Cancer Types | Ovarian Cancer - National Foundation for Cancer Research

Ovarian Cancer

Ovarian Cancer

In the U.S., ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system.

Key Facts

  • An estimated 21,750 new cases of ovarian cancer will be diagnosed in the U.S. in 2020, with 13,940 deaths expected to result from the diagnosis.
  • While all women are at risk of ovarian cancer, the overall lifetime risk of developing the disease is 1 in 78.
  • The estimated five-year survival rate for patients whose ovarian cancer is detected early is about 92%. However, only 15% of women are diagnosed at the early stages.
  • Ovarian cancer can be difficult to diagnose because initial symptoms are similar to gastrointestinal illness and indigestion such as back pain, bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, or urinary urgency or frequency in the months before diagnosis. Women who experience such symptoms daily for more than a few weeks should seek prompt medical evaluation.
Source: American Cancer Society’s Cancer Facts & Figures 2020 and the Society’s website
Ovarian
21750
new cases expected in 2020
13940
deaths expected in 2020
92
% survival rate if detected early

Ovarian Cancer Research

In addition to specific projects listed below, genomics research is helping us attack ovarian cancer – and all types of cancer. NFCR has distinguished itself from other organizations by emphasizing long-term, transformative research and working to move people toward cancer genomics.

Susan B. Horwitz, Ph.D.
Susan B. Horwitz, Ph.D.

Dr. Susan Horwitz’s work has been instrumental in the development of Taxol®, a natural product used to treat over 1.5 million cancer patients with ovarian, breast, lung and pancreatic cancer. Dr. Horwitz is collaborating with organic chemist Dr. Amos B. Smith III to develop similar natural product drugs to overcome resistance to Taxol that patients experience. They have synthesized analogues of discodermolide, a natural product from a Caribbean Sea sponge that works similar to Taxol. In ovarian cancer models, the leading compounds show promising results in their ability to kill ovarian cancer cells with reduced toxicity. Further research continues towards developing the lead candidate as a new treatment for ovarian cancer patients.

Amos B. Smith III, Ph.D.
Amos B. Smith III, Ph.D.
Wei Zhang, Ph.D.
Wei Zhang, Ph.D.

Dr. Wei Zhang is a leader of precision oncology, using NFCR support since 2006 to characterize underlying genetic mechanisms responsible for cancer growth and progression – the drivers of cancer. His research addresses the variability in cellular properties, within and across cancer types, which often leads to treatment resistance and poor survival in patients. Dr. Zhang conducts important research studies to advance Precision Oncology with the ultimate goal of maximizing outcomes for patients with ovarian cancer and other malignancies.

Robert C. Bast, Jr., M.D.
Robert C. Bast, Jr., M.D.

Dr. Robert Bast, who received NFCR funding for 18 years, is best known for developing the OC125 (CA125) monoclonal antibody in 1981 that led to the production of the CA125 radioimmunoassay – the first useful biomarker for monitoring the course of patients with epithelial ovarian cancer. Since 20% of ovarian cancers do not make the CA125 protein, Dr. Bast and his team have been evaluating other biomarkers to complement CA125 as an early detection blood test. A panel of biomarkers would detect all of the cases early and reduce the poor outcome that most patients experience due to diagnosis after the cancer has spread. Other ways for early detection include Dr. Bast’s “two-step” approach using CA125 and sonography– which results from clinical trials show it effectively reduces fatalities by 20%.

Harold F. Dvorak, M.D.
Harold F. Dvorak, M.D.

Dr. Harold F. Dvorak, who received NFCR funding for over 30 years, discovered that tumor cells secrete a vascular endothelial growth factor (VEGF) and this seminal discovery provided the molecular basis for the field of angiogenesis (meaning “blood vessel formation”). Angiogenesis makes it possible for tumors to grow and spread, and Dr. Dvorak’s discovery helped pave the way for research on anti-angiogenesis treatments that can halt and even reverse tumor growth. In 2004, the first VEGF-targeting anti-angiogenic drug Avastin® was approved by the FDA for the treatment of colorectal cancer, and later, for the treatment of non-small cell lung cancer, renal cell carcinoma, the aggressive brain cancer glioblastoma (GBM) and certain types of cervical and ovarian cancers. Specifically, Avastin is approved for stage III and IV epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel chemotherapy after surgery.

