Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which cancer cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum. These cancers are staged and treated the same way. Learn about the risk factors, diagnosis, and treatment of these cancers.
Ovaries, Uterus and Fallopian Tubes
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About
Cervix Uteri
Image by Don Bliss (Illustrator) NCI/NIH
Cervix Uteri
Cervix and Nearby Organs . Description The location of the cervix and nearby organs and lymph nodes, as well as a close-up view of the ovaries, fallopian tubes, uterus, cervix, and upper vagina.
Image by Don Bliss (Illustrator) NCI/NIH
What Are Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer?
General Information About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
KEY POINTS
Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which malignant (cancer) cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum.
Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer form in the same type of tissue and are treated the same way.
Women who have a family history of ovarian cancer are at an increased risk of ovarian cancer.
Some ovarian, fallopian tube, and primary peritoneal cancers are caused by inherited gene mutations (changes).
Women with an increased risk of ovarian cancer may consider surgery to lessen the risk.
Signs and symptoms of ovarian, fallopian tube, or peritoneal cancer include pain or swelling in the abdomen.
Tests that examine the ovaries and pelvic area are used to diagnose and stage ovarian, fallopian tube, and peritoneal cancer.
Certain factors affect treatment options and prognosis (chance of recovery).
Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which malignant (cancer) cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum.
The ovaries are a pair of organs in the female reproductive system. They are in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries make eggs and female hormones (chemicals that control the way certain cells or organs work).
The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary.
The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary.
Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.
Ovarian epithelial cancer is one type of cancer that affects the ovary.
Ovarian Germ Cell Tumors
Ovarian Low Malignant Potential Tumors
Childhood Ovarian Cancer Treatment
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (23)
Ovarian Cancer
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths. A particular blood protein called cancer antigen 125 (CA-125) is often elevated in women with ovarian cancer, though small amounts of CA-125 are produced by normal tissues throughout the body and levels of CA-125 can be elevated by other conditions. The CA-125 test is used primarily to monitor the effectiveness of treatment for ovarian cancer. There are three different kinds of ovarian cancer: the most common type is epithelial ovarian cancer (90%) which originates from the surface epithelium of the ovary and is more likely to affect older women; germ cell ovarian cancer (5%), which originates from the cells that produce eggs and is more likely to affect younger women; and stromal ovarian cancer (5%), which originates from the connective tissue within the ovary. After age, the most important risk factor for ovarian cancer is family history. Ovarian cancer is relatively uncommon, but is the fifth leading cause of cancer death in women, partly due to diagnosis difficulty; its symptoms are vague, and ovarian cancer can shed cells that can invade other internal organs long before the presence of disease is even suspected.
Image by TheVisualMD
Site of ovarian cancer
Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer - Treatment Options for Recurrent or Persistent
Image by CDC
Small Cell O Infographic
Small Cell Carcinoma of the Ovary Patient Insights Network
Image by PINSupport/Wikimedia
Ovarian cancer screening: Simple blood test shows promise
Video by Dana-Farber Cancer Institute/YouTube
Oncology: Ovarian Cancer and New Screening Tools
Video by Lee Health/YouTube
What is hereditary breast and ovarian cancer?
Video by MD Anderson Cancer Center/YouTube
What is Ovarian Cancer: 10 things you should know about ovarian cancer | Cancer Research UK
Video by Cancer Research UK/YouTube
Understanding CA-125 Screening for Ovarian Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
Understanding Ovarian Cancer Stages and Symptoms
Video by Roswell Park Comprehensive Cancer Center/YouTube
Research Cures Cancer | Ovarian Cancer | MedscapeTV
Video by Medscape/YouTube
Insight from a young ovarian cancer patient
Video by MD Anderson Cancer Center/YouTube
Understanding Ovarian Cancer - Jumo Health
Video by Jumo Health/YouTube
BRCA Gene and Ovarian Cancer
Video by Lee Health/YouTube
Ovarian Cancer | Did You Know?
Video by National Cancer Institute/YouTube
Ovarian cancer: beyond resistance
Video by nature video/YouTube
Ovarian Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Ovarian Cancer
Video by Premier Health/YouTube
Risks for Ovarian Cancer
Video by Lee Health/YouTube
Chemo for Ovarian Cancer
Video by Stanford Health Care/YouTube
Knowledge is Power: Ovarian Cancer
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Ovarian Cancer Surgery
Video by Stanford Health Care/YouTube
Can endometriosis cause ovarian cancer? - Ovarian Cancer Answers
Video by Keck Medicine of USC/YouTube
Ovarian Cancer
Video by Michigan Medicine/YouTube
Ovarian Cancer
TheVisualMD
Site of ovarian cancer
CDC
Small Cell O Infographic
PINSupport/Wikimedia
2:16
Ovarian cancer screening: Simple blood test shows promise
Dana-Farber Cancer Institute/YouTube
1:50
Oncology: Ovarian Cancer and New Screening Tools
Lee Health/YouTube
5:36
What is hereditary breast and ovarian cancer?
MD Anderson Cancer Center/YouTube
1:38
What is Ovarian Cancer: 10 things you should know about ovarian cancer | Cancer Research UK
Cancer Research UK/YouTube
2:25
Understanding CA-125 Screening for Ovarian Cancer
Roswell Park Comprehensive Cancer Center/YouTube
1:55
Understanding Ovarian Cancer Stages and Symptoms
Roswell Park Comprehensive Cancer Center/YouTube
5:57
Research Cures Cancer | Ovarian Cancer | MedscapeTV
Medscape/YouTube
1:32
Insight from a young ovarian cancer patient
MD Anderson Cancer Center/YouTube
9:13
Understanding Ovarian Cancer - Jumo Health
Jumo Health/YouTube
1:49
BRCA Gene and Ovarian Cancer
Lee Health/YouTube
3:27
Ovarian Cancer | Did You Know?
National Cancer Institute/YouTube
2:22
Ovarian cancer: beyond resistance
nature video/YouTube
5:05
Ovarian Cancer - Mayo Clinic
Mayo Clinic/YouTube
9:51
Ovarian Cancer
Premier Health/YouTube
1:53
Risks for Ovarian Cancer
Lee Health/YouTube
7:53
Chemo for Ovarian Cancer
Stanford Health Care/YouTube
0:16
Knowledge is Power: Ovarian Cancer
Centers for Disease Control and Prevention (CDC)/YouTube
9:58
Ovarian Cancer Surgery
Stanford Health Care/YouTube
0:37
Can endometriosis cause ovarian cancer? - Ovarian Cancer Answers
Keck Medicine of USC/YouTube
1:00:50
Ovarian Cancer
Michigan Medicine/YouTube
The Peritoneum
What are the types of peritoneal dialysis?
Image by TheVisualMD
What are the types of peritoneal dialysis?
Peritoneal dialysis uses the lining of the abdomen (peritoneum), which is rich in arteries and veins, as a filter. Dialysis fluid is placed into the abdominal cavity through a permanent access port in the abdomen. The fluid remains there long enough for all the wastes in the blood to be transferred to the dialysis fluid, which is then drained out of the abdomen.
Image by TheVisualMD
The Peritoneum
The digestive organs within the abdominal cavity are held in place by the peritoneum, a broad serous membranous sac made up of squamous epithelial tissue surrounded by connective tissue. It is composed of two different regions: the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which envelopes the abdominal organs (image). The peritoneal cavity is the space bounded by the visceral and parietal peritoneal surfaces. A few milliliters of watery fluid act as a lubricant to minimize friction between the serosal surfaces of the peritoneum.
The Peritoneum
Figure 23.4 The Peritoneum A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
The visceral peritoneum includes multiple large folds that envelope various abdominal organs, holding them to the dorsal surface of the body wall. Within these folds are blood vessels, lymphatic vessels, and nerves that innervate the organs with which they are in contact, supplying their adjacent organs. The five major peritoneal folds are described in the Table below. Note that during fetal development, certain digestive structures, including the first portion of the small intestine (called the duodenum), the pancreas, and portions of the large intestine (the ascending and descending colon, and the rectum) remain completely or partially posterior to the peritoneum. Thus, the location of these organs is described as retroperitoneal .
The Five Major Peritoneal Folds
Fold
Description
Greater omentum
Apron-like structure that lies superficial to the small intestine and transverse colon; a site of fat deposition in people who are overweight
Falciform ligament
Anchors the liver to the anterior abdominal wall and inferior border of the diaphragm
Lesser omentum
Suspends the stomach from the inferior border of the liver; provides a pathway for structures connecting to the liver
Mesentery
Vertical band of tissue anterior to the lumbar vertebrae and anchoring all of the small intestine except the initial portion (the duodenum)
Mesocolon
Attaches two portions of the large intestine (the transverse and sigmoid colon) to the posterior abdominal wall
DISORDERS OF THE...
Digestive System: Peritonitis
Inflammation of the peritoneum is called peritonitis. Chemical peritonitis can develop any time the wall of the alimentary canal is breached, allowing the contents of the lumen entry into the peritoneal cavity. For example, when an ulcer perforates the stomach wall, gastric juices spill into the peritoneal cavity. Hemorrhagic peritonitis occurs after a ruptured tubal pregnancy or traumatic injury to the liver or spleen fills the peritoneal cavity with blood. Even more severe peritonitis is associated with bacterial infections seen with appendicitis, colonic diverticulitis, and pelvic inflammatory disease (infection of uterine tubes, usually by sexually transmitted bacteria). Peritonitis is life threatening and often results in emergency surgery to correct the underlying problem and intensive antibiotic therapy. When your great grandparents and even your parents were young, the mortality from peritonitis was high. Aggressive surgery, improvements in anesthesia safety, the advance of critical care expertise, and antibiotics have greatly improved the mortality rate from this condition. Even so, the mortality rate still ranges from 30 to 40 percent.
Source: CNX OpenStax
Additional Materials (13)
Peritoneal Cavity - Part 1 - Anatomy Tutorial
Video by AnatomyZone/YouTube
The Peritoneum
A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
Image by CNX Openstax
General Distribution of the Peritoneum
Cross section through the abdomen showing the continuity of the parietal and visceral peritoneum through the mesentery and the principal muscles that contribute to the abdominal wall.
Image by Dennis M DePace, PhD/Wikimedia
Mesentery
Mesentery
Image by Anatomist90
Mesentery
Horizontal disposition of the peritoneum in the lower part of the abdomen.
Image by Henry Vandyke Carter
Mesentery - structure of the gut wall
The general structure of the gut wall
Image by Auawise at English Wikipedia
Peritoneal Cavity
Cross section of the Peritoneal Cavity
Image by Dr. Johannes Sobotta
Peritoneum - 3D Schematic Anatomy & Relations
Video by About Medicine/YouTube
Peritoneum tutorial
Video by The Noted Anatomist/YouTube
Tracing the peritoneum in sections - simplified
Video by Human Anatomy Education/YouTube
4.3 what makes understanding the peritoneum so difficult?
