Ovarian cancer develops from the cells of the ovaries, the glands that produce female hormones and eggs. Often described as a "silent cancer" because of its late, non-specific symptoms, its early diagnosis is a real challenge.
Ovarian cancer develops from different types of ovarian cells. It can occur at any age, but is more common after the menopause. There are several types of ovarian cancer:
Epithelial tumours These are the most common (85-90% of cases). They develop from the cells that cover the surface of the ovary. Several subtypes are distinguished:
Epithelial tumours These are the most common (85-90% of cases). They develop from the cells that cover the surface of the ovary. Several subtypes are distinguished:
Germ cell tumours Rarer (around 5% of cases), they mainly affect young women, sometimes even adolescents. They develop from the cells that normally give rise to eggs. These tumours are generally very sensitive to chemotherapy and their prognosis is often favourable, even at an advanced stage.
Several factors can increase the risk of ovarian cancer:
Ovarian cancer treatment is personalised and depends on:
Unlike breast cancer, there is no organised screening programme for ovarian cancer. Its diagnosis is often late, because the initial symptoms are non-specific (persistent bloating, pelvic pain, digestive problems, unexplained fatigue, abnormal bleeding)
The diagnosis relies on several examinations:
In ovarian cancer, several surgical procedures may be necessary:
Removal of the ovaries and fallopian tubes: This operation, called adnexectomy, consists of removing both ovaries and the fallopian tubes where the cancer develops. In women who have not reached the menopause, this removal will cause an immediate menopause that will require specific support.
Hysterectomy: This is the complete removal of the uterus. It is generally necessary because ovarian cancer can spread to the uterus, and its presence could encourage a recurrence.
Omentectomy: This operation consists of removing the omentum, a fatty tissue that covers the organs of the abdomen. This tissue is often a preferred site of ovarian cancer spread, so its removal is important to optimise the treatment.
Lymph node dissection: This is the removal of the lymph nodes of the pelvis and abdomen to check whether the cancer has spread there. This step is essential to determine the exact extent of the disease and adapt the complementary treatments.
Removal of suspicious lesions: The surgeon carefully examines the entire abdominal cavity and removes any area suspected of being affected by the cancer. This procedure is crucial because ovarian cancer tends to spread within the abdomen in the form of small nodules.
Chemotherapy is a treatment that circulates throughout the body via the bloodstream to destroy cancer cells, whether they are in the ovary or have spread elsewhere. It is generally given by infusion over several cycles It can be given before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy).
Targeted therapies are more recent treatments that act very precisely on cancer cells. Among them, PARP inhibitors prevent cancer cells from repairing their DNA, thereby leading to their destruction. These drugs are particularly effective in patients with a genetic predisposition to ovarian cancer (BRCA gene mutation), because their cancer cells depend more heavily on this repair mechanism. These treatments therefore improve the effectiveness of care by adapting to the specific characteristics of your cancer.
An oncogenetics consultation may be recommended in the event of a family history. It assesses the risk and proposes appropriate monitoring.
Persistent digestive symptoms, unusual bloating, pelvic pain or unexplained fatigue should lead you to consult.
Fertility preservation is a major concern for young women facing ovarian cancer. This question deserves to be raised from the very start of your care. In some cases of cancers detected very early and depending on their type, conservative surgery preserving one ovary and the uterus can be considered. This decision is taken after an in-depth discussion with your medical team, taking into account your pregnancy plans, your age and, above all, the characteristics of your cancer so as not to compromise your chances of cure. Do not hesitate to express your wishes and concerns on this subject: it is an important part of your care.
It is recommended in the majority of cases, except for certain very early cancers. The protocol is adapted to each situation.
Regular follow-up is set up with clinical examinations, marker measurements and imaging examinations according to a personalised schedule.
The effects vary according to the treatments: fatigue, nausea, digestive problems, risk of infection… The medical team supports you in managing them as well as possible.
This depends on the type of treatment and your general health. Adjustments may be necessary and should be discussed with your medical team.
A balanced diet and adapted physical activity are recommended. Your medical team will give you personalised advice.
Many associations offer valuable support and guidance throughout your journey. Click here to discover a selection of patient associations that can accompany you.
