What is Epithelial Ovarian Cancer?

Epithelial ovarian cancer is a type of cancer that begins in the epithelial cells, which are the cells lining the outer surface of the ovaries. This is the most common type of ovarian cancer, accounting for about 90% of ovarian cancer cases. It can affect women of any age but is most commonly diagnosed in women over the age of 50, especially after menopause. Because the ovaries are located deep within the pelvis, the cancer often goes undetected in the early stages, leading to a higher risk of spread to other parts of the body by the time it is diagnosed.

What Are the Causes and Risk Factors of Epithelial Ovarian Cancer?

The exact cause of epithelial ovarian cancer is still not fully understood, but several factors may increase the risk of developing this condition:

• Age: The risk of ovarian cancer increases with age, especially after the age of 50.
• Family History: Women with a family history of ovarian cancer, breast cancer, or other cancers (like colorectal cancer) are at higher risk. This may be due to inherited gene mutations, such as mutations in the BRCA1 or BRCA2 genes.
• Inherited Genetic Mutations: Inherited mutations in genes like BRCA1 and BRCA2 significantly increase the risk of developing ovarian cancer. Other genetic mutations associated with ovarian cancer include those in the Lynch syndrome genes.
• Reproductive History: Women who have never been pregnant or who started menstruating early and went through menopause later are at increased risk. Conversely, women who have had multiple pregnancies or breastfed may have a lower risk.
• Hormone Replacement Therapy (HRT): Prolonged use of estrogen-based hormone replacement therapy may increase the risk of ovarian cancer.
• Personal History of Cancer: Women who have had breast, uterine, or colorectal cancer have a higher risk of developing ovarian cancer.
• Obesity: Being overweight or obese may increase the risk of developing ovarian cancer, possibly due to hormonal changes associated with excess fat.

What Are the Symptoms of Epithelial Ovarian Cancer?

The symptoms of epithelial ovarian cancer can often be subtle and nonspecific, which makes early detection challenging. Common symptoms include:

• Abdominal bloating or swelling: Persistent bloating or feeling full quickly may be a sign of ovarian cancer.
• Pelvic or abdominal pain: Unexplained pain in the pelvic or abdominal area, often described as pressure or discomfort.
• Changes in bowel habits: Constipation, diarrhea, or frequent urination may occur if the tumor presses on the bladder or intestines.
• Unexplained weight loss or gain: Significant weight changes without an obvious cause can be a symptom.
• Fatigue: Feeling unusually tired or weak, even after rest.
• Loss of appetite: A decrease in appetite or feeling full after eating only a small amount of food.
• Menstrual changes: Irregular periods, postmenopausal bleeding, or other menstrual changes.
• Indigestion or nausea: Some women may experience digestive issues like indigestion or nausea, often without relief.

How is Epithelial Ovarian Cancer Diagnosed?

Diagnosing epithelial ovarian cancer typically involves several steps:

• Physical Exam: A doctor will perform a pelvic exam to feel for any abnormalities in the ovaries or pelvic region.
• Imaging Tests: An ultrasound (usually transvaginal) or CT scan is often used to visualize the ovaries and check for any abnormalities, such as a mass or cyst.
• Blood Tests: A blood test to measure the levels of CA-125, a protein that is often elevated in women with ovarian cancer, can help in diagnosis. However, elevated CA-125 can also be seen in other conditions, so this test alone is not conclusive.
• Biopsy: If a mass is found, a biopsy may be performed to confirm the presence of cancer cells. A tissue sample can be taken during surgery or through a needle biopsy.
• Genetic Testing: If there is a family history of ovarian or breast cancer, genetic testing for BRCA1 and BRCA2 mutations may be recommended.

How is Epithelial Ovarian Cancer Treated?

Treatment for epithelial ovarian cancer depends on the stage of the cancer and the overall health of the patient. Common treatment options include:

• Surgery: The primary treatment for ovarian cancer is surgery to remove the tumor. This may involve removing the ovaries (oophorectomy), fallopian tubes (salpingectomy), and possibly the uterus (hysterectomy). In some cases, nearby lymph nodes and other tissues may also be removed.
• Chemotherapy: Chemotherapy is often used after surgery to kill any remaining cancer cells. It may also be used for more advanced stages of cancer or if surgery is not possible. Common chemotherapy drugs used for ovarian cancer include cisplatin, carboplatin, and paclitaxel.
• Targeted Therapy: Targeted therapies like bevacizumab (Avastin) can block blood vessel growth to tumors, helping to slow cancer growth. Other targeted therapies may involve drugs that block specific molecular pathways involved in cancer cell growth.
• Hormone Therapy: Hormonal treatments, such as progestins or anti-estrogens, may be used in certain cases to slow cancer cell growth, especially if the tumor is hormone receptor-positive.
• Immunotherapy: Some forms of immunotherapy are used to help the body’s immune system recognize and attack cancer cells.
• Clinical Trials: New treatments and drugs for ovarian cancer are often tested in clinical trials. Your doctor may discuss these options if your cancer is advanced or not responding to standard treatments.

When Should You See a Doctor About Epithelial Ovarian Cancer?

It is important to seek medical attention if you experience any of the common symptoms of ovarian cancer, especially if they persist for more than a few weeks. Early detection is crucial, so if you have a family history of ovarian or breast cancer, or if you are experiencing unexplained changes in your body, it’s important to consult with a healthcare provider.