Epithelial Ovarian Cancer: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Thajammul Samrin , Gynecologists

Epithelial Ovarian Cancer is the most common type of ovarian cancer, accounting for approximately 90% of all ovarian malignancies. It develops from the epithelial cells that cover the outer surface of the ovaries and includes several subtypes, such as serous, mucinous, endometrioid, clear cell, and transitional cell carcinomas.

The disease often causes few or nonspecific symptoms in its early stages, which may delay diagnosis. Common symptoms include abdominal bloating, pelvic or abdominal pain, difficulty eating, feeling full quickly, urinary urgency, and changes in bowel habits.

Early diagnosis and prompt treatment with surgery, chemotherapy, targeted therapy, and, when appropriate, immunotherapy or hormone therapy are essential to improve survival and quality of life.

What are the Stages of Epithelial Ovarian Cancer?

Epithelial ovarian cancer is categorized into four primary stages, each delineating the extent of cancer spread. Understanding these stages is vital for determining the appropriate treatment approach.

Stage I

At this initial stage, cancer is confined to one or both ovaries. It is further sub-categorized based on whether the cancer cells are present on the outer surface or if the capsule of the ovary is intact.

Stage II

Here, cancer has extended to the pelvic region, affecting the fallopian tubes, uterus, or other pelvic tissues.

Stage III

Stage III indicates a more advanced spread, where cancer has reached the abdominal lining or lymph nodes. It is the most common stage at diagnosis due to the disease's subtle early symptoms.

Stage IV

This final stage is characterized by the spread of cancer beyond the abdomen to distant organs such as the liver or lungs.

What are the Symptoms of Epithelial Ovarian Cancer?

Symptoms of epithelial ovarian cancer are often vague and easily mistaken for other conditions. Early detection remains challenging, but awareness of these symptoms can lead to timely medical consultation:

These symptoms tend to persist and worsen over time, distinguishing them from more benign conditions.

What are the Causes of Epithelial Ovarian Cancer?

While the precise causes of epithelial ovarian cancer remain under investigation, several factors have been identified as potential contributors. Genetic mutations, particularly in the BRCA1 and BRCA2 genes, significantly elevate the risk. Additionally, factors like age, reproductive history, and hormonal influences are also considered significant. The interplay of these elements underscores the complexity of pinpointing a singular cause.

Other contributing factors may include a family history of ovarian or breast cancer, inherited cancer syndromes such as Lynch syndrome, and prolonged exposure to estrogen without progesterone. Lifestyle and environmental factors, including obesity and certain fertility treatments, may also play a role. In some cases, chronic inflammation of the ovaries or fallopian tubes is being studied as a possible contributing factor, further highlighting the multifactorial nature of the disease.

When to See a Doctor for Epithelial Ovarian Cancer?

Women with persistent abdominal bloating, pelvic pain, early satiety, or urinary symptoms lasting more than a few weeks should consult a Gynecologist. If ovarian cancer is suspected or diagnosed, care is typically managed by a Gynecologic Oncologist.

You should see a doctor if you experience:

Seek immediate medical attention if you:

These symptoms may indicate serious complications requiring urgent medical evaluation.

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How Is Epithelial Ovarian Cancer Diagnosed?

Diagnosis of epithelial ovarian cancer involves several steps, beginning with a thorough medical history and physical examination. Given the disease's elusive nature, additional diagnostic tools are often employed:

Imaging Tests

Ultrasounds and CT scans are commonly used to visualize the ovaries and detect any abnormalities.

Blood Tests

The CA-125 blood test measures a protein often found at elevated levels in women with ovarian cancer, though it is not exclusively indicative of cancer.

Biopsy

A definitive diagnosis usually requires a biopsy, where tissue samples are examined for cancerous cells.

What are the Treatment Options for Epithelial Ovarian Cancer?

Treatment plans for epithelial ovarian cancer are highly individualized, factoring in the stage of cancer, patient health, and personal preferences. The primary treatment modalities include:

Surgery

Surgical intervention is often the first line of treatment, aiming to remove as much of the tumour as possible. This may involve a hysterectomy, removal of the ovaries, and excision of affected lymph nodes.

Chemotherapy

Post-surgery chemotherapy is typically employed to target any remaining cancer cells. Intravenous or intraperitoneal chemotherapy is a common approach.

Targeted Therapy

Targeted therapies have emerged as a promising option. These therapies focus on specific genetic mutations within cancer cells. They aim to minimize damage to healthy cells while effectively combating cancerous ones.

Radiation Therapy

Though less common in treating ovarian cancer, radiation therapy may be utilized in some instances to manage symptoms or treat areas unresponsive to other treatments.

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What are the Risk Factors for Epithelial Ovarian Cancer?

Several risk factors have been associated with an increased likelihood of developing epithelial ovarian cancer:

Understanding these risk factors is essential for developing preventative strategies and encouraging proactive health monitoring.

What is the Recovery Process of Epithelial Ovarian Cancer?

Recovery varies depending on treatment type and stage, with ongoing monitoring required for recurrence.