Video by Centre for Innovation - Leiden University/YouTube
4.4 The relation of the peritoneum to the gut
Video by Centre for Innovation - Leiden University/YouTube
4.1 Introduction the peritoneum
Video by Centre for Innovation - Leiden University/YouTube
8:28
Peritoneal Cavity - Part 1 - Anatomy Tutorial
AnatomyZone/YouTube
The Peritoneum
CNX Openstax
General Distribution of the Peritoneum
Dennis M DePace, PhD/Wikimedia
Mesentery
Anatomist90
Mesentery
Henry Vandyke Carter
Mesentery - structure of the gut wall
Auawise at English Wikipedia
Peritoneal Cavity
Dr. Johannes Sobotta
5:10
Peritoneum - 3D Schematic Anatomy & Relations
About Medicine/YouTube
24:42
Peritoneum tutorial
The Noted Anatomist/YouTube
32:05
Tracing the peritoneum in sections - simplified
Human Anatomy Education/YouTube
4:46
4.3 what makes understanding the peritoneum so difficult?
Centre for Innovation - Leiden University/YouTube
6:20
4.4 The relation of the peritoneum to the gut
Centre for Innovation - Leiden University/YouTube
2:53
4.1 Introduction the peritoneum
Centre for Innovation - Leiden University/YouTube
Structure of an Ovary
Female Reproductive organs, Ovulation and Uterus, Ovary, Fallopian Tube, Cervix
Image by TheVisualMD
Female Reproductive organs, Ovulation and Uterus, Ovary, Fallopian Tube, Cervix
Female Reproductive organs, Ovulation and Uterus, Ovary, Fallopian Tube, Cervix
Image by TheVisualMD
Structure of an Ovary
The primary female reproductive organs, or gonads, are the two ovaries. Each ovary is a solid, ovoid structure about the size and shape of an almond, about 3.5 cm in length, 2 cm wide, and 1 cm thick. The ovaries are located in shallow depressions, called ovarian fossae, one on each side of the uterus, in the lateral walls of the pelvic cavity. They are held loosely in place by peritoneal ligaments.
The ovaries are covered on the outside by a layer of simple cuboidal epithelium called germinal (ovarian) epithelium. This is actually the visceral peritoneum that envelops the ovaries. Underneath this layer is a dense connective tissue capsule, the tunica albuginea. The substance of the ovaries is distinctly divided into an outer cortex and an inner medulla. The cortex appears more dense and granular due to the presence of numerous ovarian follicles in various stages of development. Each of the follicles contains an oocyte, a female germ cell. The medulla is a loose connective tissue with abundant blood vessels, lymphatic vessels, and nerve fibers.
Source: National Cancer Institute (NCI)
Additional Materials (29)
Clinical Reproductive Anatomy - Ovary and Fallopian Tubes - 3D Anatomy Tutorial
Video by AnatomyZone/YouTube
Anatomy and physiology of the female reproductive system
Video by Osmosis/YouTube
Anatomy of the internal structures of the ovary
Anatomy of the internal structures of the ovary
Image by Rosa Elemil Martínez
Sensitive content
This media may include sensitive content
Ooctye Erupting from Ovary
Visualization of an oocyte erupting from the surface of the ovary. The ovary, which is suspended by the ovarian ligament, is seen in cross section. Revealed are the ovarian follicles which are oocytes in various stages of maturation. Each month, one of the mature follicles ejects it's oocyte through the surface of the ovary. This event is called ovulation. The finger-like projections of the fallopian tube sweep up the oocyte into the duct where it awaits fertilization. Meanwhile, the remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum which eventually degenerates if fertilization does not occur. If fertilized, however, the egg secretes the a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.
Image by TheVisualMD
Fallopian Tube and Ovary
Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans.
Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.
Image by TheVisualMD
Ovary and Fallopian Tube
Visualization of ovary and fallopian tube based on real human data. The ovaries produce female gametes, the eggs, and hormones such as estrogen and progesterone. The fallopian tubes form the first part of the female duct system. During ovulation, the egg is released from a follicle at the surface of the ovary and finger-like projections of the fallopian tube, fimbrae, sweep it into the uterine tube where it awaits fertilization.
Image by TheVisualMD
Fallopian Tube and Ovary
Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.
Image by TheVisualMD
Ovary
Menstrual cycle - order of changes in ovary
Image by Shazz
Human Reproductive Anatomy and Gametogenesis
Oocytes develop in (a) follicles, located in the ovary. At the beginning of the menstrual cycle, the follicle matures. At ovulation, the follicle ruptures, releasing the egg. The follicle becomes a corpus luteum, which eventually degenerates. The (b) follicle in this light micrograph has an oocyte at its center. (credit a: modification of work by NIH; scale-bar data from Matt Russell)
Image by CNX Openstax
Fallopian Tube and Ovary - Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.
Fallopian Tube and Ovary: Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.
Image by TheVisualMD
Ovary and Fallopian Tube
Illustration of ovary and fallopian tube. The major female sex hormones, estrogen and progesterone are produced in the corpora lutea of the ovaries. Estrogen plays a major role in the maintenance of the reproductive organs and the development of secondary sex characteristics. Progesterone plays a role in preparing and maintaining the uterus which supports the development of the embryo.
Image by TheVisualMD
Follicle-stimulating hormone
Follicle-stimulating hormone
Image by MartaFF
Sites of tubo ovarian abscess
This image contains parts or fractions of this image: File:Blausen 0732 PID-Sites.png. That image was cropped and re-labelled to create this image of the ovary and fallopian tube
Image by Bfpage
Anatomy of the internal structures of the ovary
Anatomy of the internal structures of the ovary
Image by Kimanh Nguyen
Ovarian Cycle Showing Oocyte and Matured Follicle
Visualization of the ovarian cycle. The ovarian cycle is a process by which an oocyte matures, erupts from the follicle and travels down the fallopian tube to the uterus. What is left of the follicle becomes a structure known as the corpus luteum. At the top of this image are oocytes and below them are primary follicles containing oocytes. As the follicle matures, the surrounding cells proliferate forming a multi-layered coat of granulosa cells. The granulosa cells are surrounded by thecal cells. The antrum, a cresent-shaped cavity filled with follicular fluid, develops within the maturing follicle. Once the follicle becomes fully mature, the ovum is discharged from the ovary, enters the fallopian tube and travels toward the uterus to awaits fertilization. The remaining follicle transforms into the corpus luteum which secretes hormones estrogen and progeterone. If fertilization does not occur, the corpus luteum degenerates. If fertilized, however, the egg secretes the human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby allowing the development and maintainance of the thick uterine lining of the womb.
Image by TheVisualMD
Human Pregnancy and Birth
In humans, fertilization occurs soon after the oocyte leaves the ovary. Implantation occurs eight or nine days later.(credit: Ed Uthman)
Image by CNX Openstax (credit: Ed Uthman)
Ovary, cross section of fallopian tube and fimbriae
Ovary, cross section of fallopian tube and fimbriae
Image by TheVisualMD
Medical animation still showing passage of oocyte from ovary to the uterus.
3D medical animation still showing passage of oocyte from ovary to the uterus.
Image by Scientific Animations, Inc.
Fertilization
Image by Zappys Technology Solutions
Comparison of Male and Female Embryonic Urogenital Organ
Medical visualization comparing the development of male and female urogenital organs during the 8th week. At left is the developing Mullerian duct and ovary of the female; at right is the developing Wolffian duct and testicle of the male. At 5 weeks of development, all fetuses have two undifferentiated sets of ducts: the Mullerian ducts and the Wolffian ducts. After 5 weeks, differentiation begins as the sex-determining region Y (SRY) gene on the Y chromosome signals testicle development in the male fetus. As the testicles form, they start producing anti-Mullerian hormone (AMH) and testosterone. As a result, the Mullerian ducts degenerate and the Wolffian ducts are stimulated to grow into the epididymis, vasa deferentia, and seminal vesicles. Since the female fetus lacks SRY, and consequently, AMH and testosterone, ovaries will form instead of testicles, and the Mullerian ducts will grow into the uterus, fallopian tubes, and cervix, and the Wolffian ducts will degenerate.
Image by TheVisualMD
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
Image by TheVisualMD
Female Reproductive Organ Revealing Urethra
Three-dimensional visualization reconstructed from scanned human data. Lateral view of cross-section through the female reproductive organs revealing the urethra. Women are more susceptible to urinary tract infections (UTIs) due to a shorter urethra. UTIs are caused by growth of bacteria in the bladder, urethra, colon, or other parts of the gastrointestinal tract.
Image by TheVisualMD
Female Reproductive System
Computer generated image reconstructed from scanned human data. This image presents a left-frontal view of the primary organs of the human female reproductive system. Within the center of the image is the uterus, the site in which the fertilized egg will implant and undergo embryonic development. The two highlighted yellow regions on the left and right sides of the uterus are the ovaries, which contain the female sex cells, the oocytes. The oocytes are discharged from the follicles of the ovaries and swept into the fallopian tubes, the pale pink tube-like structures connecting the ovaries to the uterus. When fertilization occurs, the fertilized egg implants itself to the wall of uterus where embryonic development can begin.
Image by TheVisualMD
Female Reproductive Organ
Computer generated image reconstructed from scanned human data. This image presents a frontal view of primary components of the human female reproductive system. In the center is the uterus, an oval-shaped structure, highlighted in purple. The uterus opens into the vagina, indicated as the light brownish-purple structure extending from below the uterus. The two highlighted yellow regions on the left and right sides of the uterus are the ovaries containing eggs, or oocytes, the female sex cells. The oocytes are released from the ovaries and travel through the fallopian tubes, the pink tube-like structures observed in this image. When fertilization occurs, the fertilized egg will implant itself to the wall of uterus where embryonic development can begin. If fertilization does not occur, menstruation ensues.
Image by TheVisualMD
Female Reproductive Organ
Computer generated image reconstructed from scanned human data. This image presents a left-frontal view of the primary organs of the human female reproductive system. Within the center of the image is the uterus, the site in which the fertilized egg will implant and undergo embryonic development. The two highlighted yellow regions on the left and right sides of the uterus are the ovaries, which contain the female sex cells, the oocytes. The oocytes are discharged from the follicles of the ovaries and swept into the fallopian tubes, the pale pink tube-like structures connecting the ovaries to the uterus. When fertilization occurs, the fertilized egg implants itself to the wall of uterus where embryonic development can begin.
Image by TheVisualMD
Female Pelvis Showing Reproductive Organ
3D visualization of the external and internal reproductive organs in a female reconstructed from scanned human data. The female reproductive system plays a more complex role than that of a male since it must produce gametes as well as prepare to house and nurture an embryo during its development. Revealed are the ovaries and the accessory ducts of the internal genitalia: the fallopian tubes, the uterus, the cervix and vagina. The external structures such as the labium minus and labium majus are also visible.
