About Ovarian Cancer:

Ovarian cancer is a disease where cells in either the ovary or fallopian tube multiply and grow abnormally.

There are three major types of ovarian cancer based on the cells where they start:

• Epithelial cell
• Germ cell
• Stromal cell

The most common is epithelial which accounts for 85% of all ovarian cancers.These cancers typically affect women between the ages of 40 and 80. Some women may have a strong family history of ovarian cancer or a gene mutation known to increase risk for this disease. At UHN, we have a dedicated clinic (Familial Ovarian Cancer Clinic) to manage patients at higher risk of ovarian cancer. We also have a devoted genetics team to diagnose any hereditary syndromes.

Symptoms:

The typical symptoms of ovarian cancer can be vague but often worsen as the cancer progresses.

• abdominal bloating & pain
• feeling full or trouble eating
• low appetite
• change in bowel habits
• change in bladder habits
• unintentional weight gain or weight loss

Diagnosis:

Unfortunately, there are not accurate or reliable methods for screening for ovarian cancer.  It is important for women to be aware of risk factors and symptoms for this illness. To test for ovarian cancer, our team will perform a series of investigations:

• complete history & physical exam
• blood tests, including testing for tumor markers (CA-125)
• CT scan of the abdomen, pelvis and thorax
• potentially a biopsy

Treatment:

At UHN, any patient with a suspicion of ovarian cancer is contacted by our Ovarian Cancer Clinical Navigation Leader, whose job is to assist patients in navigating appointments, tests and questions.

The best outcomes in ovarian cancer are related to expertise, experience and a multi-disciplinary team of specialists that includes surgeons, medical oncologists, pathologists, radiologists, radiation oncologists, as well as nurses, social workers and other allied health professionals. At UHN, we are national and international leaders in the management of ovarian cancer, with a comprehensive program to support patients at every part of their cancer journey.

Treatment for epithelial ovarian cancer includes a combination of surgery and chemotherapy. When a patient is diagnosed with epithelial ovarian cancer, the one of the most critical decisions is to determine if the patient will benefit from primary debulking surgery or treatment with neoadjuvant chemotherapy. Acknowledging how important this decision is to the prognosis, we initiated a new ovarian cancer program at UHN, to discuss every new advance ovarian cancer case in a multi-disciplinary conference of experts in this field. This allows each patient to have personally tailored treatment, often consisting of:

• Surgery (either laparotomy, laparoscopy or robotic)
• Chemotherapy
  • Intra-peritoneal (IP)
  • Intravenous (IV)
• Heated intra-peritoneal chemotherapy (HIPEC)
• Oral chemotherapy

What to expect before and after surgery for ovarian cancer?

What to expect during intravenous chemotherapy treatment for ovarian cancer?

What to expect during intraperitoneal chemotherapy treatment for ovarian cancer?

Germ cell tumours affect children and young women. In general, they are eligible for fertility sparing surgery. Almost all of these cancers can be cured with a combination of surgery and chemotherapy.

Stromal cell cancers are uncommon, representing <5% of all ovarian tumors. They are usually slow growing and are generally treated with surgery, and in some situations additional radiation.

Read more about ovarian cancer or watch this video from Dr. Taymaa May.