What is Ovarian Cancer?
Ovarian cancer is characterised by the presence of cancerous or malignant cells in the ovaries. These cells then form a tumor which can be identified based on their origin. There are 3 main types of ovarian cancer tumors:
Epithelial tumors: These tumors originate from cells which cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors.
Germ cell tumors: These originate from the cells that produce the reproductive eggs or ova.
Stromal tumors: These originate from cells which provide the structural support for the ovaries and produce the female hormones estrogen and progesterone.
The symptoms of ovarian cancer are often uncharacteristic, vague and/or slowly emerging. The symptoms may consist of the sensation of a pelvic or abdominal mass, pain in the pelvis or abdomen, an altered sensation or pattern of toilet habits or obstipation, nausea, vomiting, dyspnoea and/or fatigue.
There is an estimated 239,000 new cases worldwide each year. A total of 140.000 women worldwide die annually from ovarian cancer including more than 400 Danish, 1.700 Nordic and 45,000 European women .
Denmark has one of the highest incidences of ovarian cancer in the world. The lifetime risk of developing ovarian cancer being about 2% for Danish women compared to 1.4% - 1.8% in the United States (Reference: Role of CA125 in predicting ovarian cancer survival - a review of the epidemiological literature Digant Gupta and Christopher G Lis (Journal of Ovarian Cancer Research)).
When the patient is referred with symptoms suspected of ovarian cancer, a combined gynaecological and ultrasound examination is conducted. A cancer biomarker (CA125) is obtained from a blood sample. If patient's are suspected of having ovarian cancer, additional imaging modalities such as MRI, CT or PET/CT may be used prior to surgery or biopsy. The diagnosis can only be truly confirmed by histological examination from a biopsy or from removal of tumor masses. So far, there is no method for screening for ovarian cancer.
Survival of ovarian cancer is highly correlated to the stage of disease at the time of diagnosis. In Denmark, the 5-year overall survival for women with ovarian cancer in stage I, II, III and IV are 83%, 62%, 23% and 14% respectively. Unfortunately, the vast majority of women are diagnosed in stage III and IV.