Our pathologists and researchers are skilled at diagnosing common and rare ovarian cancers, including: Epithelial : This is the most common type of ovarian cancer, which starts in the epithelial tissue, the lining on the outside of the ovary or in the fallopian tube. Epithelial ovarian cancer also includes primary peritoneal cancer and fallopian tube cancer. This type of ovarian cancer is divided into serous high grade and low grade , mucinous, endometrioid high grade and low grade , clear cell, transitional, and undifferentiated types.
Ovarian carcinosarcoma is another rare type of ovarian cancer that we treat. Germ cell : Germ cell tumors begin in the egg-producing cells. The main subtypes are teratoma, dysgerminoma, endodermal sinus tumor, and choriocarcinoma.
Sex cord stromal : These rare tumors grow in the connective tissue that holds the ovary together and makes estrogen and progesterone. Sub-types include granulosa, granulosa-theca, and Sertoli-Leydig cell tumors. If you would like a second opinion You may want to consider a second opinion: To confirm your diagnosis For an evaluation of an uncommon presentation For details on the type and stage of cancer To better understand your treatment options To learn if you are eligible for clinical trials Phone: DFCI or Online: Complete the Appointment Request Form If you cannot travel to Boston in person, you can take advantage of our Online Second Opinion service.
Tests to diagnose ovarian cancer After our doctors carefully review your medical history and your familial risk of developing ovarian cancer, and complete a pelvic exam, they will conduct a combination of biopsies and imaging tests.
Recommended tests to determine the presence of ovarian cancer Transvaginal ultrasound : a procedure in which high-energy sound waves ultrasound are bounced off internal tissues or organs, such as the vagina, uterus, fallopian tubes, and bladder. The wave echoes form a picture of body tissues called a sonogram. Blood test : a test to measure a substance in the blood called CA a tumor marker that is often found to be elevated in the blood of women with ovarian cancer.
This test is used to monitor the progress of treatment. CT Scan and Surgery : When the presence of ovarian cancer is detected, a CT scan or another radiologic procedure is performed to determine the extent of the disease. If the disease appears resectable able to be removed through surgery , surgery is performed to make a definitive diagnosis and remove the tumor.
If the disease does not appear to be resectable, a biopsy is performed to make a definitive diagnosis and determine the course of treatment. Inherited gene mutations Up to 20 percent of ovarian, fallopian tube, and peritoneal cancers are caused by inherited gene mutations, such as the BRCA1 and BRCA2 genes and Lynch syndrome genes.
Tests to determine the stage of ovarian cancer If ovarian cancer is found after examining ovarian tissue samples, further tests are done to see if the cancer cells have spread within the ovaries or to other parts of the body. Donate a wig. Donating your hair. Connect and learn. Cancer Connect. Managing Cancer Workshops.
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Health professionals. Industry news and resources. Referrals to our cancer nurses. Don't Delay. Cancer treatment FAQs. Essential services and supplies. News Read our latest news for health professionals. Women were followed for a maximum of The primary outcome was death from ovarian cancer. However, this trend was not statistically significant and the confidence intervals were wide. Preventive Services Task Force USPSTF and the American Academy of Family Physicians recommend against routine screening for ovarian cancer in asymptomatic women, 16 , 35 but recommend that women with a high-risk family history be offered referral for genetic counseling and, if appropriate, genetic testing 35 , 36 Table 3 11 , 13 — An American College of Physicians practice guideline also recommends against screening, including annual pelvic examinations, in asymptomatic women.
Risk-reducing bilateral salpingo-oophorectomy is the most effective prophylactic treatment for BRCA carriers. Risk-reducing salpingo-oophorectomy induces premature menopause with its attendant risks and limits reproductive capacity.
It may also negatively affect a woman's body image and sexuality. Other preventive measures are avoiding long-term greater than five years postmenopausal hormone therapy and maintaining a healthy lifestyle.
Long-term hormonal contraceptive use is a promising chemopreventive approach, even for BRCA1 carriers, and especially in women with early menarche, women who delay first pregnancy, or women who are infertile.
However, this potential benefit should be balanced against adverse effects and a slight increase in the risk of breast cancer. Posttreatment care involves providing emotional support, monitoring for and managing treatment complications and comorbid conditions, and promoting general well-being.
According to expert opinion, posttreatment surveillance should be provided by a gynecologic oncologist for the first five years after diagnosis. After that, care may transition to an annual review of systems and physical examination in primary care. Computed tomography, positron emission tomography, or both are recommended if recurrence is suspected.
Gynecologic oncologist visits every two to four months for two years and then every three to six months for three years; annual visits after five years surveillance may transition to primary care at this point. Testing for cancer antigen or other tumor markers every visit, if initially elevated.
Palliative care and advance directives, including designation of a health care proxy, should be discussed at the time of initial decision making about treatment. This is particularly important for patients with stage II to IV disease, and is an area for primary care clinical involvement.
Palliative care planning should focus on maximizing quality of life through aggressive management of distressing symptoms such as pain, nausea and vomiting, respiratory symptoms, urinary tract infection, renal failure, edema, cancer-related fatigue and neuropathy, hypercalcemia, and anxiety or depression.
End-of-life care is the terminal phase in the care continuum. Validated tools, such as the Memorial Symptom Assessment Scale, 41 facilitate communication between the patient and care team. Psychological and social support for the patient and family, as well as spiritual and existential issues, become central if there is no realistic hope of cure. Comfort care is critical when death is imminent. Data Sources : A PubMed search was completed in Clinical Queries using the key terms ovarian cancer, epidemiology, diagnosis, treatment, screening, surveillance, survival, and palliative care AND end-of-life care.
The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Search dates: March 9, , and March 9, The authors thank Alexis M. Zebrowski and Linda L. Pang for revisions and editorial assistance. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. ANNA R. At the time the article was written, Dr. Address correspondence to Chyke A. Reprints are not available from the authors. National Institutes of Health. National Cancer Institute.
Surveillance, Epidemiology, and End Results Program. Statistical summaries: cancer stat fact sheets ovary and cancer statistics review CSR , — Accessed April 27, Clarke-Pearson DL.
Clinical practice. Screening for ovarian cancer. N Engl J Med. Tavassoli FA, Devilee P, eds. Jelovac D, Armstrong DK. Recent progress in the diagnosis and treatment of ovarian cancer. CA Cancer J Clin. American Cancer Society. Ovarian cancer.
Accessed March 8, Granulosa cell tumor of the ovary. J Clin Oncol. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. Mosher WD, Jones J. Use of contraception in the United States: — Vital Health Stat Identification and management of women with BRCA mutations or hereditary predisposition for breast and ovarian cancer.
Mayo Clin Proc. Hunn J, Rodriguez GC. Ovarian cancer: etiology, risk factors, and epidemiology. Clin Obstet Gynecol. Ferlay J, et al. Int J Cancer. Accessed March 7, Ford D, et al. The Breast Cancer Linkage Consortium. Am J Hum Genet. Chen S, Parmigiani G. Moyer VA. Screening for ovarian cancer: U. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. Cannistra SA. Cancer of the ovary [published correction appears in N Engl J Med.
Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis. Falconer H, et al. Ovarian cancer risk after salpingectomy: a nationwide population-based study. J Natl Cancer Inst.
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