Image by TheVisualMD
Female Reproductive System
Female Reproductive System
Image by CFCF
5:48
Clinical Reproductive Anatomy - Ovary and Fallopian Tubes - 3D Anatomy Tutorial
AnatomyZone/YouTube
13:55
Anatomy and physiology of the female reproductive system
Fallopian Tube and Ovary - Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.
TheVisualMD
Ovary and Fallopian Tube
TheVisualMD
Follicle-stimulating hormone
MartaFF
Sites of tubo ovarian abscess
Bfpage
Anatomy of the internal structures of the ovary
Kimanh Nguyen
Ovarian Cycle Showing Oocyte and Matured Follicle
TheVisualMD
Human Pregnancy and Birth
CNX Openstax (credit: Ed Uthman)
Ovary, cross section of fallopian tube and fimbriae
TheVisualMD
Medical animation still showing passage of oocyte from ovary to the uterus.
Scientific Animations, Inc.
Fertilization
Zappys Technology Solutions
Comparison of Male and Female Embryonic Urogenital Organ
TheVisualMD
Early Pregnancy Uterus, fallopian tube, and cross section of ovary
TheVisualMD
Female Reproductive Organ Revealing Urethra
TheVisualMD
Female Reproductive System
TheVisualMD
Female Reproductive Organ
TheVisualMD
Female Reproductive Organ
TheVisualMD
Female Pelvis Showing Reproductive Organ
TheVisualMD
Female Reproductive System
CFCF
Ovaries
Cross Section Uterus and Ovary, Fallopian Tube, Fimbria
Image by TheVisualMD
Cross Section Uterus and Ovary, Fallopian Tube, Fimbria
Cross Section Uterus and Ovary, Fallopian Tube, Fimbria
Image by TheVisualMD
Ovaries
The ovaries are the female gonads. Paired ovals, they are each about 2 to 3 cm in length, about the size of an almond. The ovaries are located within the pelvic cavity, and are supported by the mesovarium, an extension of the peritoneum that connects the ovaries to the broad ligament. Extending from the mesovarium itself is the suspensory ligament that contains the ovarian blood and lymph vessels. Finally, the ovary itself is attached to the uterus via the ovarian ligament.
The ovary comprises an outer covering of cuboidal epithelium called the ovarian surface epithelium that is superficial to a dense connective tissue covering called the tunica albuginea. Beneath the tunica albuginea is the cortex, or outer portion, of the organ. The cortex is composed of a tissue framework called the ovarian stroma that forms the bulk of the adult ovary. Oocytes develop within the outer layer of this stroma, each surrounded by supporting cells. This grouping of an oocyte and its supporting cells is called a follicle. The growth and development of ovarian follicles will be described shortly. Beneath the cortex lies the inner ovarian medulla, the site of blood vessels, lymph vessels, and the nerves of the ovary. You will learn more about the overall anatomy of the female reproductive system at the end of this section.
Female Reproductive System
The major organs of the female reproductive system are located inside the pelvic cavity.
Source: CNX OpenStax
Additional Materials (13)
The female pelvic organs. Bladder, vagina, uterus, fallopian tube, ovaries
Video by 3D Anatomy Lyon/YouTube
Anatomy of the Uterus | Ovaries | 3D Anatomy Tutorial
Video by Geeky Medics/YouTube
This browser does not support the video element.
Female Reproductive System Showing Ovulation
Close up shot of a still image of the female pelvis and the reproductive system. There is a sagital cross-section view of the uterus and bladder. The right ovary and fallopian tube is not crossed sectioned. Camera zooms in on the right ovary and the surface dissolves away to show a cross-section. Within the cross-section is the development of an ovarian follicle from day 4 up to day 14, when follicle ruptures and releases the ovum into the fallopian tube.
Video by TheVisualMD
Fallopian Tube and Ovary
Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Ooctye Erupting from Ovary
Visualization of an oocyte erupting from the surface of the ovary. The ovary, which is suspended by the ovarian ligament, is seen in cross section. Revealed are the ovarian follicles which are oocytes in various stages of maturation. Each month, one of the mature follicles ejects it's oocyte through the surface of the ovary. This event is called ovulation. The finger-like projections of the fallopian tube sweep up the oocyte into the duct where it awaits fertilization. Meanwhile, the remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum which eventually degenerates if fertilization does not occur. If fertilized, however, the egg secretes the a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb.
Image by TheVisualMD
Follicle-stimulating hormone
Follicle-stimulating hormone
Image by MartaFF
Fallopian Tube and Ovary
Medical visualization of a cross-section of the ovary, as well as the associated fallopian tube; seen inside the cross-section are a developing follicle, corpus luteum, and corpus albicans. The ovaries are the site of egg production and maturation within the human female. Each month, an oocyte is ejected from a mature follicle to the surface of one of the two ovaries. This event is called ovulation. The finger-like projections of the fallopian tube (fimbriae) sweep up the oocyte into the duct where it awaits fertilization. The remains of the ruptured follicle in the ovary are transformed into a structure called the corpus luteum. Upon fertilization, the egg secretes a hormone called human chorionic gonadotropin (HCG) which signals the corpus luteum to continue progesterone secretion, thereby maintaining the thick uterine lining of the womb. If fertilization does not occur, the corpus luteum degenerates into a corpus albicans, which is essentially scar tissue and is mostly comprised of collagen.
Image by TheVisualMD
Ovary and Fallopian Tube
Illustration of ovary and fallopian tube. The major female sex hormones, estrogen and progesterone are produced in the corpora lutea of the ovaries. Estrogen plays a major role in the maintenance of the reproductive organs and the development of secondary sex characteristics. Progesterone plays a role in preparing and maintaining the uterus which supports the development of the embryo.
Image by TheVisualMD
Medical animation still showing passage of oocyte from ovary to the uterus.
3D medical animation still showing passage of oocyte from ovary to the uterus.
Image by Scientific Animations, Inc.
Khan Academy - Anatomy of the Female Reproductive System
Clinical Reproductive Anatomy - Ovary and Fallopian Tubes - 3D Anatomy Tutorial
AnatomyZone/YouTube
4:45
Female Reproductive Anatomy
Handwritten Tutorials/YouTube
Risk Factors
Break the Cycle and Peel the Layers of Fat Off 1
Break the Cycle and Peel the Layers of Fat Off 2
Break the Cycle and Peel the Layers of Fat Off 3
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Break the Cycle and Peel the Layers of Fat Off
Interactive by TheVisualMD
Break the Cycle and Peel the Layers of Fat Off 1
Break the Cycle and Peel the Layers of Fat Off 2
Break the Cycle and Peel the Layers of Fat Off 3
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Break the Cycle and Peel the Layers of Fat Off
Break the Cycle and Peel the Layers of Fat Off
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Who Is at Risk for Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer?
Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer form in the same type of tissue and are treated the same way.
Women who have a family history of ovarian cancer are at an increased risk of ovarian cancer.
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for ovarian cancer.
Risk factors for ovarian cancer include the following:
Family history of ovarian cancer in a first-degree relative (mother, daughter, or sister).
Inherited changes in the BRCA1 or BRCA2 genes.
Other hereditary conditions, such as hereditary nonpolyposis colorectal cancer (HNPCC; also called Lynch syndrome).
Endometriosis.
Postmenopausal hormone therapy.
Obesity.
Tall height.
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
Some ovarian, fallopian tube, and primary peritoneal cancers are caused by inherited gene mutations (changes).
The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary ovarian cancer makes up about 20% of all cases of ovarian cancer. There are three hereditary patterns: ovarian cancer alone, ovarian and breast cancers, and ovarian and colon cancers.
Fallopian tube cancer and peritoneal cancer may also be caused by certain inherited gene mutations.
There are tests that can detect gene mutations. These genetic tests are sometimes done for members of families with a high risk of cancer.
Women with an increased risk of ovarian cancer may consider surgery to lessen the risk.
Some women who have an increased risk of ovarian cancer may choose to have a risk-reducing oophorectomy (the removal of healthy ovaries so that cancer cannot grow in them). In high-risk women, this procedure has been shown to greatly decrease the risk of ovarian cancer.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (8)
Sterilization can cut the risk of ovarian cancer, but that doesn’t mean it’s an easy decision
Are your ovaries and uterine tubes friends or foes? Most ovarian cancers actually originate in the uterine tubes. A simple salpingectomy, or removal of the tubes, can reduce your risk of ovarian cancer by 60%.
Image by StoryMD
Cross Section of Thin Female / Cross Section of Obese Female Body
Cross-Section Thin vs Obese Female Body
If you have overweight or obesity, your risk for many health problems is higher than that of women who are at a normal weight. Even a small amount of weight loss can lower your risk for or even prevent health problems like diabetes and heart disease.
Interactive by TheVisualMD
Ovarian cancer by age group
Ovarian cancer cases diagnosed by age group. From SEER
Image by Keilana/Wikimedia
Visceral Fat of a thin person / Visceral fat of a obese person
Visceral Fat of a thin person / Visceral fat of a obese person
1) Visceral Fat of a thin person
1) Visceral fat of a obese person
Interactive by TheVisualMD
Ovarian Cancer: Risk Factors, Prevention and Early Detection Video – Brigham and Women’s Hospital
Video by Brigham And Women's Hospital/YouTube
Chemotherapy
Variety of chemotherapy drugs in vials and an IV bottle.
Image by Bill Branson (Photographer)
Ovarian cancers by histopathology
Classification of primary ovarian cancers in women aged 20+, with area representing histopathological type, and colors representing 5-year relative survival rate.
Image by Mikael Häggström/Wikimedia
Ovarian tumors by incidence and cancer risk
Ovarian tumors by incidence and risk of ovarian cancer. Reference:
(2014). "Spectrum of ovarian tumors in a referral hospital in Nepal". Journal of Pathology of Nepal 4 (7): 539–543. DOI:10.3126/jpn.v4i7.10295. ISSN 2091-0908.
Minor adjustment for mature cystic teratomas (0.17 to 2% risk of ovarian cancer): (2012). "Malignant Transformation in a Mature Teratoma with Metastatic Deposits in the Omentum: A Case Report". Case Reports in Pathology 2012: 1–3. DOI:10.1155/2012/568062. ISSN 2090-6781.It does not include metastases to the ovary, which constitute about 5-30% of ovarian cancers:
Lee SJ, Bae JH, Lee AW, Tong SY, Park YG, Park JS (2009). "Clinical characteristics of metastatic tumors to the ovaries.". J Korean Med Sci 24 (1): 114-9. DOI:10.3346/jkms.2009.24.1.114. PMID 19270823. PMC: 2650975.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
Sterilization can cut the risk of ovarian cancer, but that doesn’t mean it’s an easy decision
StoryMD
Cross-Section Thin vs Obese Female Body
TheVisualMD
Ovarian cancer by age group
Keilana/Wikimedia
Visceral Fat of a thin person / Visceral fat of a obese person
TheVisualMD
5:51
Ovarian Cancer: Risk Factors, Prevention and Early Detection Video – Brigham and Women’s Hospital
Brigham And Women's Hospital/YouTube
Chemotherapy
Bill Branson (Photographer)
Ovarian cancers by histopathology
Mikael Häggström/Wikimedia
Ovarian tumors by incidence and cancer risk
Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
BRCA Genetic Test
BRCA Genetic Test
Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing, BRCA1 Genetic Test
A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.
