Bay Biosciences provides high-quality, biopsy tissue samples. FFPE tissue blocks with matching fresh, frozen sera (serum), plasma, peripheral blood mononuclear cells (PBMC) bio-fluids from patients diagnosed with ovarian cancer.
The sera (serum), plasma and PBMC biofluid specimens are processed from ovarian patient’s peripheral whole-blood using customized collection and processing protocols.
Biopsy tissue and matched biofluid samples are collected from unique patients diagnosed with ovarian cancer and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
Sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluids are processed from ovarian cancer patients peripheral whole-blood using customized collection and processing protocols.
Ovarian Cancer Overview
Ovarian cancer is a type of cancer that begins in a woman’s ovaries. These are small organs in the female reproductive system that produces eggs. This type of cancer can be difficult to detect because it often doesn’t cause any symptoms until later stages.
The term ovarian cancer includes several different types of cancer (an uncontrolled division of abnormal cells that can form tumors) that all arise from cells of the ovary.
Ovarian cancer ranks fifth most common cause of cancer-related death among females in the United States. That said, deaths from ovarian cancer have been falling in the U.S. over the past 2 decades, according to the American Cancer Society (ACS).
The (ACS) estimates that this year, around 21,410 women may receive a diagnosis of ovarian cancer. Around 13,770 ovarian cancer patients are likely to die from this condition.
Ovarian cancer is a relatively uncommon type of cancer that arises from different types of cells within the ovary, an almond-shaped egg-producing female reproductive organ. The most common ovarian cancers are known as epithelial ovarian cancers (EOC) or ovarian carcinoma.
Other types of ovarian cancer include ovarian low malignant potential tumor (OLMPT), germ cell tumors, and sex cord-stromal tumors like the granulosa-stromal tumors and Sertoli-Leydig cell tumors.
Inherited mutations in the BRCA1 and BRCA2 genes greatly increase a woman’s ovarian cancer risk as well as breast cancer risk.
Most ovarian cancers are diagnosed in advanced stages because there are no reliable early cancer-related symptoms and signs of ovarian cancer. Even in more advanced tumors, symptoms and signs are vague and nonspecific.
Types of Ovarian Cancer
Usually ovarian tumors arise from the epithelium, or lining cells, of the ovary. These include epithelial ovarian cancer which are the cells on the surface of the ovary. Fallopian tube, and primary peritoneal which is the lining inside the abdomen that coats many abdominal structures, cancers.
These are all considered to be one disease process. There is also an entity called ovarian low malignant potential tumor; these tumors have some of the microscopic features of cancer but tend not to spread like typical cancers.
There are also lesser common forms of ovarian cancer within the ovary, including germ cell tumors and sex cord-stromal tumors.
Epithelial Ovarian Cancer (EOC)
Epithelial ovarian cancer (EOC) or ovarian carcinoma accounts for a majority (85%-90%) of all ovarian cancers according to the American Cancer Society (ACS).
It is generally thought of as one of three types of cancer that include ovarian, fallopian tube, and primary peritoneal (lining tissues of the pelvis and abdomen) cancer.
All three tumors types behave and are treated the same way. The four most common tumors cell types of epithelial ovarian cancer are serous, mucinous, clear cell, and endometrioid.
These cancers arise due to DNA changes in cells that lead to the development of cancer.
The serous cell type is the most common variety. It is now thought that many of these cancers actually come from the lining in the fallopian tube, and fewer of them from the cells on the surface of the ovary, or the peritoneum.
However, it is often hard to identify the sources of these cancers when they are found at advanced stages, which is very common.
Ovarian Low Malignant Potential Tumor (OLMPT; borderline tumor)
Ovarian tumors of low malignant potential (OLMPT; formerly referred to as borderline tumors) account for about 15% of EOC. They are most often serous or mucinous cell types.
