About Ovarian Cancer
Over 90% of ovarian cancer arises from the uncontrolled growth and replication of epithelial cells which form the surface of the ovary. Cancer involving this type of cell is known as epithelial ovarian cancer. High grade serous carcinoma is a subtype of epithelial ovarian cancer accounting for approximately 70% of cases. If detected at a very early stage, ovarian cancers can usually be removed surgically and this can be potentially curative. However due to a lack of clear early stage signs and symptoms, in approximately 90% of ovarian cancer cases, the cancer has spread to other parts of the body before a person is diagnosed.
Ovarian Cancer Types
There are 3 main types of ovarian cancer:
- Epithelial carcinoma (90% of cases) is characterized by cancer in cells covering the lining of the ovaries
- Germ cell carcinoma originates from cells destined to form eggs within the ovaries
- Stromal cell carcinoma is a cancer of hormone releasing cells that connect different structures within the ovaries
Causes and Risk Factors
The underlying mechanisms that lead to ovarian cancer are not well understood. A number of factors may increase a woman's risk of developing ovarian cancer:
- Genetics: Up to 15% of ovarian cancers result from an inherited tendency to develop the disease. For example, women with mutations in the genes BRCA1 or BRCA2 have a 45-60% or 11-35% lifetime risk, respectively, of developing ovarian cancer, whereas women who are not carriers of the BRCA1 or BRCA2 mutations have a 1.7% overall lifetime risk
- Family history: If a woman's mother or sister has had ovarian, breast, or uterine cancer, she is at greater risk of developing ovarian cancer
- Age: The risk of ovarian cancer increases with age. Half of all ovarian cancers are found in women 63 years of age or older. However, younger women can also have ovarian cancer, and these women are more likely to have a genetic risk or family history associated with risk for ovarian cancer.
- Childbirth and menopause: Women are at higher risk of developing ovarian cancer if they have not had children, if they started menstruating at an early age or started menopause at a later than average age, or if they have never taken a hormonal contraceptive
- Previous gynecological problems: Women who have previously had ovarian cysts or endometriosis are also more likely to develop ovarian cancer
- Lifestyle: Obesity and a sedentary lifestyle are linked to an increased risk of ovarian cancer
Patients with advanced ovarian cancer will typically undergo a standard treatment regimen referred to as platinum-based chemotherapy. Examples of platinum-based chemotherapies include cisplatin, oxaliplatin, and carboplatin. If the ovarian cancer recurs before or after 6 months of treatment, patients are divided into two subgroups: those with 'platinum-sensitive' disease and those with 'platinum-resistant disease'. Patients are said to have 'platinum-sensitive' disease if their ovarian cancer returns later than six months after completion of the last platinum-based chemotherapy. A patient's disease is considered 'platinum-resistant' if their ovarian cancer comes back less than six months after completing prior platinum-based chemotherapy. Clovis Oncology is conducting clinical studies in patients with platinum-sensitive relapsed ovarian cancer.
Factors Affecting Prognosis
Platinum-sensitivity is one important way your healthcare provider can determine which treatments are most likely to benefit you. However, there are many other factors that can influence how you will do, including your overall health. A healthy balanced diet and being active can help your overall well-being. Consider educating yourself and your family members about your disease. It helps to be informed about your options so you and your family (along with your healthcare provider) can choose the treatment that best suits you. We have a short list of resources that can help you learn more about ovarian cancer.