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At Boston Medical Center (BMC), the care of patients with ovarian cancer is a collaborative, multidisciplinary process. BMC’s Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits. The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling cancer, while managing its impact on quality of life.
As the primary teaching affiliate of the Boston University School of Medicine, BMC combines personal, patient-focused care with the state-of-the-art-expertise and technological advances of a major teaching hospital. BMC is at the forefront of clinical practice, surgical expertise, and research in oncology.
In addition to ovarian cancer, BMC’s gynecologic oncologists have expertise in treating many types of female pelvic cancers, including cancers of the uterus, cervix, vulva, and trophoblast (placenta). Patients with a diagnosis or strong suspicion of cancer are given appointments within 72 hours.
What Is Ovarian Cancer?
Ovarian cancer is a type of cancer that begins in the ovaries. The ovaries are part of the female reproductive system. They are located on either side of the uterus in the pelvic region of the body. The ovaries produce eggs (called ova) and are the primary source of several female hormones.
There are three main types of malignant (cancerous) ovarian tumors:
- Epithelial (surface) cell tumors begin in the cells that cover the outer surface of the ovary. They are the most common type of ovarian tumor.
- Germ cell tumors begin in the cells that form the eggs (ova) and are fairly rare.
- Stromal cell tumors begin in the cells that help keep the ovary together and produce the female hormones. This type of tumor is also rare.
Many ovarian tumors are benign (noncancerous) and never spread beyond the ovary. The cancerous tumors are more dangerous because they can spread to other parts of the body.
Symptoms of Ovarian Cancer
The symptoms of ovarian cancer are often vague and non-specific. However, women with ovarian cancer often report signs and symptoms that include
- Abdominal bloating or swelling
- Feeling full
- Frequent urination
- Pelvic pain
- Loss of appetite and weight loss
- Shortness of breath from fluid build-up around the lungs
Patients with concerns about any of the signs and symptoms listed above are urged to consult their physician immediately.
Causes of Ovarian Cancer
Although the exact causes of ovarian cancer remain unknown, certain risk factors—things that increase an individual's chances of developing a cancer—have been identified. While risk factors may be useful in identifying high-risk individuals, they do not determine whether an individual develops a disease. Some risk factors, such as diet, are within an individual’s control, while others, such as age, are not.
Some risk factors for ovarian cancer include
- Age: Older women have a greater risk of developing ovarian cancer. Most women who develop ovarian cancer are over age 50.
- Family history: If women have immediate family members with ovarian cancer, they have an increased risk of the disease. Family histories of breast and colon cancers can also increase the risk of ovarian cancer.
- Genetic syndromes: There are several inherited gene mutations (changes to a cell’s genetic makeup) that may increase a woman’s chances of developing ovarian cancer. For example, mutations in either the BRCA1 or the BRCA2 genes increase your risk for both ovarian and breast cancers and can be passed on through generations. View more information on the BRCA1 and BRCA2 genes here.
- Obesity: Women who are obese have an increased risk of developing ovarian cancer.
- Having children: Women who have given birth have a decreased risk of developing ovarian cancer. A woman’s risk continues to drop with each additional full-term pregnancy.
Currently, there are no screening procedures in place to detect ovarian cancer. However, patients with a strong family history of ovarian or breast cancer may be eligible for genetic counseling. For more information, patients can visit Genetic Counseling or talk to their physician to request a referral.
Staging is the process of determining how extensive the cancer is. It is an important part of diagnosis because it is used to determine the most appropriate treatment options for patients. The stages of ovarian cancer range from Stage I (the least severe stage) to Stage IV.
Stage I: Cancer is present in one or both ovaries.
Stage II: Cancer is present in one or both ovaries and has spread to other organs in the pelvic region (e.g., the uterus, fallopian tubes, bladder, sigmoid colon, or rectum).
Stage III: Cancer is present in one or both ovaries and has advanced beyond the pelvis to the lining of the abdomen and/or the lymph nodes in the back of the abdomen.
Stage IV: Cancer has spread to organs outside of the peritoneal (abdominal) cavity.. Cancer cells in the fluid around the lungs also mean Stage IV ovarian cancer.
(American Cancer Society 2015, Society of Gynecologic Oncology 2014)
American Cancer Society. 2015. Detailed Guide: Ovarian Cancer. PDF.
