If you have been diagnosed with ovarian cancer, then there has undoubtedly been a lot of the words below thrown around. Maybe you don’t feel like you have the extra time to ask your doctor, or you want to do a little more research on your own. Either way, below is a list of terms and their definitions often used with ovarian cancer.
To learn more about support and/or clinical trials, visit our Resources page. For more information on ovarian cancer in general, such as staging and treatments, visit our full Ovarian Cancer article. We also have information about interventions for ovarian cancer during pregnancy.
We wish you a swift and successful battle with ovarian cancer.
Terms to know
A
Adjuvant chemotherapy – refers to when chemotherapy is given, in this case, after a conservative or debulking surgery to remove a cancerous growth(s).
Aggressive – when cancer is labeled this way, it means that cancer’s growth rate and metastasis rate are extremely rapid. In this state, cancerous growths may grow and spread faster than therapies such as chemo, radiation, or surgery can prevent it.
Ascites – an above-normal amount of fluid in the abdominal cavity. In later stage ovarian cancer, this is caused by metastasis to the peritoneum from cancer cells sloughing off a primary growth. The collection of cells and cellular components in the abdominal cavity includes cancerous cells and pro-inflammatory, tumor-promoting proteins and cofactors. The fluid reaches a point where it can no longer drain as fast as it is being produced. Inflammation and leakage from the tumor contribute to the excess fluid.
B
Benign – if a tumor is called “benign,” it does not yet reflect a cancerous growth. It would continue to be referred to as a tumor. [also: noncancerous]
Biopsy – a sample of tissue or fluid is removed during a medical procedure, such as surgery, and sent to a lab for further testing. In ovarian cancer, this is usually to determine if the tumor is cancerous (malignant) or noncancerous (benign).
Bladder – stores urine that the kidneys produce. Since it sits right below the uterus, cancerous growths can occasionally spread here.
C
CA 125 – this is a cancer marker “Cancer Antigen 125” that can be tested to confirm a malignancy. It is not present on noncancerous cells. The test is not done in all cases of suspected ovarian cancer.
Cervix – the pathway between the vagina and the uterus, and is considered the lower end of the uterus. It is usually tightly closed. Ovarian cancer can occasionally metastasize here.
Chemotherapy – this refers to the use of strong medicines or drugs to fight and kill cancer. Most chemotherapy involves a medley of multiple chemo drugs at the same time. This is because each chemo drug is specific for different parts of the cancer cell and/or its life cycle; this way, cancer cells can be attacked from multiple angles at once. For more information on the types of chemo drugs available, visit the American Cancer Society’s website. There are a few different ways to take chemotherapy drugs:
- Intravenously (IV) – liquid chemo medication is administered directly into a vein and reaches the entire body through the venous system.
- Intraperitoneally (IP) – this avenue first requires that a “port” be installed. This port will allow the liquid chemo drugs to flow directly throughout the peritoneum (a thin tissue that encases most of the abdominal organs), which increases the concentration of the chemo flowing directly to cancer. IP is often used in conjunction with IV when treating ovarian cancer.
- Orally – this type is less often used and is typically more expensive. It can be taken in pill or liquid form at home and reaches the entire body. It does deliver a dose as strong as IV chemotherapy. This treatment is not as common for ovarian cancer.
Chemotherapy can be used before or after surgery to remove visible, large, or especially problematic cancerous growths. Generally, it is used to cure cancer, control the spread or size, or to prolong the life of someone with terminal cancer. Chemo during pregnancy is only suggested in the 2nd and 3rd trimesters, although it is suggested to receive chemotherapy after birth. No confirmed evidence of fetal malformations or toxicity has been published, though long-term effects on the baby have not been adequately studied. [also: chemo]
Conservative surgery – when full debulking surgery cannot be completed right away (for reasons such as illness or pregnancy), this is done to remove some of the larger/more accessible cancerous growths after a cancer diagnosis.
Cystectomy – this refers to the removal of the bladder. This may be necessary with advanced ovarian cancer if it has metastasized to the bladder. Ovarian Cystectomy refers to the removal of a cyst(s) on the ovary which may or may not be related to cancer.
Cytology – quite generally, the study of cells. A cytology report from a hospital laboratory is often run on any fluid samples (such as ascites) when a biopsy is taken to determine if an ovarian tumor is cancerous or not. The fluid is checked for the presence of malignant cells and for tumor markers such as CA 125 and alpha-fetoprotein (AFP). This, along with histological studies, determines the grade of cancer (how differentiated the cells remain). Some researchers believe that an early test of the fluid of an ovarian tumor (fine needle aspiration) guided by ultrasonography, may allow earlier diagnosis and thus a better prognosis.
