Jill Ashinsky

  • Ovarian Cancer is the 5th most common cancer among women
  • It causes more deaths than any other female reproductive cancer
  • 12.9 per 100,00 women are diagnosed with Ovarian Cancer every year
  • Approximately 60% of women with Ovarian Cancer are diagnosed with advanced or Stage III
  • When Ovarian Cancer is found early, before it has spread outside the ovaries, the 5-year survival rate is greater than 92%
  • Women who used oral contraceptives for 10 years have about a 60% reduction in risk of ovarian cancer


  • Ovarian Cancer starts in the ovaries
  • The exact cause of Ovarian Cancer remains unknown
  • More than half of the women diagnosed with ovarian cancer are 60 years or older
  • Hereditary Ovarian Cancer can be caused by mutations in specific genes (BRCA1 and BRCA2)
  • Stage I - limited to one or both ovaries
    • IA - one ovary, capsule intact, no tumor on ovarian surface, no malignant cells is ascites, no peritoneal washings
    • IB - both ovaries, capsule intact, no tumor on ovarian surface, negative washings
    • IC - tumor limited to ovaries, capsule ruptured, tumor on ovarian surface, positive washings
  • Stage II - pelvic extension or implants
    • IIA - extensions or implants onto uterus or fallopian tube, negative washings
    • IIB - extensions or implants onto other pelvic structures, negative washings
    • IIC - pelvic extension or implants, positive peritoneal washings
  • Stage III - microscopic peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum
    • IIIA - microscopic peritoneal metastases beyond pelvis
    • IIIB - macroscopic peritoneal metastases bryond pelvis less than 2 cm in size
    • IIIC - peritoneal metastases beyond pelvis > 2 cm or lymph node metastases
  • Stage IV - distant metastases to the liver or outside the peritoneal cavity

  • Signs and symptoms of Ovarian Cancer are frequently absent early on an when they exist, may be subtle
  • Bloating or swollen belly area
  • Difficulty eating or feeling full quickly
  • Excessive hair growth that is coarse and dark
  • Sudden urge to urinate
  • Needing to urinate more often than usual
  • Build up of fluid in the abdominal cavity

  • Ovarian Cancer at its early stages (I/II) is difficult to diagnose until it spreads and advances to later stages (III/IV)
  • 1A. Physical Exam - may reveal increased abdominal girth and/or fluid within the abdominal cavity
  • IB. Pelvic Exam - may reveal an ovarian or abdominal mass
  • 2. Blood Test - for CA-125 and sometimes other markers
  • 3. Transvaginal Ultrasound
  • 4. Surgery - inspect abdominal cavity, take biopsies, look for cancer cells in abdominal fluid
    • laparotomy: incision through the abdominal wall
    • laparoscopy: keyhole surgery

  • Surgical treatment may be sufficient for malignant tumors that are well-differentiated and confined to the ovary
    • Unilateral Oophorectomy - removal of one ovary
    • Bilateral Oophorectomy - removal of both ovaries
    • Salpingectomy - removal of fallopian tubes
    • Hysterectomy - removal of the uterus
  • Chemotherapy is used after surgery to treat any residual disease, if appropriate
  • Addition of chemotherapy may me required for more aggressive tumors that are confined to the ovary
  • For patients with advanced disease, a combination of surgical reduction with chemotherapy is standard

  • Have children, the more the better, at a young age
  • Breastfeed
  • Tubal ligation and hysterectomy
  • Bilateral Salpingo-oophorectomy
  • Use oral contraceptives (birth control pills) for 5 years or more