Society of Gynecologic Oncology. 2014. FIGO Ovarian Cancer Staging. PDF. https://www.sgo.org/wp-content/uploads/2012/09/FIGO-Ovarian-Cancer-Staging_1.10.14.pdf
Tratamientos y Servicios
Cirugía para el cáncer de ovario
La mayoría de los pacientes se someterán a una cirugía como parte de su plan de tratamiento. El objetivo del tratamiento quirúrgico es eliminar la mayor cantidad posible de cáncer (un proceso llamado citorreducción). Si el cáncer de ovario se diagnostica en una etapa temprana, entonces el cirujano (ginecólogo oncólogo) tiene más posibilidades de extirpar todo el cáncer y curar a la paciente. Si los pacientes son diagnosticados en etapas posteriores, es posible que necesiten uno o más procedimientos quirúrgicos.
La quimioterapia es un medicamento o una combinación de medicamentos que se usan para tratar el cáncer. La quimioterapia puede administrarse por vía oral (en forma de pastilla) o inyectarse por vía intravenosa (IV).
Diagnósticos y Pruebas
Ovarian cancer is often diagnosed in the late stages when the disease is already advanced. This is because the symptoms are vague and often attributed to other conditions, which delays diagnosis. Sometimes, these common symptoms are more severe in women with ovarian cancer, but this isn't always the case. Early-stage diagnosis is beneficial because it improves survival rates. Therefore, it is important for women to be aware of overall changes in the way they feel and see their physician if they notice any new symptoms that don't improve over time.
If a primary care physician suspects that ovarian cancer might be the cause of his or her patient’s symptoms, he or she will be refer the patient to a gynecologist or gynecologic oncologist, a physician who specializes in treating conditions of the ovaries, uterus, and cervix.
Starting with her first visit to BMC, the patient will receive coordinated, multidisciplinary care that is managed by a gynecologic oncologist. At this time, specialists will use one or more of the following methods to diagnose ovarian cancer.
If a cancer diagnosis is made, multiple specialists will review the patient’s case at a biweekly Tumor Board meeting. This interdepartmental review process guides recommendations for treatment. In consultations with the patient and her primary care physician, the best course of treatment is planned based on the type and extent of the cancer and the patient’s overall health.
Examen físico para el cáncer de ovario
Su médico le hará una serie de preguntas y es probable que le realice un examen físico. El examen físico incluirá el examen de cualquier área específica de preocupación, especialmente en lo que se refiere al motivo de su visita al consultorio. El examen físico puede incluir palpar el área pélvica para encontrar ovarios agrandados o líquido en el área del abdomen (ascitis).
Pruebas de diagnóstico por imágenes para el cáncer de ovario
Se pueden realizar diversas pruebas de diagnóstico por imágenes para ayudar a diagnosticar el cáncer de ovario. Estas pruebas de diagnóstico por imágenes pueden incluir ecografías o tomografías computarizadas.
La ecografía de diagnóstico, también llamada ecografía o ecografía médica de diagnóstico, es un método de obtención de imágenes que utiliza ondas sonoras de alta frecuencia para producir imágenes de estructuras dentro del cuerpo. Las imágenes pueden proporcionar información valiosa para diagnosticar y tratar una variedad de enfermedades y afecciones. La mayoría de los exámenes de ultrasonido se realizan con un dispositivo de sonar fuera del cuerpo, aunque algunos exámenes de ultrasonido implican colocar un dispositivo dentro del cuerpo.
Tomografía computarizada (TC)
Las tomografías computarizadas utilizan equipos de rayos X y procesamiento por computadora para producir imágenes bidimensionales del cuerpo. El paciente se acuesta en una mesa y pasa a través de una máquina que parece una rosquilla grande y cuadrada.
BMC’s comprehensive ovarian cancer team includes physicians who work in surgical oncology specific to gynecology, medical oncology and radiation oncology. The team’s patient-centered, multidisciplinary approach assures each patient benefits from the collaborative expertise of physicians uniquely focused on their individual needs.
Gregory Russo, MD
Attending Physician, Department of Radiation Oncology, Boston Medical Center
Clinical Assistant Professor of Radiation Oncology, Boston University School of Medicine
Recursos del Paciente
BMC offers a number of clinical trials specifically for ovarian cancer patients. Promising new techniques in the diagnosis, treatment, and care of patients with ovarian cancer are tested in these studies. The number and types of clinical trials available are constantly changing.