Ovarian Epithelial Cancer
Aleta Quint
Colorado Christian University

Ovarian Epithelial Cancer Ovarian cancer can occur in any part of the ovary and can be any kind of cancerous growth, however, most kinds of ovarian cancer arise in the outer lining, or epithelium. Ovarian cancer is not considered common, but it does cause more deaths than cancer in other female reproductive cancers. It ranks fifth in cancer deaths among women (What are the key statistics for ovarian cancer, 2014).
Etiology and Risk Factors Ovarian cancer is tricky because the etiology of is unknown. It may be related to exposure to cancer causing elements that may pass through the vagina to reach the fallopian tubes and ovaries and to mechanisms involved in ovulation (Huether & McCance, 2012, p. 817). Kurman and Shih (2011) explain, “Ovarian cancer originates from the ovarian surface epithelium (mesothelium) which invaginates into the underlying stroma resulting in inclusion cysts that eventually undergo malignant transformation.” According to this theory, tumors in the ovary then develop from these cysts. However, this is simply just one of many theories of cause and origin. This disease is usually not associated with any pattern of inheritance, but it is approximated that 10% of the cases are because of the inheritance associated with mutations of the breast cancer susceptibility gene and hereditary nonpolyposis colon cancer (Huether & McCance, 2012, p. 817). There are several suspected risk factors and factors that lower risk of this disease. Because most ovarian cancers develop after menopause, the risk of developing ovarian cancer gets higher with age. It is also suspected that obesity leads to a higher risk of this type of cancer. The risk goes down with women who have had a full term pregnancy before the age of 26, and the risk continues to go down with each full-tem pregnancy. Fertility drugs and using estrogens after menopause can lead to an increased risk.
Pathogenesis
The ovaries are made up of epithelial cells that cover the ovary, germ cells that are found inside the ovary and stromal cells that form the supportive tissue and produce female hormones. Epithelial tumors start from the lining of the ovary. There are benign epithelial tumors, which means that they are non-cancerous tissue abnormalities. These include serous adenomas, mucinous adenomas, and Brenner tumors. There are also tumors that are considered borderline or have low malignant potential because the look of the cells under the microscope doesn’t clearly identify them as cancerous (National Ovarian Cancer Coalition, 2013). Then there are epithelial ovarian carcinomas that affect the genetic activity in some way, and in turn, cause abnormal cell reproduction. When these tumors are looked at under the microscope, it is seen that the cells have many features that can be used to classify epithelial ovarian carcinomas into different types such as mucinous, endometrioid, and clear cell (What is ovarian cancer, 2014). There are also undifferentiated carcinomas in which the cells don’t look like any of the others listed and usually grow and spread more quickly. (What are the key statistics for ovarian cancer, 2014).
Grades and Stages On a scale of 1-3, the tumor is staged and graded depending on how much the tissue looks normal. Carcinomas that are in grade 1 are the better of the three because they look more like normal tissue. Grade 3 carcinomas look the least like normal tissue and are more serious, and grade 2 carcinomas are obviously between the two (What is ovarian cancer, 2014). Ovarian tumors are staged from 1 (detected early and limited to the ovary)- 4 (most advanced stage and spread to multiple parts of the body) and subdivided into a, b, and c categories based on where the tumor first started in the ovary and how far it has spread (National Ovarian Cancer Coalition, 2013).
Clinical Manifestations There aren’t many early or easily