When you hear the term ovarian cancer, most of us tend to think it’s a single disease, a malignancy in the ovaries. However, there are several different types of ovarian cancer, which first develop in different parts of the ovaries, and are largely a result of differences in age groups, and the genetic makeup of the patient. As a result, treatment options may vary greatly too.
This is the most common type of ovarian cancer and accounts for approximately 80 per cent of all ovarian malignancies. Epithelial cancer tends to impact women who are over the age of 50, however, may occur at any age. They are now believed to arise from the lining of the fallopian tube and then implant on the surface of the ovary. Within this category of ovarian cancer, there are subgroups (serous, mucinous, endometrioid, clear cell), with serous tumours being the most common. Traditionally, epithelial ovarian cancer is treated with a combination of surgery and chemotherapy, although hormone therapy may also be prescribed, especially for low-grade serous tumours.
Another type of epithelial ovarian cancer is called endometrioid, which is the same kind of cancer found in the lining of the uterus. This type of tumour can occasionally be associated with endometriosis, although most women with endometriosis do not have this malignancy.
There are uncommon and may arise primarily on the ovary or represent spread from the appendix, stomach or bowel.
Sex cord-stromal tumours
The other group of ovarian cancers are called sex cord-stromal tumours and come from the stroma, which is the supporting structure around the ovary. These types of cancers account for approximately three to five per cent of all primary ovarian cancers. Most are diagnosed at an early stage and can be treated with surgery alone when caught early enough.
Granulosa or theca cell tumour
The most common sex cord-stromal tumour is called granulosa or theca cell tumour. Unlike epithelial tumours, these tumours usually develop in women in their 30’s and 40’s, but can on occasion develop in older women, or even young girls. According to medical experts, these tumours tend to make hormones such as estrogen, and they can actually cause uterine cancer by secreting a lot of it (estrogen).
These tumours are diagnosed due to a certain set of symptoms. When a woman has both a mass and bleeding, doctors consider the possibility of this type of ovarian tumour. A blood test will reveal whether a woman is producing a very high level of a substance called inhibin, which in turn may indicate a sex cord-stromal tumour.
Germ Cell Tumours
Germ cell tumours account for about 5 per cent of all primary ovarian cancer diagnoses. These tumours arise in the ovarian cells that develop eggs and tend to develop in younger girls and women in their early twenties.
Most germ cell ovarian tumours are diagnosed early and treated with surgery. Chemotherapy isn’t generally necessary Unless the tumour is spread beyond the ovary or of the yolk sac tumour type. It is the most curable of all ovarian tumours.
Understanding your diagnosis
When you’re diagnosed with an ovarian cancer, it’s important to understand the type of ovarian cancer you and your medical team are dealing with for several reasons:
- It helps doctors know how best to treat the cancer, in terms of the type of surgery required
- When chemotherapy is recommended, the type of tumour helps determine which type of chemotherapy or immunotherapy will work best
- And it’s important for women to know what kind of tumour they have so they can learn about their genetic risk and that of other family members.
Reviewed by Professor Selvan Pathar on behalf of Lifehouse (5.7.21).
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