当异常细胞生长并在人的卵巢内部或表面形成肿瘤时，就会发生卵巢癌. Almost 20,000 women are diagnosed with ovarian cancer in the U.S. each year.

What is ovarian cancer?

两个卵巢是位于子宫两侧的生殖器官. The ovaries contain different types of cells, including surface epithelial cells, germ cells and sex-cord stromal cells. The ovaries contain eggs that are released monthly during ovulation. The ovaries also secrete the hormones estrogen and progesterone. 当卵巢细胞不受控制地生长并形成肿瘤时，卵巢癌就会发展.

以下三个地方是卵巢内可形成卵巢癌(包括良性和恶性)的地方.

• Epithelial cells: These tumors grow from cells on the surface of one or both ovaries. This is the most common type of ovarian cancer tumor. Approximately 95% of ovarian cancers are epithelial in origin. 包括高级别浆液性癌、低级别浆液性癌、黏液性癌、子宫内膜样癌和透明细胞癌. In addition, 有证据表明，某些类型的上皮性卵巢癌可能起源于输卵管细胞.
• Germ cells: These tumors develop from cells inside the ovaries that contain eggs. 它们包括胚芽发育不良瘤、卵黄囊瘤、胚胎癌、绒毛膜癌和畸胎瘤.
• Stromal cells: These tumors develop in the cells of the ovaries that produce hormones. 这些肿瘤包括颗粒细胞瘤、腺瘤、纤维瘤和上皮间质瘤.

Ovarian Cancer Symptoms

卵巢癌在早期阶段通常很难发现，因为这种疾病几乎没有明显的症状或体征. 许多症状是模糊和非特异性的，可能与其他常见疾病有关.

Signs of ovarian cancer can include:

• Abnormal vaginal discharge or bleeding after menopause
• Bloating or swollen feeling in the stomach
• Feeling full very soon after starting to eat
• New urinary frequency
• New constipation or other changes in bowel movements
• Discomfort or pain in the pelvic area, abdomen or lower back
• Fatigue
• Unexplained weight loss

Ovarian Cancer Risk Factors

Nobody knows exactly what causes ovarian cancer. The lifetime risk of being diagnosed with it is 1.3%. Common ovarian cancer risk factors include:

• Older age
• Genetic mutations. Approximately 15% of ovarian cancers are linked to genetic mutations. 大多数是由于BRCA1(乳腺癌基因1)或BRCA2(乳腺癌基因2)突变. 然而，其他突变也可能与卵巢癌有关，包括林奇综合征.
• 卵巢癌家族史:有亲属被诊断患有卵巢癌的人(如母亲), sister, grandmother or aunt) have higher risk.
• Endometriosis
• Obesity
• Early menstruation and late menopause
• Never being pregnant

Lowering Ovarian Cancer Risk

Studies show you can do things to reduce the risk of ovarian cancer. These include:

• Eating a healthy diet and maintaining a healthy weight
• Consider taking birth control pills. Talk to your doctor about whether they may be a good option for you.
• Know your family history and consider genetic testing. Again, talk to your doctor.
• Consider having your fallopian tubes removed (salpingectomy). Studies indicate this could decrease your risk of ovarian cancer.

Ovarian Cancer Diagnosis

不幸的是，目前还没有经过批准的检测卵巢癌的筛查试验. If you have signs or symptoms of ovarian cancer, schedule an appointment to discuss them with your gynecologist, who can perform several tests to determine if you have ovarian cancer, including:

• Pelvic exam: 你的医生检查阴道和子宫颈的内部，寻找异常. The doctor also feels the size and shape of the uterus and ovaries, which can help identify a problem. A pelvic exam alone cannot rule out ovarian cancer.
• Imaging tests: Ultrasounds, MRI and/or CT scans 腹部和骨盆区域的扫描可以让医生更仔细地观察卵巢并发现异常. They can also help the gynecologist decide whether to order more tests.
• Blood tests: If an ovarian mass is found by imaging, 你的医生可能会要求你做血液检查，以帮助确定你患癌症的可能性. 这些测试不能诊断癌症，但它们可以帮助医生决定下一步最好的治疗方法.
• Surgery: Sometimes, 发现你是否患有卵巢癌的唯一方法是手术切除一个或两个卵巢. 然后病理学家将检查卵巢或卵巢是否有癌细胞的迹象.