BRCA Genetic Test
Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing, BRCA1 Genetic Test
A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
Related conditions
A BRCA gene test uses a sample of your blood, saliva (spit), or cells from inside of your cheek to look for changes in your BRCA1 and BRCA2 genes that may increase your risk of cancer. Changes in your genes are called gene variants or mutations. Not all gene variants are harmful.
Genes are parts of DNA that you inherit from your parents. They carry information that controls what you look like and how your body works. BRCA genes repair damaged DNA in your cells and protect you from getting certain types of cancer. If you have a harmful variant in your BRCA genes, they may not work properly. This increases your risk of getting cancer.
The most common cancers linked to harmful BRCA variants are:
Breast cancer. BRCA is short for breast cancer gene. The increased risk for breast cancer mostly affects females. But the breast cancer risk for males who have a harmful BRCA variant is higher than for other males.
Ovarian cancer. This is cancer of the female reproductive glands where eggs form.
Prostate cancer. This is cancer of the male reproductive gland that makes fluid for semen.
Pancreatic cancer. This is cancer of the pancreas, an organ that helps you digest food and makes important hormones.
Not everyone who has a harmful variant in BRCA1 or BRCA2 will get cancer. And if you find out you have a harmful variant, you may be able to take steps to lower your risk and protect your health.
This test is used to find out if you have harmful changes in your BRCA1 or BRCA2 genes that increase your risk of getting certain cancers, especially breast, ovarian, prostate, and pancreatic cancer.
Harmful BRCA gene variants are rare. They affect only about 0.2 percent of the U.S. population. So, BRCA testing is not recommended for most people.
You and your family members are more likely to have a BRCA1 or BRCA2 variant if either side of your family has a strong history of breast or ovarian cancer. If you're concerned that you may have a harmful variant in the BRCA1 or BRCA2 gene, your health care provider or a genetic counselor can review your personal and family health history to see if you need this test.
In general, it's important to talk with a provider about BRCA testing if your personal or family health history includes:
Breast cancer, especially:
Before age 50
In both breasts
In a male
Triple negative breast cancer which has limited treatment options, including chemotherapy and/or surgery
Cancer of the ovaries, fallopian tubes (tubes connecting the ovaries to the uterus), or peritoneum (tissue that covers your belly organs).
Prostate cancer that spreads to other parts of the body (metastatic cancer).
Pancreatic cancer.
Ashkenazi (Eastern European) Jewish ancestry. BRCA variants are much more common in this group compared with the general population. They are also more common in people from other parts of Europe, including Iceland, Norway, and Denmark.
A relative already diagnosed with a harmful gene variant in BRCA1 or BRCA2.
When you think about your family health history, consider all breast, ovarian, prostate, and pancreatic cancers on both sides of your family. And consider the health of your grandparents, parents, aunts and uncles, siblings, half-siblings, nieces and nephews, and grandchildren.
A BRCA test can use either a sample of your blood, saliva, or a cheek swab.
For a blood test: A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a saliva test: You'll spit into a container or use a cotton pad to soak up some saliva.
For a cheek swab: A health care professional will wipe the inside of your cheek with a small tool to remove some cells. You may have the option of doing it yourself.
An at-home test kit is available to buy without a prescription. It allows you to collect a saliva sample to send to a lab for testing. The test checks for the three most common harmful variants in BRCA genes. But there are more than 1000 known variants. So, a home test can't rule out the possibility that you have a variant. Ask your provider whether an at-home test is right for you.
For a blood test: You don't need any special preparations.
For a saliva test: A half hour before the test, you may need to stop eating, drinking, or smoking. Follow all the instructions your provider gives you or the instructions in an at-home kit.
For a cheek swab: You may be asked to rinse your mouth before the test.
With any type of genetic test, you may want to meet with a genetic counselor first to see if testing is right for you. Your counselor can explain the pros and cons of learning more about your cancer risk. After your test, a counselor can help with the medical and emotional impact that your results may have on you and your family.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There are no risks linked to providing a saliva sample or having a cheek swab.
Your provider or genetic counselor will need to explain how your results affect your risk for certain cancers. That's because the meaning of your test results depends on the exact type of variant you have and your personal and family health history.
In general, your results may be reported using these terms:
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
An uncertain result may also be called a "variant of uncertain significance (VUS)". It means that a variant in your BRCA genes was found, but researchers don't know whether that variant causes cancer.
A positive result may also be called a "likely pathogenic variant." It means that you have a harmful gene variant that is known to increase the risk of certain cancers. But the test cannot tell whether you will develop cancer.
If your results show that you have a harmful variant in your BRCA genes, talk with your provider about ways to lower your cancer risk. You may discuss:
Your schedule for cancer screening tests. Should you get tested for cancer sooner and more often than usual? These are important questions for all adults who have a harmful BRCA variant.
Taking certain medicines and/or having surgery to reduce the risk of cancer. Surgery may include removing both breasts and/or the ovaries and fallopian tubes.
BRCA Genetic Test: MedlinePlus Medical Test [accessed on Dec 26, 2023]
BRCA Mutations: Cancer Risk and Genetic Testing Fact Sheet - National Cancer Institute [accessed on Dec 26, 2023]
BRCAssure BRCA1 and 2 Analysis [accessed on Dec 26, 2023]
BRCA Gene Mutation Testing - Testing.com. Nov 9, 2021 [accessed on Dec 26, 2023]
BRCA1 and BRCA2 gene testing: MedlinePlus Medical Encyclopedia [accessed on Dec 26, 2023]
Additional Materials (13)
Chances of Developing Breast Cancer by Age 70
Specific inherited mutations in the BRCA1 and BRCA2 genes increase the risk of breast and ovarian cancers.
Image by National Cancer Institute (NCI)
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BRCA-1 and BRCA-2 Genes, Breast Examination
Mammograms use low-dose X-rays to create images of the breast on film. Screening mammograms typically image the breast from above and from an angled side view. Yearly mammograms are recommended for women 40 and over. Women at high risk should have an MRI scan and a mammogram every year, beginning at age 30. Mammograms can also be used for diagnosis of cancer and to guide biopsy of suspicious lesions. The National Cancer Institute estimates that women with certain mutations in the BRCA1 and BRCA2 genes have a 60% lifetime risk of breast cancer, which is five times higher than the general population. Only 0.2% of women have these specific mutations. Women who test negative for high-risk mutations in the BRCA1 and BRCA2 genes still have a 12% lifetime risk of breast cancer and a 1.4% lifetime risk of ovarian cancer, which means the most of these cancers are caused by factors other than BRCA genes.
Image by TheVisualMD
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Breast Self-Exam (BSE)
When done correctly and regularly, breast self-exam (BSE) can help save lives. Women who perform BSE are more likely to be diagnosed with smaller tumors, and cancer is less likely to have spread to their underarm lymph nodes. An important part of BSE is self-awareness. Women should be aware of what their breasts normally feel and look like so that they notice any change, and they should bring that change to the attention of their doctor immediately.
Image by TheVisualMD
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BRCA: Breasts
In the 1990s, researchers discovered that certain inherited mutations of the genes increased a woman's risk of developing breast or ovarian cancer. But genes are not destiny; early detection, preventive surgery and drug therapies can also play roles.
Image by TheVisualMD
What is a BRCA Gene Mutation?
Video by Centers for Disease Control and Prevention (CDC)/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by JAMA Network/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by TheJAMAReport/YouTube
BRCA Genes and Breast Cancer
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Understanding BRCA Mutations and Risk
Video by Dr. Susan Love Foundation/YouTube
BRCA Genes
The BRCA genes are tumor suppressor genes pictured here on their respective chromosomes. BRCA 1 has the cytogenetic location 17q21 or the q arm of Chromosome 17 at position 21. BRCA 2 has the cytogenetic location 13q12.3 or the q arm of Chromosome 13 at position 12.3. Both genes produce proteins that help repair damaged DNA, keeping the genetic material of the cell stable. A damaged BRCA gene in either location can lead to increased risk of cancer, particularly breast or ovarian in women.
Image by Tessssa13/Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
More than 225,000 cases of invasive breast cancer are diagnosed annually in the U.S. and 40,000 die from the disease. In recent years, however, great strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests such as those for the BRCA1 and BRCA2 genes have been devised to identify increased familial risk of breast cancer. The majority of breast cancers start in the mammary ducts; most of the remainder arise in the lobules. Breast cancers are divided into in situ and invasive cancers. In situ cancers remain confined to the duct or gland where they began. Invasive cancers break through the walls of the duct or gland and penetrate into the surrounding tissue.
Image by TheVisualMD
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to increase a person's chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.
Image by YassineMrabet / NIH
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
The breast cancer susceptibility genes BRCA-1 and BRCA-2 normally help prevent cancer by repairing damaged DNA. Certain inherited mutations in these genes, however, can impair this function and result in a greatly increased risk of breast cancer or ovarian cancer (there are hundreds of different BRCA mutations, but are very rare or not linked with an increased risk of cancer). Of 200,000 women diagnosed each year with breast cancer and 20,000 diagnosed with ovarian cancer, 5-10% are due to BRCA mutations.
Image by TheVisualMD
Chances of Developing Breast Cancer by Age 70
National Cancer Institute (NCI)
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BRCA-1 and BRCA-2 Genes, Breast Examination
TheVisualMD
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Breast Self-Exam (BSE)
TheVisualMD
Sensitive content
This media may include sensitive content
BRCA: Breasts
TheVisualMD
1:28
What is a BRCA Gene Mutation?
Centers for Disease Control and Prevention (CDC)/YouTube
4:39
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
JAMA Network/YouTube
2:20
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
TheJAMAReport/YouTube
3:12
BRCA Genes and Breast Cancer
Centers for Disease Control and Prevention (CDC)/YouTube
3:52
Understanding BRCA Mutations and Risk
Dr. Susan Love Foundation/YouTube
BRCA Genes
Tessssa13/Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
TheVisualMD
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
YassineMrabet / NIH
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
TheVisualMD
Symptoms
Pelvic Pain
Image by TheVisualMD
Pelvic Pain
Pelvic Pain
Image by TheVisualMD
What Are the Signs and Symptoms of Ovarian, Fallopian Tube, or Peritoneal Cancer?
Signs and symptoms of ovarian, fallopian tube, or peritoneal cancer include pain or swelling in the abdomen.
Ovarian, fallopian tube, or peritoneal cancer may not cause early signs or symptoms. When signs or symptoms do appear, the cancer is often advanced. Signs and symptoms may include the following:
Pain, swelling, or a feeling of pressure in the abdomen or pelvis.
Sudden or frequent urge to urinate.