They often develop into large masses that may cause symptoms, but they only rarely metastasize that is, spread to other areas. Often, removal of the tumor, even at more advanced stages, can be a cure.
Germ Cell Ovarian Cancers
Germ cell tumors arise from the reproductive cells of the ovary. These tumors are uncommon and are seen most commonly in teens or young women. This type of tumor includes different categories: dysgerminomas, yolk sac tumors, embryonal carcinomas, polyembryomas, non-gestational choriocarcinomas, immature teratomas, and mixed germ cell tumors.
Stromal Ovarian Cancers
Another category of ovarian tumor is the sex cord-stromal tumors. These arise from supporting tissues within the ovary itself. As with germ cell tumors, these are uncommon.
These cancers come from various types of cells within the ovary. They are much less common than the epithelial tumors. Stromal ovarian cancers (hormone-producing tumors) include granulosa-stromal tumors and Sertoli-Leydig cell tumors.
Stages of Ovarian Cancer
Once the ovarian cancer is diagnosed, the doctors will need to determine the stage and grade to decide on a treatment plan. Stage refers to how far the cancer has spread. For example:
- Localized: Cancer cells affect only the ovaries or fallopian tubes and have not spread elsewhere.
- Regional: Cancer has spread to nearby organs, such as the uterus.
- Distant: Cancer is present elsewhere in the body. It now affects other organs, such as the lungs or liver.
The grade, meanwhile, refers to how abnormal the cancer cells appear.
Getting an early diagnosis usually means that treatment can be more effective. However, other factors can affect this. These factors include the person’s age and overall health and the type or grade of the cancer cell, as some types are more aggressive than others.
Signs and Symptoms of Ovarian Cancer
Following are some of the signs and symptoms of ovarian cancer:
- Abdominal Pain
- Bloating
- Changes in bowel movements, such as constipation
- Fatigue
- Feeling any unusual lumps
- Finding increase in the size of your abdomen
- Feeling of fullness after a meal
- Frequent urination or urgency
- Headache
- Indigestion
- Loss of appetite
- Nausea
- Pain or pressure in the pelvis
- Pain in the back
- Shortness of breath
- Swelling in the legs
- Unexplained Weight Loss
- Vaginal bleeding
These symptoms can be very subtle and vague, as well as very common. This only makes diagnosing ovarian cancer much more difficult and obtaining a definitive diagnosis even harder.
OLMPT and some benign tumors can present with similar symptoms. In addition, they are often seen with very large masses in the ovary. Often these masses are large enough to cause bloating, abdominal distension, constipation, and changes in bladder habits such as frequent urination.
Causes and Risk Factors of Ovarian Cancer
Exact causes of ovarian cancer are unknown. However, you may have a higher risk of developing ovarian cancer if you have the following factors:
Family History
Having a close relative with a history of breast cancer or ovarian cancer increases a person’s chance of developing ovarian cancer.
Undergoing genetic screening for mutations in the BRCA1 gene may help determine if someone has a higher risk of both ovarian and breast cancer.
Age Factor
According to the American Cancer Society (ACS) ovarian cancer mostly develops in older women patients. About half of the women who are diagnosed with ovarian cancer are 63 years or older. It is more common in white women than African American women patients.
Reproductive History
Having had one or more full term pregnancies is associated with a lower risk of ovarian cancer. The more pregnancies a woman has, the lower the risk seems to be. Breastfeeding may also lower the risk. For ovarian cancer, each pregnancy provides an additional risk reduction.
However, having children later in life (after age 35) or never having children are associated with a higher risk of developing ovarian cancer. Patients who use some types of fertility treatment may have a higher chance of developing borderline cells.
Women who use birth control pills or an injectable contraceptive hormone also appear to have a lower risk of developing ovarian cancer.
Breast Cancer
Patients with a family history of breast cancer seem to have a higher chance of ovarian cancer. This may be due to changes in the BRCA gene.