Ovarian Cancer Stages

癌症分期可以帮助你和你的治疗团队了解你身体的哪些部位受到了影响，以及癌症是否已经扩散到卵巢外.

• Stage 1: 癌症只在一个或两个卵巢或输卵管中被检测到. It has not spread to lymph nodes or other organs.
• Stage 2: 在一个或两个卵巢中检测到癌细胞，并已扩散到附近的盆腔组织. There is no cancer in nearby lymph nodes.
• Stage 3: 肿瘤已扩散到骨盆外/上方的腹腔和/或已扩散到骨盆或主动脉旁淋巴结.
• Stage 4: 癌细胞已经扩散到远处的器官，如肺、肝或脾. The cancer may also have invaded through the entire wall of the intestine.

Ovarian Cancer Treatment

卵巢癌有许多不同类型，治疗包括手术组合, chemotherapy and/or hormonal therapy. 你的妇科肿瘤学家会根据你的具体癌症类型制定治疗方案.

Surgery for Ovarian Cancer

推荐的手术类型取决于癌症的分期和扩散. Ovarian cancer surgeries include one or more of the following procedures.

• Salpingo-oophorectomy: removal of one or both fallopian tubes and ovaries
• Hysterectomy: removal of the uterus
• Pelvic and/or para-aortic lymphadenectomy: removal of lymph nodes in the abdomen and pelvis
• Omentectomy: removal of fatty tissue (omentum) that drapes over the intestines. Ovarian cancer has a high propensity to spread to the omentum.
• Cytoreduction (debulking): If cancer has spread throughout the abdomen, surgery to remove the cancer and affected organs may be recommended. 这可能是一个广泛的手术，可能包括切除其他器官或其他器官的一部分, including the small and/or large intestine, bladder, liver, spleen and peritoneal surfaces throughout the abdomen. 这种手术可以在化疗之前或之后进行，这取决于你的情况.

Chemotherapy for Ovarian Cancer

你的医生可能会建议化疗来杀死癌细胞或干扰它们的生长能力. 化疗药物可以静脉注射，有些可以口服. Chemotherapy may be given before and/or after surgery for ovarian cancer. In some situations, 化疗可通过腹腔口直接进入腹腔(腹腔内化疗)。, or it can be given intraoperatively during cytoreductive surgery as hyperthermic intraperitoneal chemotherapy (HIPEC).

Hormone Therapy for Ovarian Cancer

激素或激素阻断药物可用于治疗某些类型的卵巢肿瘤. These medications block the production of estrogen, 降低雌激素水平或阻止雌激素在肿瘤生长的地方循环.

Targeted Therapy for Ovarian Cancer

靶向药物是针对肿瘤生长周期中的特定途径的药物. 你的肿瘤的个体分子测试可以用来帮助确定哪种药物对肿瘤的反应最好.

Immunotherapy and Ovarian Cancer

Immunotherapy harnesses the body’s immune system to kill cancer cells. Depending on the tumor’s characteristics, your gynecologic oncologist may recommend immunotherapy treatment options.

Ovarian Cancer and Pregnancy

卵巢癌有很多种类型，一些被诊断患有卵巢癌的人可以怀孕. Using a combination of fertility-sparing surgery and therapies, some patients can go on to have children after treatment. 如果癌症没有扩散，外科医生可能会保留未受影响的卵巢和/或子宫. In addition, there may be other fertility preservation options, including freezing of eggs and/or ovarian tissue. 你的妇科肿瘤科医生和生殖内分泌科医生可以帮助你确定这些治疗和程序是否可行. It’s important to discuss your fertility goals with your doctor.

Ovarian Cancer Prognosis

被诊断患有卵巢癌的妇女的五年生存率取决于诊断时癌症的阶段和卵巢癌的类型.

• Local: About 93% survival when there is no sign of cancer outside the ovaries
• Regional: 当肿瘤在卵巢外附近的淋巴结或器官中被发现时，大约75%的患者存活下来
• Distant: 当癌细胞扩散到远处的器官或远处的淋巴结时，大约31%的人存活下来