Trouble eating or feeling full.
A lump in the pelvic area.
Gastrointestinal problems, such as gas, bloating, or constipation.
These signs and symptoms also may be caused by other conditions and not by ovarian, fallopian tube, or peritoneal cancer. If the signs or symptoms get worse or do not go away on their own, check with your doctor so that any problem can be diagnosed and treated as early as possible.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (2)
What Are the Warning Signs of Ovarian Cancer?
Video by Roswell Park Comprehensive Cancer Center/YouTube
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Female Breast with Cancer
Computer generated image of a female breast with breast cancer. The sagittal cross-section reveals the cancerous cells within the breast tissue and mammary glands.
Image by TheVisualMD
2:20
What Are the Warning Signs of Ovarian Cancer?
Roswell Park Comprehensive Cancer Center/YouTube
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Female Breast with Cancer
TheVisualMD
Diagnosis
Ovarian Squamous Carcinoma Tumor
Image by Yan Luo and Ce Bian/Wikimedia
Ovarian Squamous Carcinoma Tumor
Abdominal CT shows a 7.1 × 4.3 × 5.4 cm septal cystic, solid mass was detected on the left adnexal, and the solid components were enhanced.
Image by Yan Luo and Ce Bian/Wikimedia
How Are Ovarian, Fallopian Tube, and Peritoneal Cancer Diagnosed?
Tests that examine the ovaries and pelvic area are used to diagnose and stage ovarian, fallopian tube, and peritoneal cancer.
The following tests and procedures may be used to diagnose and stage ovarian, fallopian tube, and peritoneal cancer:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.
CA 125 assay: A test that measures the level of CA 125 in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA 125 level can be a sign of cancer or another condition such as endometriosis.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the abdomen, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.Abdominal ultrasound. An ultrasound transducer connected to a computer is passed over the surface of the abdomen. The ultrasound transducer bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).Some patients may have a transvaginal ultrasound.Transvaginal ultrasound. An ultrasound probe connected to a computer is inserted into the vagina and is gently moved to show different organs. The probe bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A very small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue is usually removed during surgery to remove the tumor.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (6)
Uterus and Ovaries in Ultrasound
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
CA-125: Ovaries and Uterus
The cancer antigen 125 test (CA-125) is used to monitor treatment for ovarian cancer. If blood levels of CA-125 fall during treatment, it usually means the cancer is responding; if levels rise after treatment is complete, it may indicate that the cancer has returned.
Image by TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
As our understanding of cancer has deepened and treatment options expanded, the emphasis has shifted to early detection and aggressive treatment. The hope is that earlier and more accurate diagnoses will push survival rates for ovarian cancer higher.
Image by TheVisualMD
CA-125 Molecule
The cancer antigen 125 test (CA-125) measures blood levels of CA-125, a protein elevated in about 80% of women with ovarian cancer. CA-125 is also produced by normal tissues throughout the body, however, and blood levels may be elevated with a variety of conditions, including pregnancy, menstruation, endometriosis, diverticulitis, uterine fibroids, pelvic inflammatory disease, hepatitis and cirrhosis of the liver. For this reason, the CA-125 test is not used as a general screening test for all women.
Image by TheVisualMD
Understanding CA-125 Screening for Ovarian Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
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Breast Cancer
Woman with Breast Tissue and Tumor Revealed through Skin: Nude figure of woman, right side view, with breast tissue revealed through transparent skin showing breast cancer in right breast, along with muscle tissue, adipose (fat) tissue, and skeletal system. In cancer, a cell's DNA has been damaged. The damaged cell starts to reproduce in an uncontrolled way, creating more abnormal cells. It outlives the normal cells around it and forms a tumor (a lump or mass).
Image by TheVisualMD
Uterus and Ovaries in Ultrasound
TheVisualMD
CA-125: Ovaries and Uterus
TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
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CA-125 Molecule
TheVisualMD
2:25
Understanding CA-125 Screening for Ovarian Cancer
Roswell Park Comprehensive Cancer Center/YouTube
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Breast Cancer
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Pelvic Exam
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
Pelvic Exam
Also called: Pelvic Examination, Gynecological Exam
A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
Related conditions
A pelvic exam is a physical exam of the vulva, vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. First, the vulva is checked for redness, swelling, sores, or other abnormalities. A speculum is then inserted into the vagina to widen it so the vagina and cervix can be checked for signs of disease. Cell samples may be taken for a Pap test or HPV test to screen for cervical cancer. The health care provider then inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand to feel for lumps and check the size, shape, and position of the uterus and ovaries. The rectum may also be checked for lumps or abnormal areas.
Pelvic Exam. NCI's Dictionary of Cancer Terms [accessed on Oct 03, 2021]
Pelvic Exam: Preparation, Process, and More. Healthline. [accessed on Oct 03, 2021]
What Is a Pelvic Exam? | Questions About Gynecology Exams. Planned Parenthood. [accessed on Jan 15, 2022]
Pelvic Exam | Michigan Medicine [accessed on Jan 15, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
A cervical screening test - What can you expect?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
How can I deal with the fear of getting a pelvic exam in the doctor's office?
Video by IntermountainMoms/YouTube
Dr. Doe's Pelvic Exam
Video by sexplanations/YouTube
Pelvic Exam Illustration
Line drawing showing pelvic exam procedure.
Image by National Cancer Institute / Unknown Illustrator
Pelvic Exam
Leopold maneuvers
Image by Christian Gerhard Leopold
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
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Healthy Cervix
The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Uterus and Ovaries in Ultrasound
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
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Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Women's Health Checkup
Doctors Examining Pregnant Woman
Image by Israel Defense Forces
2:13
A cervical screening test - What can you expect?
Healthchanneltv / cherishyourhealthtv/YouTube
2:21
How can I deal with the fear of getting a pelvic exam in the doctor's office?
IntermountainMoms/YouTube
5:45
Dr. Doe's Pelvic Exam
sexplanations/YouTube
Pelvic Exam Illustration
National Cancer Institute / Unknown Illustrator
Pelvic Exam
Christian Gerhard Leopold
Screening for Cancer
TheVisualMD
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Healthy Cervix
TheVisualMD
Uterus and Ovaries in Ultrasound
TheVisualMD
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Pap Test: Pap Smear (Pap Test)
TheVisualMD
Women's Health Checkup
Israel Defense Forces
Cancer Antigen 125 Test
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen, CA-125
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen, CA-125
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
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Use the slider below to see how your results affect your
health.
(i.U.)/mL
35
Your result is Normal.
Having a normal CA-125 result doesn't mean you don't have ovarian cancer. Some women with early ovarian cancer have a normal CA-125 level.
Related conditions
This test measures the amount of a protein called CA-125 (cancer antigen 125) in a sample of your blood. CA-125 is a type of tumor marker. High levels of certain tumor markers in your blood may be a sign of cancer. If you have cancer, measuring certain tumor markers may help provide important information about how to treat your disease.
High levels of CA-125 are often found in people who have ovarian cancer. The ovaries are a pair of female reproductive glands that store ova (eggs) and make female hormones. Ovarian cancer happens when the cells in an ovary begin to grow out of control.
If you have ovarian cancer, CA-125 blood tests can help show whether your treatment is working.
Other names: cancer antigen 125, glycoprotein antigen, ovarian cancer antigen, CA-125 tumor marker
A CA-125 blood test may be used:
To see if ovarian cancer treatment is working and to check for ovarian cancer that has come back. This is the most common use of CA-125 blood testing.
To learn more about a growth or lump in your pelvis (the area below your belly). If a suspicious lump shows up on imaging, such as an ultrasound, your health care provider may check your CA-125 levels along with other tests to find out whether the lump could be ovarian cancer. But a CA-125 blood test alone can't diagnose cancer.
To screen for ovarian cancer if you're risk is very high. If your family health history includes ovarian cancer, your provider may suggest a CA-125 blood test and other tests to look for signs of cancer. But a CA-125 test is not used as a routine screening test for people who don't have a high risk for ovarian cancer. That's because many common conditions that aren't cancer can also cause high CA-125 levels, such as endometriosis or even a menstrual period.
If you've been diagnosed with ovarian cancer, you may have several CA-125 blood tests:
During your treatment to see if your cancer is going away. If CA-125 levels go down, it usually means your treatment is working
After your treatment, to check whether your cancer has returned
If you have a lump in your pelvis that could be ovarian cancer, you may need a CA-125 test to help find out if it could be ovarian cancer. But only a biopsy can diagnose ovarian cancer.
If you have a very high risk of getting ovarian cancer, your health care provider may suggest checking your CA-125 levels. If they're high, you'll probably need more tests to find out if you have cancer. You're more likely to get ovarian cancer if you:
Have a mother or sister, or two or more other relatives who had ovarian cancer
Have family members who have had breast cancer or colorectal cancer (colon cancer)
Have inherited certain gene changes or conditions that increase your risk of ovarian cancer, such as:
Changes in your genes, including BRCA 1 or BRCA 2 genes
Lynch syndrome (also called hereditary non-polyposis colorectal cancer), an inherited disorder that increases the risk for many types of cancer
Have had breast, uterine (uterus), or colorectal cancer
If you're concerned about getting ovarian cancer, talk with your provider about your risk.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a CA-125 blood test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your provider will review your CA-125 test results along with other information about your condition. Together, you can discuss how your results affect your diagnosis, treatment, and need for more testing.
In general:
If you are being treated for ovarian cancer, and the results of several tests show that your CA-125 levels are going down, it usually means that the treatment is helping. If your levels go up or stay the same over time, it may mean that the treatment isn't working.
If you have finished your treatment for ovarian cancer and your CA-125 levels begin to increase over time, your cancer may be coming back.
If you have a high risk for ovarian cancer or have a suspicious pelvic lump, a high CA-125 levels could be a sign of cancer. Your provider will usually order more tests to make a diagnosis.
A high CA-125 level doesn't always mean cancer. Other conditions may increase CA-125, including:
Endometriosis
Pelvic inflammatory disease (PID)
Uterine fibroids
Liver disease
Pregnancy
Your menstrual period, at certain times during your cycle
A normal CA-125 test result doesn't rule out ovarian cancer. That's because CA-125 levels may be low in the early stages of cancer. And not everyone with ovarian cancer makes high levels of CA-125.
Talk with your provider if you have questions about your results.
The most common type of ovarian cancer is epithelial ovarian cancer. If you have been treated for this type of cancer, you may be tested for a tumor marker called HE4 along with CA-125. Some studies show that measuring both tumor markers provides more accurate information to check whether treatment is working and to look for the return of this type of cancer.
