Newly Diagnosed With Ovarian Cancer
If you are diagnosed with ovarian cancer, it is essential to find a gynecologic oncologist to treat you. Gynecologic oncologists are specialists who receive extensive training in diagnosing and treating gynecologic cancers, including ovarian cancer.
The Ovarian Cancer Research Alliance (OCRA) has a Find a Doctor tool where you can enter your address or zip code to find gynecologic oncologists and other specialists in your area.
The NCCN Guidelines for Patients: Ovarian Cancer is a valuable resource for better understanding your cancer, treatment, and more. We also invite you to check out our webinar on Ovarian Cancer 101 to learn some of the basics.
Types of Ovarian Cancer
- Epithelial ovarian cancer develops from the surface of the ovary. This is the most common type of ovarian cancer, of which approximately 75% are high-grade serous ovarian cancer (HGSOC). Less common types include endometrioid carcinoma, low-grade serous ovarian cancer (LGSOC), mucinous carcinoma, and ovarian clear cell carcinoma (OCCC). This designation also includes fallopian tube and primary peritoneal cancers, which share similarities, including how they are treated.
- Germ cell ovarian cancer develops from the reproductive cells of the ovaries. It is rare and tends to occur in adolescents and young adults.
- Stromal cell ovarian cancer develops from the connective tissue cells of the ovaries. It is rare and is usually diagnosed at earlier stages than other ovarian cancers.
It is important to know and understand your ovarian cancer tumor type because it impacts your treatment options and will make you more informed in your treatment decision-making. Ask your doctor if you are not sure what kind of ovarian cancer you have.
Genetic and Tumor Testing
Although ovarian cancer usually occurs for unknown reasons, about 25% are caused by mutations (changes) passed down from parent to child, which is called hereditary ovarian cancer. Causes of hereditary ovarian cancer include mutations in either the BRCA1 or BRCA2 genes and Lynch syndrome, which can also raise your risk of some other cancers.
Genetic testing can tell if you have a gene mutation linked to hereditary cancer. Everyone diagnosed with ovarian cancer should receive genetic testing. Your doctor or a genetic counselor can do genetic testing, which involves taking normal tissue (blood, saliva, or a cheek swab).
In addition to testing for inherited (germline) mutations, your tumor should also be tested for mutations (somatic or tumor mutations).
Diagnosed with hereditary ovarian cancer? FORCE (Facing Our Risk of Cancer Empowered) provides support, information, and resources for individuals and families affected by hereditary cancer.
Stages of Ovarian Cancer
There are two staging systems for ovarian cancer: the American Joint Committee on Cancer (AJCC) and the International Federation of Gynecology and Obstetrics (FIGO). While similar, the FIGO system is most commonly used. Doctors assign a stage based on the location of tumors and whether the cancer has spread to nearby lymph nodes or other areas of the body.
One of the goals of ovarian cancer surgery is to determine the post-surgery (pathologic) stage or surgical stage, which is determined by tissue samples that have been removed and examined in the lab. The pathologic stage provides the most accurate information on how far the cancer has spread. If surgery is not an option, your doctor may assign a clinical stage based on imaging and physical examination results.
Stage I: The cancer is limited to the ovary (or ovaries) or fallopian tube(s).
- Stage IA: the cancer is isolated to one ovary or fallopian tube
- Stage IB: the cancer is found in both ovaries or fallopian tubes
- Stage IC: the cancer is found in one or both ovaries or fallopian tubes and:
- Stage IC1 – the covering of the ovary (called the capsule) broke open during surgery (surgical spill).
- Stage IC2 – the covering of the ovary (called the capsule) broke open before surgery, or there is cancer on the outer surface of the ovary or the fallopian tube.
- Stage IC3 – cancer cells are found in abdominal fluid (ascites) or washings.
Stage II: The cancer involves one or both ovaries or fallopian tubes and has spread to other parts of the pelvis.
- Stage IIA: the cancer has spread to the uterus or fallopian tubes.
- Stage IIB: the cancer has spread to other organs or tissues in the pelvis.
Stage III: The cancer involves one or both ovaries or fallopian tubes and has spread beyond the pelvis.
- Stage IIIA1: the cancer has spread to lymph nodes in the back of the abdomen.
- Stage IIIA1 (i) – the cancer in the lymph nodes is 10 mm or smaller.
- Stage IIIA1 (ii) – the cancer in the lymph nodes is bigger than 10 mm.
- Stage IIIA2: the cancer has spread to the lining of the abdomen (peritoneum), but it is small and can only be seen with a microscope. It may also be in the lymph nodes in the back of the abdomen.
- Stage IIIB: the cancer has spread to the lining of the abdomen (peritoneum) and is visible but 2 cm or smaller. It may also be in the lymph nodes in the back of the abdomen.
- Stage IIIC: the cancer has spread to the lining of the abdomen (peritoneum) and is visible and bigger than 2 cm. It may also be in the lymph nodes in the back of the abdomen and on the outer surface of the liver or spleen.
Stage IV: The cancer has spread to organs some distance away from the ovaries, such as the spleen, liver, or lungs.
- Stage IVA: the cancer is in the fluid around the lungs (malignant pleural effusion).
- Stage IVB: the cancer has spread to the inside of the liver or spleen, to distant lymph nodes, or other organs outside the abdomen.
Grades of Ovarian Cancer
The grade of an ovarian tumor describes how the cancer cells look under a microscope compared to surrounding normal, healthy cells.
Grade 1
Grade 2
Grade 3
Grade 3 describes cancer tissue lacking normal structure in which more abnormal than healthy cells appear, also called “poorly differentiated” or “undifferentiated.”
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