For this reason, some patients with breast cancer who test positive for this gene mutation may opt to have an oophorectomy, or surgery to remove the ovaries, as preventive therapy.
Hormone Therapy
Undergoing Hormone Replacement Therapy (HRT) after menopause appears to increase the risk of ovarian cancer. The longer a person uses HRT, the higher the risk. However, the risk appears to fall after treatment stops.
Obesity and Overweight
Being overweight or obese can have far-reaching health consequences, including raising your risk for certain types of cancer. Ovarian cancer is more common in patients with a body mass index BMI of over 30.
Gynecologic Surgery
Having surgery to remove the uterus, called a hysterectomy, may reduce the risk of ovarian cancer by one third. Without ovaries, your risk of developing ovarian cancer is lower, but there’s still some risk. That’s because ovarian cells can migrate to the perineum, which is the area between the vagina and anus.
If this migration happened before the ovaries were removed, those cells remain behind. These remaining ovarian cells can become cancerous just like the ovaries can. And if they do, it’s still considered ovarian cancer even if the ovaries are removed before the cancer develops.
Cancer can also develop from cells in the peritoneum, the tissue lining the wall of your abdomen. And while this isn’t ovarian cancer, it behaves in much the same way as ovarian cancer.
Human Papillomavirus (HPV)
Scientists have been finding links between the human papillomavirus (HPV) and various cancers, including tonsil cancer and cervical cancer.
In 2013, the authors of a meta-analysis reported finding a high rate of HPV among patients with ovarian cancer. However, they could not confirm that HPV causes it, and they called for further research.
Other Risk Factors
Other factors that may increase the risk of some types of ovarian cancer include the following. However, researchers have not yet proven a link between these factors and ovarian cancer.
- Alcohol use
- Having high levels of androgens, or male hormones
- Dietary factors
- The use of talcum powder
Genetics and Ovarian Cancer
Genes are a part of our DNA and are essentially the blueprint our cells use to reproduce themselves. We are born with a particular genetic makeup.
Our genes can be influenced by our family (inherited traits) and by changes that happen to our genes over time. These changes are called mutations.
Two of the most common gene mutations that have been pinpointed as being related to ovarian cancer are BRCA1 and BRCA2.
The BRCA1 and BRCA2 genes are inherited which means you get part of each gene from each parent. Your genes are twin pieces (you have two parts that make up each gene, so two parts to BRCA1).
You could have a mutation in one part of the gene without having cancer. However, if both parts of the gene are mutated, cancer can develop. BRCA1 and BRCA2 typically suppress the growth of cancerous cells.
Mutations keep these genes from doing their job and preventing abnormal cell growth. BRCA1 and BRCA2 are also linked to breast cancer.
Gene mutations aren’t always inherited. Throughout your life, your genes can change. A somatic mutation is one that happens over time.
One common genetic mutation that’s seen in ovarian cancer is a somatic mutation of the TP53 gene. The mutation changes part of the gene, and the protein called the TP53 protein.
This protein normally works to fight tumors and keep them from developing. However, when it’s changed by this mutation, it can’t keep the tumor from growing. This same process can happen to many different genes in your body and they can all contribute to cancer growth.
Diagnosis of Ovarian Cancer
During routine screening or symptoms suggest that a patient may have ovarian cancer, a doctor will typically:
- Ask the patient about their personal and family medical history
- Carry out a pelvic examination
They may also recommend performing the following diagnostic tests:
Blood tests: Blood tests will check for high levels of a marker called CA-125.
Imaging tests: These tests include a transvaginal ultrasound, CT scan and MRI scan.
Laparoscopy: A healthcare professional will insert a thin tube with a camera attached through a small hole in the abdomen, to see the ovaries and perhaps take a tissue sample for a biopsy.
Biopsy: This involves the microscopic examination of a tissue sample.
Only a biopsy can confirm that a patient has cancer. A doctor may do this as part of the initial assessment or following surgery to remove a tumor.
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