CA 125 Blood Test (Ovarian Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Ovarian Cancer
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths. A particular blood protein called cancer antigen 125 (CA-125) is often elevated in women with ovarian cancer, though small amounts of CA-125 are produced by normal tissues throughout the body and levels of CA-125 can be elevated by other conditions. The CA-125 test is used primarily to monitor the effectiveness of treatment for ovarian cancer. There are three different kinds of ovarian cancer: the most common type is epithelial ovarian cancer (90%) which originates from the surface epithelium of the ovary and is more likely to affect older women; germ cell ovarian cancer (5%), which originates from the cells that produce eggs and is more likely to affect younger women; and stromal ovarian cancer (5%), which originates from the connective tissue within the ovary. After age, the most important risk factor for ovarian cancer is family history. Ovarian cancer is relatively uncommon, but is the fifth leading cause of cancer death in women, partly due to diagnosis difficulty; its symptoms are vague, and ovarian cancer can shed cells that can invade other internal organs long before the presence of disease is even suspected.
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CA-125: Ovaries and Uterus
The cancer antigen 125 test (CA-125) is used to monitor treatment for ovarian cancer. If blood levels of CA-125 fall during treatment, it usually means the cancer is responding; if levels rise after treatment is complete, it may indicate that the cancer has returned.
Image by TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
As our understanding of cancer has deepened and treatment options expanded, the emphasis has shifted to early detection and aggressive treatment. The hope is that earlier and more accurate diagnoses will push survival rates for ovarian cancer higher.
Image by TheVisualMD
Ovarian Cancer Fact Sheet
Ovarian cancer is cancer that begins in the ovaries.
The ovaries make female hormones and produce a
woman’s eggs. Ovarian cancer is a serious cancer that
is more common in older women. Treatment is most
effective when the cancer is found early.
Document by Office on Women's Health, U.S. Department of Health and Human Services
Ovarian Cancer: Symptoms and Treatment
Video by MainMD/YouTube
Premature Ovarian Aging and Early Menopause
Video by Center for Human Reproduction/YouTube
Ovarian cancer: beyond resistance
Video by nature video/YouTube
Ovarian Cancer
TheVisualMD
CA-125: Ovaries and Uterus
TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
TheVisualMD
Ovarian Cancer Fact Sheet
Office on Women's Health, U.S. Department of Health and Human Services
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
A female pelvic ultrasound is a test that uses an ultrasound machine to examine the organs and tissues inside your pelvis, including your cervix, fallopian tubes, ovaries, uterus, vagina, and bladder.
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
Abnormalities in the structure of the ovaries
Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
Ectopic pregnancy (pregnancy that occurs outside of the uterus)
Abnormal bleeding or pelvic pain
Postmenopausal bleeding
Find an intrauterine contraceptive device (IUD)
As part of the work-up for infertility and assisted reproduction techniques
There are two ways to perform a female pelvic ultrasound, which are transabdominal (external, through the abdominal wall) and transvaginal (internal, through the vagina).
Transabdominal pelvic ultrasound
For the transabdominal pelvic ultrasound, you will be asked to unzip your pants, uncover your abdomen, and lie on your back on the medical exam table. Then, a healthcare practitioner will apply a water-based gel on the skin of your lower abdominal area and then place a small probe to visualize your pelvic organs on a screen.
Transvaginal pelvic ultrasound
For the transvaginal pelvic ultrasound, you will be asked to remove your underwear and lie on your back. Then, a healthcare practitioner will apply a water-based gel on a probe that has been previously covered with a plastic/latex sheath, and the probe will be carefully inserted on your vagina. During the procedure, the healthcare practitioner will move the probe a little bit to examine your organs properly.
Either of these procedures usually takes no more than 20 minutes, and there is no need for an anesthetic because they’re painless.
For the transabdominal pelvic ultrasound you must have a full bladder; therefore, you will be asked to drink about 32 ounces of liquid at least 1 hour before the exam.
For the transvaginal pelvic ultrasound your bladder must be empty, so you will be asked to urinate right before the exam.
There are no risks related to a female pelvic ultrasound test.
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
Fibroid tumors
Cysts
Ovarian torsion
Pelvic masses
Pelvic inflammatory disease
Ectopic pregnancy
Miscarriage
Free liquid in the pelvic cavity
Endometrial hyperplasia, which is a thickening of the endometrium
This test can provide information about the location, size, and structure of pelvic masses, but cannot provide a definite diagnosis of cancer or several other conditions.
Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
Pelvic Ultrasound [accessed on Dec 27, 2018]
Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
What to Expect From a Female Pelvic Ultrasound Exam
Video by RAYUS Radiology™/YouTube
2:19
What to Expect From a Female Pelvic Ultrasound Exam
RAYUS Radiology™/YouTube
PET Scan
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
There are no problems detected in the size, shape, or function of the organ being scanned. There are no areas in which the tracer has abnormally collected.
Related conditions
A PET (positron emission tomography) scan is a nuclear imaging test that looks at how well your tissues and organs are working. It also checks for signs of cancer. For the scan, you will get an injection of a small amount of a tracer, which is a safe radioactive substance.
The tracer settles in areas of your body that have high levels of chemical activity. This activity can be a sign of cancer or other diseases. The tracer can also help measure blood flow, oxygen use, and changes in the metabolism of a particular tissue or organ. Metabolism is the process your body uses to make energy from the food you eat.
Chemical changes in your body can show up before you even have symptoms of a disease. Since a PET scan can see how your organs are working in real-time, it can find signs of disease at an early stage, often before the disease can be seen on other imaging tests.
Other names: positron emission tomography
A PET scan is most often used to:
Diagnose or monitor certain cancers, including breast, thyroid, and lung cancers
Find out how well your heart muscle is working
Check blood flow to your heart
Check for signs of certain brain disorders, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and other types of dementia
A PET scan is often done along with a CT scan, a type of x-ray that takes a series of pictures as it rotates around you.
You may need a PET scan to find out if you have cancer. If you've already been diagnosed with cancer, you may need this test to see if your cancer treatment is working.
A PET scan also helps diagnose and monitor heart and brain diseases. So you may need this test if you:
Have a family history of heart disease.
Are being treated for heart disease. This test can show if the treatment is working.
Have symptoms of a brain disease, such as tremors, memory problems, and/or seizures.
Before the scan, you will change into a hospital gown. You may be asked to empty your bladder. During the scan:
A health care provider will inject the radioactive tracer into your vein through an intravenous (IV) line. The tracer sends out a form of energy called gamma rays. The scanner picks up the rays to create images of the inside of your body.
You will need to wait for your body to absorb the tracer, which takes 45 to 60 minutes.
You will then lie on a narrow, padded table, which will slide into a large, donut-shaped scanner.
The scanner will move slowly across your body to capture images. As this happens, you will need to be very still for about 30 minutes.
You will hear clicking or buzzing noises as the images are taken.
The scanner will send images to a computer monitor for your provider to review.
Your provider will then remove the IV line.
The test takes about two hours to complete, including the time you wait for the tracer to be absorbed by your body.
Talk to your provider about how to prepare for the test.
You may be asked to fast (not eat or drink) for four to six hours before the test.
You may be asked to avoid tobacco products and food or drinks with caffeine or alcohol for 24 hours before the test.
If you have diabetes and use insulin, you may need to change the timing of your regular dose. Your provider will give you specific instructions about adjusting your insulin since people with diabetes may not absorb the sugar in the tracer. This may affect the results of your scan.
You may need to stop taking other medicines or supplements before the test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to.
Also, tell your provider if you have claustrophobia (fear of enclosed spaces). Your provider may decide to give you a medicine to help you relax during the test.
There is very little exposure to radiation in a PET scan. Only a small amount of radioactive substance is used, and it will leave your body through your urine and stool (poop) within 2 to 10 hours. Drink more water after the test to help remove the remaining tracer from your body.
While radiation exposure in a PET scan is safe for most adults, it can be harmful to a developing baby. So be sure to tell your provider if you are pregnant or think you may be pregnant. Also, tell your provider if you are breastfeeding, since the tracer may contaminate your breast milk.
Allergic reactions to the tracer are rare and usually mild.
Depending on which part of the body was being scanned, your results may show signs of:
Cancer. Cancer cells show up as bright spots on a PET scan.
Heart disease. The scan can show decreased blood flow to the heart.
A brain disorder. The scan may show changes in certain brain chemicals that can be a sign of a disease.
Some cancers don’t show up on a PET scan, so your provider may order additional tests based on your symptoms and medical history. If you also had a CT scan, your provider will review the results of the two scans to help make a diagnosis.
If you have questions about your results, talk to your provider.
Your PET scan results will be looked at by a radiologist, a doctor who specializes in diagnosing and treating medical conditions using imaging technologies. They will share the results with your provider.
https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007341.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007342.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007343.htm [accessed on Jul 27, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (23)
What is it Like to Have a PET Scan? | Cancer Research UK
Video by Cancer Research UK/YouTube
PET Scan in 3 views
PET Scan in 3 views
PET Scan in 3 views
1
2
3
PET Scan in 3 views
PET Scan in 3 views
Interactive by TheVisualMD
PET/CT
CT
PET
1
2
3
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
How Does a PET Scan Work?
Video by NIBIB gov/YouTube
UCSF Radiology: How does a PET scan help with cancer imaging?
Video by UCSF Imaging/YouTube
Your PET/CT scan at University College Hospital
Video by University College London Hospitals NHS Foundation Trust/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
PET Scans and CAT Scans
Video by Lee Health/YouTube
Having a PET-CT scan
Video by Design Science/YouTube
How does a PET scan work?
Video by Imperial College London/YouTube
Patient exercises
EKG monitoring
Inject radiotracer
Scanning with stress
Patient rests
Inject radiotracer again
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Myocardial perfusion scan
Myocardial perfusion imaging is a test that uses a low dose of a radioactive agent to evaluate the blood flow and function of the heart. This scan is done in conjunction with a cardiac stress test a diagnostic test in which a person walks on a treadmill or pedals (a stationary bicycle) while hooked up to equipment that monitors the heart. The test monitors heart rate breathing blood pressure electrical activity (on an electrocardiogram) and the person's level of tiredness. It shows if the heart's blood supply is sufficient and if the heart rhythm is normal. A stress test can detect the following problems:
- Abnormal changes in heart rate or blood pressure
- Symptoms such as shortness of breath or chest pain
- Abnormal changes in the heart's rhythm or electrical activity
Interactive by TheVisualMD
Testing for bowel cancer
Video by Cancer Research UK/YouTube
MRI Animation
Video by Blausen Medical Corporate/YouTube
Carcinogenesis head and neck short version only animation
Video by Amsterdam UMC/YouTube
Head and Neck Cancer
Video by Robert Miller/YouTube
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Video by Memorial Sloan Kettering/YouTube
Throat Cancer
Video by Michigan Medicine/YouTube
Rush Radiosurgery: Head and Neck Cancer Radiation
Video by Rush Radiosurgery/YouTube
Treating the head and neck - Radiotherapy and its physics (3/15)
Video by OpenLearn from The Open University/YouTube
Nutrition Video for Head & Neck Cancer
Video by Stanford Health Care/YouTube
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
Video by VOA News/YouTube
What is nuclear medicine? An illustrated introduction
Video by navalorama/YouTube
3:13
What is it Like to Have a PET Scan? | Cancer Research UK
Cancer Research UK/YouTube
PET Scan in 3 views
TheVisualMD
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
1:33
How Does a PET Scan Work?
