Aside from the core information found below, we also have a section dedicated to answering common Questions about Ovarian cancer.
Ovarian cancer is more common in the affluent west with the highest levels in North America, Western and Northern Europe. It is the 5th commonest cancer in women with approximately 6000 new cases in the UK and 20000 in the USA. The majority of cases are in women more than 55 years old.
One association is the number of ovulatory cycles (periods) that a woman has during her lifetime so those who had less monthly cycles due to being pregnant or on the oral contraceptive pill for five years or longer have been shown to be reduced risk. Hysterectomy (removal of the womb) with or without the removal of an ovary has also been associated with a decreased risk.
It was thought that women who had undergone infertility treatment may be at increased risk due to hyperstimulation of the ovaries but this has not been proven.
Heredity is also a risk factor. Ovarian cancer can run in families due to a mutation in a number of genes, the most well known being BRCA1, BRCA2 which also have an association with breast cancer and the Lynch Type II syndrome which is associated with an increased risk of colon and endometrial (womb) cancers.
If there is a strong family history of ovarian cancer, then discussion with a cancer geneticist should be arranged as well as testing for the common gene mutations. Even if these are negative, it is worth considering removal of the ovaries (oophorectomy). The age when this should be considered is dependent on the age that ovarian cancer developed in the relatives. Although no one knows the ideal time, it makes sense to consider oophorectomy approximately five years before the onset occurred in other members of the family.
Two large prospective trials could find no evidence that ovarian cancer was associated with low vitamin intake or carotenoids. One of the trials suggested that excess Vitamin E ingestion may possibly be associated but this was not shown in the second trial.
The standard treatment is surgery which is then followed by chemotherapy if considered necessary. The standard chemotherapy is a combination of two drugs. The first is a platinum compound called cisplatin or carboplatin and the second is known as a taxane the commonest being paclitaxel.
An inability to tolerate this treatment or failure of the tumour to respond will result alternative chemotherapy agents being given, the most common is liposomal doxorubicin, topotecan or gemcitabine.