Related Content

We Are Stronger Than the Cancer: Maria’s Story

Maria Gonzales was no stranger to cancer by the time she was diagnosed in 2008. She had watched the disease affect many of her family members, from her mother and her grandmothers to her aunts and cousins. Despite seeing her loved ones battle cancer in various forms, her diagnosis came as an absolute surprise. “When the doctors said that I had cancer, I thought they were wrong – I was too young,” Maria said. A few months before her diagnosis, Maria was packing up her classroom from one school and settling into a new one. She eagerly welcomed this exciting change to her career, but the young teacher was experiencing a bit of stress and anxiety related to the move. Amidst her move, Maria began feeling extremely fatigued as well as noticing a reoccurring stint of lower back pain. “I attributed the fatigue and lower back pain to moving schools,” Maria began. “I was packing and moving boxes and feeling very stressed. I also had irregular periods and pain in the pelvic area. Then I became so bloated it looked like I was pregnant.” Realizing that something may not be right in her body, Maria met with a doctor. She went through many blood tests in search of an answer, but the tests were not revealing anything helpful. Finally, she was scheduled for a CT scan. The CT scan showed that Maria had a large mass from her ovaries to her spleen, thus spearheading her journey with cancer. “I had to have emergency surgery, which determined I had stage 3C ovarian cancer,” Maria shared. “I then had to have chemotherapy and I had anaphylactic shock from the first drug.” After changing medications, Maria continued receiving chemotherapy for approximately six months. During her treatment, Maria experienced a range of uncomfortable side effects, including the infamous nausea and vomiting. Though she expected side effects all along, Maria was quite surprised by the nature of the effects she experienced. “People think that every cancer patient looks the same, but we don’t,” Maria said. “I never lost my hair. I never expected to experience anxiety, panic attacks, insomnia, fatigue or chemo brain. Cancer doesn’t have a face; it can happen to anyone and not everyone reacts the same way.” Once Maria finished her chemotherapy, she was declared NED – no evidence of disease. The excitement of this news was short-lived, as she soon learned that ovarian cancer was a chronic disease. Maria went on to have five reoccurrences. She continues maintenance treatment every four weeks and visits her doctor every eight weeks.  “Just because the treatment is over doesn’t mean the journey with cancer is over,” Maria reflected.  “The battle might not be physical, but it becomes mental.” Though every step of her journey with cancer sparked new and often unexpected challenges, Maria continuously adjusted to new ways of coping. For Maria, faith, hope, prayer, and the support of her loved ones got her through even the darkest moment. She learned to accept asking for help but, more importantly, she learned that her friends and family were always willing to provide that help. “It’s really important […]

Five Facts Every Woman Should Know About Gynecologic Cancer

As we honor Gynecologic Cancer Awareness Month, it’s important to be cognizant of the realities of these deadly diseases. All women with reproductive organs are susceptible to developing one of the seven gynecologic cancers, with the exception of women who have received a full hysterectomy and are at a lower risk. Know your body, know the facts, know your risk. #1. Gynecologic cancer is an umbrella term for seven different cancers that occur in women’s reproductive organs. Types of gynecologic cancers include… Cervical cancer. This occurs when the cells inside and outside the cervix mutate. This is the most preventable cancer through annual screenings and routine check-ups. Treatment can look like surgery, chemo, radiation or immunotherapy. Vulvar cancer. This cancer is unique to other gynecologic cancers because it forms on the outside of the genitalia on the labia. Receiving the HPV vaccination decreases the chances of developing vulvar cancer. Depending on the type and stage it’s found in, the cancer has a variety of treatment options. Uterine/endometrial cancer. Caused by cells growing too rapidly on the lining of the uterus, the most common diagnosis of uterine cancer is endometrial carcinoma. There is a high risk of metastasis for uterine and endometrial cancer. This cancer usually results in an operation, but chemotherapy and radiation are implemented in treatment plans too. Vaginal cancer. Vaginal cancer is one of the rarest gynecologic cancers. It typically occurs in the lining of the vagina and most cases require surgery or chemo. Getting an HPV vaccine can reduce the risk of developing vaginal cancer. Ovarian cancer. Three subgroups exist under ovarian cancer: stromal cell (begins in cells that produce female hormones), germ cell (begins in cells that produce eggs in the ovaries) and epithelial cancer (originates in cells that line the ovaries or fallopian tubes). Ovarian cancer is primarily treated with surgery in combination with chemo. Gestational Trophoblastic Disease (GTD). GTD occurs when unusual uterine cells grow to what would normally be a placenta during a healthy pregnancy. This cancer is highly treatable and allows women to carry healthy pregnancies afterwards. Primary Peritoneal Cancer. A relative of epithelial ovarian cancer, this disease presents few warning signs and can result in the removal of the ovaries. Cells in the peritoneum, a thin layer of tissue surrounding the abdomen, mutate into cancer cells. #2. Some gynecologic cancers have very few symptoms. Women with gynecologic cancers don’t always experience the same symptoms, and some experience little to no symptoms at all. Other times, symptoms like bloating, back pain or quickly feeling full while eating are difficult to recognize as being related to cancer because they occur from other ailments. The different subtypes of gynecologic cancer present different symptoms; ovarian cancer is known to have the most such as abnormal bleeding, constipation, pressure and pain, while cervical cancer, a disease known as the “silent killer”, only present irregular discharge or menstrual bleeding. Talk to a doctor right away if you are demonstrating bleeding between periods, after intercourse or after menopause, and if you have any other signs or symptoms of gynecologic cancer for two weeks or longer. Read a  list […]