NIBIB gov/YouTube
1:30
UCSF Radiology: How does a PET scan help with cancer imaging?
UCSF Imaging/YouTube
3:31
Your PET/CT scan at University College Hospital
University College London Hospitals NHS Foundation Trust/YouTube
4:42
How X-rays see through your skin - Ge Wang
TED-Ed/YouTube
1:37
PET Scans and CAT Scans
Lee Health/YouTube
5:17
Having a PET-CT scan
Design Science/YouTube
4:25
How does a PET scan work?
Imperial College London/YouTube
Myocardial perfusion scan
TheVisualMD
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
0:36
MRI Animation
Blausen Medical Corporate/YouTube
4:03
Carcinogenesis head and neck short version only animation
Amsterdam UMC/YouTube
7:27
Head and Neck Cancer
Robert Miller/YouTube
2:35
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
18:04
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Memorial Sloan Kettering/YouTube
6:01
Throat Cancer
Michigan Medicine/YouTube
1:13
Rush Radiosurgery: Head and Neck Cancer Radiation
Rush Radiosurgery/YouTube
1:57
Treating the head and neck - Radiotherapy and its physics (3/15)
OpenLearn from The Open University/YouTube
4:25
Nutrition Video for Head & Neck Cancer
Stanford Health Care/YouTube
2:39
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
VOA News/YouTube
3:02
What is nuclear medicine? An illustrated introduction
navalorama/YouTube
Staging
Stages 1 Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 2A to 2C Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 3A to 3C Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 4 Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
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Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Interactive by Cancer Research UK / Wikimedia Commons
Stages 1 Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 2A to 2C Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 3A to 3C Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Stages 4 Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
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Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Interactive by Cancer Research UK / Wikimedia Commons
What Are the Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer?
KEY POINTS
After ovarian, fallopian tube, or peritoneal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for ovarian epithelial, fallopian tube, and primary peritoneal cancer:
Stage I
Stage II
Stage III
Stage IV
Ovarian epithelial, fallopian tube, and primary peritoneal cancers are grouped for treatment as early or advanced cancer.
Ovarian epithelial, fallopian tube, and primary peritoneal cancers can recur (come back) after treatment.
After ovarian, fallopian tube, or peritoneal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body.
The process used to find out whether cancer has spread within the organ or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose cancer are often also used to stage the disease.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if ovarian epithelial cancer spreads to the lung, the cancer cells in the lung are actually ovarian epithelial cancer cells. The disease is metastatic ovarian epithelial cancer, not lung cancer.
The following stages are used for ovarian epithelial, fallopian tube, and primary peritoneal cancer:
Stage I
In stage IA, cancer is found inside a single ovary or fallopian tube. In stage IB, cancer is found inside both ovaries or fallopian tubes. In stage IC, cancer is found inside one or both ovaries or fallopian tubes and one of the following is true: (a) either the tumor or the capsule (outer covering) of the ovary has ruptured (broken open), or (b) cancer is also found on the surface of the ovary or fallopian tube, or (c) cancer cells are found in the pelvic peritoneal fluid.
In stage I, cancer is found in one or both ovaries or fallopian tubes. Stage I is divided into stage IA, stage IB, and stage IC.
Stage IA: Cancer is found inside a single ovary or fallopian tube.
Stage IB: Cancer is found inside both ovaries or fallopian tubes.
Stage IC: Cancer is found inside one or both ovaries or fallopian tubes and one of the following is true:
the tumor ruptured (broke open) during surgery; or
the capsule (outer covering) of the ovary ruptured before surgery, or there is cancer on the surface of the ovary or fallopian tube; or
cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).
Stage II
In stage IIA, cancer is found in one or both ovaries or fallopian tubes and has spread to the uterus and/or the fallopian tubes and/or the ovaries. In stage IIB, cancer is found in one or both ovaries or fallopian tubes and has spread to organs in the peritoneal cavity, such as the colon. In primary peritoneal cancer, cancer is found in the pelvic peritoneum and has not spread there from another part of the body.
In stage II, cancer is found in one or both ovaries or fallopian tubes and has spread into other areas of the pelvis, or primary peritoneal cancer is found within the pelvis. Stage II is divided into stage IIA and stage IIB.
Stage IIA: Cancer has spread from where it first formed to the uterus and/or the fallopian tubes and/or the ovaries.
Stage IIB: Cancer has spread from the ovary or fallopian tube to organs in the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).
Stage III
In stage III, cancer is found in one or both ovaries or fallopian tubes, or is primary peritoneal cancer, and has spread outside the pelvis to other parts of the abdomen and/or to nearby lymph nodes. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.
In stage IIIA, one of the following is true:
Cancer has spread to lymph nodes behind the peritoneum only; or
Cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum outside the pelvis, such as the omentum (a fold of the peritoneum that surrounds the stomach and other organs in the abdomen). Cancer may have spread to nearby lymph nodes.
In stage IIIA, cancer is found in one or both ovaries or fallopian tubes and (a) cancer has spread to lymph nodes behind the peritoneum only, or (b) cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum outside the pelvis, such as the omentum. Cancer may have also spread to nearby lymph nodes.
Stage IIIB: Cancer has spread to the peritoneum outside the pelvis, such as the omentum, and the cancer in the peritoneum is 2 centimeters or smaller. Cancer may have spread to lymph nodes behind the peritoneum.In stage IIIB, cancer is found in one or both ovaries or fallopian tubes and has spread to the peritoneum outside the pelvis, such as the omentum. The cancer in the omentum is 2 centimeters or smaller. Cancer may have also spread to lymph nodes behind the peritoneum.
Stage IIIC: Cancer has spread to the peritoneum outside the pelvis, such as the omentum, and the cancer in the peritoneum is larger than 2 centimeters. Cancer may have spread to lymph nodes behind the peritoneum or to the surface of the liver or spleen.In stage IIIC, cancer is found in one or both ovaries or fallopian tubes and has spread to the peritoneum outside the pelvis, such as the omentum. The cancer in the omentum is larger than 2 centimeters. Cancer may have also spread to lymph nodes behind the peritoneum or to the surface of the liver or spleen (not shown).
Stage IV
In stage IV, cancer has spread beyond the abdomen to other parts of the body. In stage IVA, cancer cells are found in extra fluid that builds up around the lungs. In stage IVB, cancer has spread to organs and tissues outside the abdomen, including the lung, liver, and lymph nodes in the groin.
In stage IV, cancer has spread beyond the abdomen to other parts of the body. Stage IV is divided into stage IVA and stage IVB.
Stage IVA: Cancer cells are found in extra fluid that builds up around the lungs.
Stage IVB: Cancer has spread to organs and tissues outside the abdomen, including lymph nodes in the groin.
Ovarian epithelial, fallopian tube, and primary peritoneal cancers are grouped for treatment as early or advanced cancer.
Stage I ovarian epithelial and fallopian tube cancers are treated as early cancers.
Stages II, III, and IV ovarian epithelial, fallopian tube, and primary peritoneal cancers are treated as advanced cancers.
Ovarian epithelial, fallopian tube, and primary peritoneal cancers can recur (come back) after treatment.
The cancer may come back in the same place or in other parts of the body. Persistent cancer is cancer that does not go away with treatment.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (1)
How are the stages of ovarian cancer determined?
Video by Swedish/YouTube
1:59
How are the stages of ovarian cancer determined?
Swedish/YouTube
Treatment
Surgery
Image by Vidal Balielo Jr./Pexels
Surgery
Image by Vidal Balielo Jr./Pexels
How Are Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treated?
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with ovarian epithelial cancer.
Three kinds of standard treatment are used.
Surgery
Chemotherapy
Targeted therapy
New types of treatment are being tested in clinical trials.
Radiation therapy
Immunotherapy
Treatment for ovarian epithelial, fallopian tube, and primary peritoneal cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with ovarian epithelial cancer.
Different types of treatment are available for patients with ovarian epithelial cancer. Some treatments are standard, and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the treatment currently used as standard treatment, the new treatment may become the standard treatment. Patients with any stage of ovarian cancer may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three kinds of standard treatment are used.
Surgery
Most patients have surgery to remove as much of the tumor as possible. Different types of surgery may include:
Hysterectomy: Surgery to remove the uterus and, sometimes, the cervix. When only the uterus is removed, it is called a partial hysterectomy. When both the uterus and the cervix are removed, it is called a total hysterectomy. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy. Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and fallopian tube are removed; or (b) the uterus plus both (bilateral) ovaries and fallopian tubes are removed. In a radical hysterectomy, the uterus, cervix, both ovaries, both fallopian tubes, and nearby tissue are removed. These procedures are done using a low transverse incision or a vertical incision.
Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
Omentectomy: A surgical procedure to remove the omentum (tissue in the peritoneum that contains blood vessels, nerves, lymph vessels, and lymph nodes).
Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
A type of regional chemotherapy used to treat ovarian cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, the anticancer drugs are carried directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment used during surgery that is being studied for ovarian cancer. After the surgeon has removed as much tumor tissue as possible, warmed chemotherapy is sent directly into the peritoneal cavity.
Treatment with more than one anticancer drug is called combination chemotherapy.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells.
Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies may be used in combination with chemotherapy as adjuvant therapy.
Bevacizumab is a monoclonal antibody and angiogenesis inhibitor that may be used with chemotherapy to treat ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that has recurred (come back). It binds to a protein called vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. Other angiogenesis inhibitors are being studied in the treatment of advanced or recurrent ovarian cancer.
Poly (ADP-ribose) polymerase inhibitors (PARP inhibitors) are targeted therapy drugs that block DNA repair and may cause cancer cells to die. Olaparib, rucaparib, and niraparib are PARP inhibitors that may be used as maintenance therapy to treat certain types of ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that have recurred. Veliparib is a PARP inhibitor that is being studied in combination with chemotherapy to treat advanced ovarian cancer.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Some women receive a treatment called intraperitoneal radiation therapy, in which radioactive liquid is put directly in the abdomen through a catheter. Intraperitoneal radiation therapy is being studied to treat advanced ovarian cancer.
Immunotherapy
Immunotherapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This cancer treatment is a type of biologic therapy.
Vaccine therapy is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find the tumor and kill it. Vaccine therapy is being studied to treat advanced ovarian cancer.
Treatment for ovarian epithelial, fallopian tube, and primary peritoneal cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (6)
Monoclonal Antibody
Monoclonal Antibody
Image by TheVisualMD
What is T-cell adoptive transfer Immunotherapy?
Cancer specific T-cells can be obtained by fragmentation and isolation of tumour infiltrating lymphocytes, or by genetically engineering cells from peripheral blood. The cells are activated and grown prior to transfusion into the recipient (tumour bearer).