D
Doppler – an added technique to an ultrasound. An ultrasound can visualize structures, but with Color or Spectral Doppler, you can also see vascular movement and flow. This can help determine the movement of blood to determine blockages or if a mass is vascularized (has blood flow). Vascularized large tumors are more likely to be malignant than benign.
E
Epithelial cell cancer – this refers to cancer that begins in the cells which form the outside layer of the ovary and is usually called ovarian carcinoma. This type of ovarian cancer accounts for 85 – 90% of all ovarian cancers and is often the most dangerous due to late diagnosis. However, most epithelial tumors are benign.
F
Fallopian tubes – these are thin tubes lined with cilia (tiny projections of a cell that act as movable “hairs”) that connect the ovaries and the uterus. The egg travels down and is fertilized in the fallopian tubes when pregnancy occurs. These are often removed along with the ovaries or the uterus. The removal is called a salpingectomy.
G
Germ cell cancer – this refers to cancer that begins in the cells in the ovaries that produce eggs. Like epithelial cell tumors, most are benign. When they become malignant, the most common germ cell cancers are teratomas, endodermal sinus tumors, and dysgerminomas. This cancer is most common among teens and 20-somethings. Nowadays, it is highly survivable, and many times a woman can remain fertile after treatment.
H
Histology – the study of cells under a microscope. Microscope slides with an extremely thin section of tissue taken from a biopsy sample will be reviewed with different stains to mark different portions of the cell. This is a very important step in the diagnostic process. [also: histopathology]
Hysterectomy – the removal of the uterus. A partial hysterectomy means only a portion or the entirety of the uterus is removed, while a full hysterectomy may include the ovaries, fallopian tubes, and/or cervix. If a cancerous growth spreads to the uterus from ovarian cancer, a hysterectomy may be necessary or suggested.
L
Laparoscopy – the insertion of a small, fiber-optic instrument is inserted under the skin to visualize the abdominal cavity. It often provides guidance for surgery.
Laparotomy – a surgical incision into the abdomen that allows access to the abdominal cavity. Performed during diagnostic and/or debulking surgeries.
Lymph nodes – these bean-like structures are the “checkpoints” of the lymph system, which is a part of the body’s immune system. The lymph system is the body’s sewer system and helps to clean out toxins and other particles from the body. Lymph fluid and white blood cells flow through nodes throughout the body and filter these particles out. Ovarian cancer can spread to lymph nodes, such as ones in the omentum.
M
Malignant – if a tumor is called “malignant,” it means a diagnosis of cancer. [also: malignancy, cancerous]
Metastasize – refers to the movement to and growth of cancer cells in a part of the body in which it did not originate. When a tumor metastasizes, this typically means a later stage of cancer and is usually more difficult to treat. [also: metastasis, metastases, metastatic]
N
Neoadjuvant chemotherapy – chemotherapy medication given before surgery to remove the cancerous growth(s).
O
Omentectomy – this refers to the removal of the omentum (see next definition). Often, ovarian cancer can spread to the lymph nodes on the omentum. An omentectomy can be partial (only the affected section) or total/supracolic (the entire omentum).
Omentum – a thin layer of fatty abdominal tissue overlying the stomach, small and large intestines, as well as other abdominal organs. It is a type of visceral peritoneum. If metastatic ovarian cancer spreads to the omentum, it may need to be surgically removed through an omentectomy.
Ovaries – female reproductive organs that produce female sex hormones and store, mature, and release eggs. Each ovary (right and left ovaries) is connected to the uterus by a fallopian tube. This is the site where ovarian cancer starts and can involve the stromal cells, epithelial cells, or the germ cells.
Ovarian Cyst – a fluid-filled sac that originates on the ovaries. These are not uncommon, and often are not a concern unless they burst, grow rapidly, there are multiple cysts, and/or cause pain, bleeding, or swelling.
P
Peritoneum – the thin layer of tissue that separates the underside of the skin from a majority of the organs of the abdomen.
R
Radiation therapy – the use of a guided beam of radioactive particles to attack cancer at the site. This is not often used to treat ovarian cancer, but in certain cases may be.
