What is ovarian cancer?
Cancer develops when cells in your body begin to grow abnormally. This can happen in any area of the body. When this abnormal growth occurs in the ovary, you develop ovarian cancer. All cells go through their own life cycles — growing, dividing and being replaced. They even undergo “programmed cell death” when they no longer function properly or have outlived their usefulness — at this point, the cells die. However, cells sometimes start to grow rapidly or no longer die when they should. This abnormal growth of cells can cause problems, typically leading to the formation of a tumor. A tumor can either be cancerous (malignant) or not cancerous (benign).
Benign and malignant tumors act differently in the body. A benign tumor doesn’t spread throughout the body. It stays in one place and slowly grows over time. Your healthcare provider may recommend watching it over time or removing a tumor surgically. Typically, benign tumors are not an immediate danger to your health. Malignant tumors are more aggressive. These tend to grow rapidly and can invade other parts of the body, causing more problems as they spread. When malignant (cancerous) cells develop in ovaries, it’s called ovarian cancer.
The ovaries are a part of your reproductive system. If you think of the organs of your reproductive system as an upside down triangle, the ovaries are a pair of round organs in the upper corners. Your ovaries — each about the size of a walnut — are connected to the uterus and there are two thin tubes called the fallopian tubes in between. The uterus makes up the bottom point of the triangle. During your reproductive years (time in your life when you could become pregnant), eggs are formed in the ovaries, travel down your fallopian tubes and then to the uterus.
What causes ovarian cancer?
The cause of ovarian cancer is not yet known. However, you may have a higher risk of ovarian cancer if you have:
- A family history of ovarian cancer (others in your family have had the disease) or have inherited a gene mutation (BRCA1 or BRCA2).
- An Eastern European (Ashkenazi) Jewish background.
- Never been pregnant.
- Had endometriosis.
- Had breast, uterine or colorectal cancer.
There is also an increased risk for developing ovarian cancer as you grow older.
Another risk factor is Lynch syndrome. This disorder runs through families and it can increase the risk of developing colon cancer. Lynch syndrome is linked to many other types of cancer. If you have Lynch syndrome, your risk of developing other cancers is increased. Lynch syndrome is an inherited condition, so talk to your family about any history of colon or colorectal cancer.
What are the symptoms of ovarian cancer?
Unfortunately, ovarian cancer can develop, become quite large and spread throughout the abdomen before it causes any symptoms. This can make early detection difficult. When you experience symptoms, they can include:
- Having pain, discomfort or bloating in your abdomen and pelvis.
- Experiencing changes in your eating habits, getting full early and losing your appetite. You may experience bloating and belching, sometimes even stomach pain.
- Having abnormal bleeding or vaginal discharge (especially if the bleeding is happening outside of your typical menstrual cycle or after you have gone through menopause) and, more often, changes in your bowels, such as diarrhea and constipation.
- Feeling any unusual lumps or finding increase in the size of your abdomen.
- Having urinary frequency or urinary urgency.
What are genes and what do they have to do with ovarian cancer?
Genes are a part of your DNA and are essentially the blueprint your cells use to reproduce themselves. You’re born with a particular genetic makeup. Your genes can be influenced by your family (inherited traits) and by changes that happen to your genes over time. These changes are called mutations. Two of the most common gene mutations that have been pinpointed as being related to ovarian cancer are BRCA1 and BRCA2.
The BRCA1 and BRCA2 genes are inherited — meaning you get part of each gene from each parent. Your genes are twin pieces (you have two parts that make up each gene, so two parts to BRCA1). You could have a mutation in one part of the gene without having cancer. However, if both parts of the gene are mutated, cancer can develop. BRCA1 and BRCA2 typically suppress the growth of cancerous cells. Mutations keep these genes from doing their job and preventing abnormal cell growth. BRCA1 and BRCA2 are also linked to breast cancer.
Gene mutations aren’t always inherited. Throughout your life, your genes can change. A somatic mutation is one that happens over time. One common genetic mutation that’s seen in ovarian cancer is a somatic mutation of the TP53 gene. The mutation changes part of the gene — the protein — called the p53 protein. This protein normally works to fight tumors and keep them from developing. However, when it’s changed by this mutation, it can’t keep the tumor from growing. This same process can happen to many different genes in your body and they can all contribute to cancer growth.
How would I know if gene mutations run in my family?
If you have a strong family history of ovarian cancer or breast cancer, your healthcare provider may suggest genetic testing. This type of testing will identify any mutations or changes you have in your genetic makeup. Understanding your family history and genetic makeup can help in early treatment of cancer. Talk to your healthcare provider about your family history of cancer and discuss what preventative measures you can take to protect your health.