Image by Simon Caulton
Finding New Ways to Help the Immune System Fight Cancer
Researchers are tapping into the innate immune system by harnessing dendritic cells to activate T-cell immunity, helping macrophages engulf cancer cells, and engineering natural killer cells to target cancer. Researchers are also investigating the gut microbiome’s role in immunity and targeting the microbiome for cancer therapy.
Image by National Cancer Institute (NCI)
Tumor microenvironment
Tumor cells can either be eliminated by the immune system or escape detection. During the elimination phase, immune effector cells such as natural killer cells, with the help of dendritic and CD4+ T-cells, are able to recognize and eliminate tumor cells (left). As a result of heterogeneity, however, tumor cells which are less immunogenic are able to escape immunosurveillance (right).
Image by Frontiers in Oncology
Genomic information
This image was created by the NHS HEE Genomics Education Programme. For further information and resources please visit our website www.genomicseducation.hee.nhs.uk
Image by NHS HEE Genomics Education Programme
How Monoclonal Antibodies Treat Cancer
Video by National Cancer Institute/YouTube
Monoclonal Antibody
TheVisualMD
What is T-cell adoptive transfer Immunotherapy?
Simon Caulton
Finding New Ways to Help the Immune System Fight Cancer
National Cancer Institute (NCI)
Tumor microenvironment
Frontiers in Oncology
Genomic information
NHS HEE Genomics Education Programme
3:20
How Monoclonal Antibodies Treat Cancer
National Cancer Institute/YouTube
Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Development and Elimination of Cancer Cells as Chemotherapy is Applied
Image by IdkItsKatieB
Development and Elimination of Cancer Cells as Chemotherapy is Applied
The cells shown either reproduce and grow into other healthy cells, or develop a tumor through the quick replication of damaged cells. A chemotherapy drug is applied to inhibit the growth and replication only of the damaged cells.
Image by IdkItsKatieB
Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
This page lists cancer drugs approved by the Food and Drug Administration (FDA) for ovarian, fallopian tube, or primary peritoneal cancer. The list includes generic and brand names. This page also lists common drug combinations used in these cancer types. The individual drugs in the combinations are FDA-approved. However, drug combinations themselves usually are not approved, but are widely used.
There may be drugs used in ovarian, fallopian tube, or primary peritoneal cancer that are not listed here.
Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Alkeran (Melphalan)
Alymsys (Bevacizumab)
Avastin (Bevacizumab)
Bevacizumab
Carboplatin
Cisplatin
Cyclophosphamide
Doxorubicin Hydrochloride
Doxil (Doxorubicin Hydrochloride Liposome)
Doxorubicin Hydrochloride Liposome
Elahere (Mirvetuximab soravtansine-gynx)
Gemcitabine Hydrochloride
Gemzar (Gemcitabine Hydrochloride)
Hycamtin (Topotecan Hydrochloride)
Infugem (Gemcitabine Hydrochloride)
Lynparza (Olaparib)
Melphalan
Mirvetuximab soravtansine-gynx
Mvasi (Bevacizumab)
Niraparib Tosylate Monohydrate
Olaparib
Paclitaxel
Paraplatin (Carboplatin)
Rubraca (Rucaparib Camsylate)
Rucaparib Camsylate
Tepadina (Thiotepa)
Thiotepa
Topotecan Hydrochloride
Zejula (Niraparib Tosylate Monohydrate)
Zirabev (Bevacizumab)
Drug Combinations Used in Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
BEP
CARBOPLATIN-TAXOL
GEMCITABINE-CISPLATIN
JEB
PEB
VAC
VeIP
Source: National Cancer Institute (NCI)
Additional Materials (2)
Catheter, Central Venous
Central venous catheter; drawing of a central venous catheter that goes from a vein below the right collarbone to a large vein above the right side of the heart called the superior vena cava. An inset shows a central venous catheter in the right side of the chest with a clear plastic dressing over it.
Central venous catheter. A central venous catheter is a thin, flexible tube that is inserted into a vein, usually below the right collarbone, and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. The catheter is also used for taking blood samples. It may stay in place for weeks or months and helps avoid the need for repeated needle sticks.
Description: Peripherally inserted central catheter (PICC); drawing of a PICC line that goes from a vein in the upper right arm to a large vein above the right side of the heart called the superior vena cava. An inset shows a PICC line in the arm with a clear plastic dressing over it. An intravenous line attached to the PICC is also shown.
Peripherally inserted central catheter (PICC). A PICC is a thin, flexible tube that is inserted into a vein in the upper arm and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. It is also used for taking blood samples. A PICC line may stay in place for weeks or months and helps avoid the need for repeated needle sticks.
Treatment of Early Ovarian Epithelial and Fallopian Tube Cancer
Sensitive content
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How is a hysterectomy performed?
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
How is a hysterectomy performed?
Diagram showing keyhole hysterectomy.
Image by Cancer Research UK / Wikimedia Commons
Treatment of Early Ovarian Epithelial and Fallopian Tube Cancer
Treatment of early ovarian epithelial cancer or fallopian tube cancer may include the following:
Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and checked under a microscope for cancer cells. Chemotherapy may be given after surgery.
Unilateral salpingo-oophorectomy may be done in certain women who wish to have children. Chemotherapy may be given after surgery.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (3)
Why would I need a hysterectomy and what are the alternatives?
Treatment of Advanced Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Schema circuito HIPEC
Image by Corrado bellini
Schema circuito HIPEC
Schema circuito HIPEC
Image by Corrado bellini
Treatment of Advanced Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Treatment of advanced ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer may include the following:
Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and checked under a microscope to look for cancer cells. Surgery is followed by one of the following:
Intravenous chemotherapy.
Intraperitoneal chemotherapy.
Chemotherapy and targeted therapy (bevacizumab).
Chemotherapy and targeted therapy with a poly (ADP-ribose) polymerase (PARP) inhibitor.
Chemotherapy and targeted therapy followed by surgery (possibly followed by intraperitoneal chemotherapy).
Chemotherapy alone for patients who cannot have surgery.
Targeted therapy with a PARP inhibitor (olaparib, rucaparib, niraparib).
A clinical trial of targeted therapy with a PARP inhibitor (veliparib).
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (1)
Schematic illustration of the VEGF-A-inhibitors bevacizumab, ranibizumab, brolucizumab and aflibercept
Schematic illustration of the VEGF-A-inhibitors bevacizumab, ranibizumab, brolucizumab and aflibercept
Image by Benff/Wikimedia
Schematic illustration of the VEGF-A-inhibitors bevacizumab, ranibizumab, brolucizumab and aflibercept
Benff/Wikimedia
Treatment of Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Olaparib mechanism, specifically in BRCA-deficient cells compared to normal cells. PARP = poly (ADP-ribose) polymerase; BRCA = breast cancer gene 1.
Image by Caulfield SE, Davis CC, Byers KF/Wikimedia
Olaparib mechanism, specifically in BRCA-deficient cells compared to normal cells. PARP = poly (ADP-ribose) polymerase; BRCA = breast cancer gene 1.
Olaparib mechanism, specifically in BRCA-deficient cells compared to normal cells. PARP = poly (ADP-ribose) polymerase; BRCA = breast cancer gene 1. aBRCA-proficient cells can repair double-strand breaks, resulting in cell survival.
Image by Caulfield SE, Davis CC, Byers KF/Wikimedia
Treatment of Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Treatment of recurrent ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer may include the following:
Chemotherapy using one or more anticancer drugs.
Targeted therapy with a poly (ADP-ribose) polymerase (PARP) inhibitor (olaparib, rucaparib, or niraparib) with or without chemotherapy.
A clinical trial of hyperthermic intraperitoneal chemotherapy (HIPEC) during surgery.
A clinical trial of a new treatment.
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (1)
Molecular mechanism of PARP1/2 in the DNA damage response.
Figure 1. Molecular mechanism of PARP1/2 in the DNA damage response. (1). Nuclear DNA is damaged (SSB, DSB) (2). PARP1/2 binds to the DNA damage site, activating its enzymatic action. (3). PARP1/2 uses an NAD molecule to form an ADP-ribose molecule and a nicotinamide molecule. ADP-ribose is added to the target protein or to existing poly (ADP-ribose) chain. The target protein can be PARP1/2 (Auto-PARylation) or other DDR proteins (PARylation). PARP inhibitors disrupt NAD binding at this step. Nicotinamide is recycled to NAD in the presence of ATP. (4). Target DDR proteins are modified, recruited or activated as a result of PARylation. (5). Damaged DNA is repaired [32].
Image by Abdullah Alhusaini,Aoife Cannon,Stephen G. Maher,John V. Reynolds ,Niamh Lynam-Lennon/Wikimedia
Molecular mechanism of PARP1/2 in the DNA damage response.
Abdullah Alhusaini,Aoife Cannon,Stephen G. Maher,John V. Reynolds ,Niamh Lynam-Lennon/Wikimedia
Prognosis
Understanding Medical Research
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Understanding Medical Research
Medical Research in the lab
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What Is the Prognosis for Ovarian Epithelial Cancer, Fallopian Tube Cancer, and Primary Peritoneal Cancer?
Certain factors affect treatment options and prognosis (chance of recovery).
The prognosis and treatment options depend on the following:
The type of ovarian cancer and how much cancer there is.
The stage and grade of the cancer.
Whether the patient has extra fluid in the abdomen that causes swelling.
Whether all of the tumor can be removed by surgery.
Whether there are changes in the BRCA1 or BRCA2 genes.
The patient’s age and general health.
Whether the cancer has just been diagnosed or has recurred (come back).
Source: PDQ® Adult Treatment Editorial Board. PDQ Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (3)
Research Cures Cancer | Ovarian Cancer | MedscapeTV
Video by Medscape/YouTube
Ovarian Cancer | Did You Know?
Video by National Cancer Institute/YouTube
Ovarian Cancer
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths. A particular blood protein called cancer antigen 125 (CA-125) is often elevated in women with ovarian cancer, though small amounts of CA-125 are produced by normal tissues throughout the body and levels of CA-125 can be elevated by other conditions. The CA-125 test is used primarily to monitor the effectiveness of treatment for ovarian cancer. There are three different kinds of ovarian cancer: the most common type is epithelial ovarian cancer (90%) which originates from the surface epithelium of the ovary and is more likely to affect older women; germ cell ovarian cancer (5%), which originates from the cells that produce eggs and is more likely to affect younger women; and stromal ovarian cancer (5%), which originates from the connective tissue within the ovary. After age, the most important risk factor for ovarian cancer is family history. Ovarian cancer is relatively uncommon, but is the fifth leading cause of cancer death in women, partly due to diagnosis difficulty; its symptoms are vague, and ovarian cancer can shed cells that can invade other internal organs long before the presence of disease is even suspected.
Image by TheVisualMD
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Research Cures Cancer | Ovarian Cancer | MedscapeTV
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Ovarian, Fallopian Tube and Primary Peritoneal Cancer
Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which cancer cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum. These cancers are staged and treated the same way. Learn about the risk factors, diagnosis, and treatment of these cancers.