Serous Ovarian Carcinoma (HGSOC):

   This is an aggressive subtype of epithelial ovarian cancer, characterised by highly abnormal cells that grow and spread rapidly. HGSOCs are often diagnosed at an advanced stage, making them more challenging to treat effectively. Patients with HGSOC may require a combination of surgery, chemotherapy, and targeted therapies to manage the disease and improve survival rates.

2. b. Clear Cell Carcinoma (CCC):

   Clear cell carcinoma is the rarest type of ovarian cancer, accounting for approximately 6% of all ovarian carcinomas. This subtype is known to be more resistant to conventional chemotherapy compared to other types of epithelial ovarian cancer. However, when detected and treated in the early stages, clear cell carcinoma has a relatively good prognosis.

Treatment typically involves surgery and chemotherapy, with ongoing research focusing on developing targeted therapies specific to this subtype.




In addition to the types mentioned above, there are two other rare cancers that closely resemble epithelial ovarian cancer: primary peritoneal carcinoma and fallopian tube cancer.




Primary peritoneal carcinoma originates in the lining of the pelvis and abdomen (peritoneum), while fallopian tube cancer develops in the fallopian tubes. Due to their similarities with epithelial ovarian cancer, these rare types are often treated using the same approaches, including surgery, chemotherapy, and targeted therapies.




When to See a Doctor


If you experience any of the symptoms persistently, it is essential to consult your healthcare provider for a thorough evaluation:

While these symptoms can be associated with various other conditions, it is crucial to rule out ovarian cancer as a potential cause. Early detection is key to successful treatment and improved outcomes. Your doctor will conduct a series of tests and procedures to determine the presence, type, and stage of ovarian cancer, which will guide the development of an appropriate treatment plan.

Treatment for ovarian cancer typically involves a combination of surgery, chemotherapy, and targeted therapies. The specific approach depends on factors such as the type and stage of the cancer, the patient’s age, overall health, and personal preferences.

Proton therapy is an advanced form of radiation therapy that uses high-energy proton beams to target and destroy cancer cells. Unlike traditional radiation therapy, which uses X-rays, proton therapy can deliver radiation more precisely to the tumour site, minimising damage to surrounding healthy tissues.




Conclusion


Regular screenings and follow-up appointments with your doctor can help detect potential recurrences early, allowing for prompt intervention and treatment adjustments as needed. By staying informed and proactive and working closely with your healthcare team, you can navigate your ovarian cancer journey with confidence and optimism.