S
Salpingectomy – the removal of the fallopian tubes. This surgery can be unilateral (one tube) or bilateral (both tubes).
Salpingo-oophorectomy – the removal of the ovaries (oophor) and the fallopian tubes (salpingo). A unilateral salpingo-oophorectomy only involves one set, and bilateral removes both sets (right and left sides).
Stromal cell cancer – this refers to cancer that begins in the cells of the ovary that act as connective tissue and release sex hormones. There are two main types of stromal cell cancers: Sertoli-Leydig cell tumors (SLCT) and granulosa cell tumors (GCT). These are both very rare, with GCTs only accounting for 2% of ovarian cancers. SLCT occurs in cells that produce a male sex hormone and cause male characteristics when cancerous. GCTs may begin from different cell types, including theca, granulosa, and fibroblasts. Stromal cell tumors typically present early and are considered low-grade.
T
Tumor Debulking [surgery] – when ovarian cancer is diagnosed, typically the first treatment is a debulking surgery, which refers to the removal of as much of the visual cancerous growth in the abdominal cavity. If the cancer is hidden or in an advanced stage, the surgeon may not be able to remove all pieces. Often, debulking is followed by chemotherapy, or less commonly, radiation therapy.
U
Ultrasound – a medical technique using a machine that emits high-frequency sound waves to see a live picture of organs under the skin. Often used for screening and diagnosis of different diseases and conditions, and most commonly used in women during pregnancy. If you have symptoms in the lower abdomen/reproductive organ region, an ultrasound may be used to check the organs for any abnormalities. [also: sonogram]
Uterus – this is the female reproductive organ above the cervix. Normally, it is the size of an orange but can stretch about 20 times its size to hold a developing baby during pregnancy. The ovaries are attached to each top corner by fallopian tubes. Ovarian cancer can sometimes metastasize here, ultimately requiring a full hysterectomy if not looking to preserve fertility.
For more information
If you have been diagnosed with ovarian cancer or a tumor on or near the ovaries, don’t be afraid to ask your doctor as many questions as you have. Remember, your doctor is your advocate! And the APA wants to be your advocate as well, which is why we want you to have all the information you need to move forward with a treatment plan and with your life! It may be helpful to keep a notebook with you throughout the day so that as questions come up for your doctor, you can jot them down and not forget them.
There are communities of support out there for you. To learn more about support and/or clinical trials, visit our Resources page. For more information on ovarian cancer in general, such as staging and treatments, visit our full Ovarian Cancer article. We also have information about interventions for ovarian cancer during pregnancy.
Compiled using information from the following sources:
1. National Ovarian Cancer Coalition (NOCC): Types & Stages of Ovarian Cancer.
2. Mayo Clinic: Bladder Removal Surgery (cystectomy).
3. American Cancer Society (ACS): Chemotherapy.
4. Moffit Cancer Center: Omentectomy for Ovarian Cancer.
5. Medline Plus (under the National Institutes of Health): Sertoli-Leydig Cell Tumor.
6. Ruddon, R. W. (2003). What Makes a Cancer Cell a Cancer Cell? Retrieved online from NCBI.
7. Bandyopadhyay, A., Chakraborty, J., Chowdhury, A. R., Bhattacharya, A., Bhattachrya, P., & Chowdhury, M. (2012). Fine needle aspiration cytology of ovarian tumors with histological correlation. Journal of Cytology, 29(1), 35–40. https://doi.org/10.4103/0970-9371.93218.
8. Yoshimura, S., Scully, R. E., Taft, P. D., & Herrington, J. B. (1984). Peritoneal fluid cytology in patients with ovarian cancer. Gynecologic Oncology, 17(2), 161–7. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/6706224.
9. Imaginis: The Women’s Health Resource. Treatment – Ovarian Cancer.
10. Ahmed, N., & Stenvers, K. L. (2013). Getting to know ovarian cancer ascites: opportunities for targeted therapy-based translational research. Frontiers in Oncology, 3, 256. https://doi.org/10.3389/fonc.2013.00256
11. Shah, D., Shah, S., Parikh, J., Bhatt, C. J., Vaishnav, K., & Bala, D. V. (2013). Doppler ultrasound: a good and reliable predictor of ovarian malignancy. Journal of Obstetrics and Gynaecology of India, 63(3), 186–9. https://doi.org/10.1007/s13224-012-0307-9
12. National Cancer Institute: Dictionary of Cancer Terms. Lymph Nodes.
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