Genetic Cues to Ovarian Cancer Explored

September is Ovarian Cancer Awareness Month, highlighting a disease that kills nearly 15,000 women annually out of the 21,000 diagnosed. Relatively uncommon as cancers go, ovarian cancer nevertheless causes the most deaths from all gynecological cancers. Known as the “silent killer”, Ovarian Cancer presents no symptoms at all, or symptoms that are so general — abdominal enlargement or swelling, abdominal fullness and pain, pain in lower abdomen — they cause no immediate alarm and are mistaken for another, and more likely, ailment. When the cancer finally is diagnosed, it is often at an advanced stage. This has led to a sobering statistic: 59 percent of women are diagnosed when the disease is advanced and less curable. Dr. Robert C. Bast, Vice President for Translational Research at the MD Anderson Cancer Center in Texas and NFCR Fellow, has made ovarian cancer his life’s work, and recently developed a model using the tumor suppressor gene DIRAS3 (also known as ARHI). DIRAS3, expressed in normal ovarian cells, was found to be downregulated in up to 60 percent of ovarian cancers, and its loss is associated with decreased progression-free survival. DIRAS3 inhibits cell growth and even acts as a negative growth regulator; Bast’s model hints that DIRAS3 carries this out via autophagy, where a cell becomes so starved of outside nutrients that it begins to consume itself in order to survive, going into a dormant state. Bast goes so far as to call DIRAS3 an autophagy “master-switch.” “We have found that dormant, drug resistant [ovarian] cancer cells found in over 80 percent of positive second look operations exhibit autophagy and express DIRAS3,” Bast observed. “That led us to look at what steps in the autophagic process this effected.” Bast found that cells with active DIRAS3 were dying in culture, but they weren’t dying from the “normal” means of apoptosis, but rather by extreme autophagy. To the layman, it may not be important how cancer cells die, just so long as they do. But to oncologists and medical investigators, how something dies, particularly a cancer cell (metastatic or otherwise), is extremely important because different drugs and therapies target different biological processes. Apoptosis is programmed into a person’s DNA; natural biochemical cues lead to cell changes that causes the cell to die. Another type of cell death, necrosis, stems from traumatic injury to the cell. Far more complex is autophagy, which, as normal bodily function, oversees the (usually) orderly degradation and recycling of cellular components, and is an adaptive response to stress. Technically speaking, it is not supposed to kill the cell. Bast postulates that DIRAS3 and autophagy may explain why some tumors seemingly go inactive but do not necessarily die; autophagy is not an instant death. Many solid cancers can remain dormant for years and then grow progressively to kill the host. Additionally, DIRAS3 is not restricted to just ovarian cancer; Bast found it plays a role in breast, colon, lung and pancreatic cancer. “We were looking for genes that were down-regulated in cancer but not in normal cells, and so we thought those might be important in the development of cancer,” says Bast. “It […]