Of all the medical conditions that have a tendency to get progressively worse, ovarian cancer is most highly associated with a mortality. Based on the research findings in the SEER 1975-2007 report (The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute), ovarian cancer is the fifth most common cancer in women, with an incidence rate of 12.9 per 100,000 women per year.
Types of ovarian cancer
Ovarian epithelial carcinoma (most common), affects the epithelial surface of the ovary sex cord-stromal tumors, affect estrogen-producing granulose cells and Sertoli-Leydig cells germ cell tumors (teratomas) originating from the germinal cells mixed tumors, affects a number of ovarian tissues. Ovarian carcinoma is believed to be caused by various groups of factors:
Who is at an increased risk?
Women with endometriosis
Women using postmenopausal estrogen replacement therapy
Women who have never been pregnant
The process of interrupting ovulation through pregnancy and contraception can lower the risk of ovarian cancer. The procedure of tubal ligation involving a woman’s fallopian tubes being clamped and sealed to prevent eggs from reaching the uterus is also another way of lowering the risk. There are at least 2 known pathways of ovarian cancerogenesis: arising stepwise from benign and borderline tumors or structures – endometriosis starting afresh from surface epithelium or surface epithelial inclusion glands.
Ovarian carcinoma, like other cancers, occurs as a result of multi-stage interactions of genetic and environmental factors. Ovarian cancer transformation is triggered by mutations in certain genes. The majority of the critical genes are involved in the same signaling pathways. Even subtle changes in these pathways might induce cancerogenesis and result in a different morphologic type of cancer and different molecular characteristics. There is also a large group of genes involved in further cancer development, neoangiogenesis – increasing malignancy and peritoneal metastasis formation.
Recognition of individuals and families with inherited cancer predisposition syndromes and individuals at high risk due to familial cancer clustering, is fundamentally important for the management and treatment and for future prevention of cancer both in patients and their families. It is essential to choose the optimal treatment for a particular neoplasm.