Pathophysiology

Pathophysiology of Ovarian Cancer

Ovarian cancer, like many other types of cancer, starts with the disregulation or disturbance of apoptsis. Apoptosis is the normal, programmed death of cells that occurs when the cell is damaged or no longer needed. Apoptosis disregulation is a dangerous situation because this crazy overgrowth of cells is very damaging to the cells around it. Unnatural clumps of prolific cells steal oxygen, blood and nutrients from other cells, depriving them and causing them damage. A quick growing mass of unnatural cells also mechanically compresses healthy tissue, causing ischemia of healthy cells.

There are several different subtypes of ovarian cancer that can occur, depending on which part of the ovary the apoptosis starts in. The 5 main types are:

●High-grade serous carcinoma (70 to 80 percent): High-grade serous carcinoma is the most common type of ovarian cancer and accounts for approximately 70 to 80 percent of all malignant ovarian neoplasms. Very quick-growing and aggressive.

●Endometrioid carcinoma (10 percent)  Endometrioid carcinoma of the ovary accounts for approximately 10 percent of all ovarian carcinomas. They have a much better prognosis than serous carcinomas, as they are normally detected earlier and are more responsive to chemotherapy. Endometrioid ovarian carcinoma is associated with carcinoma of the endometrium in 15 to 20 percent of cases. It is possible that endometrioid carcinoma is a metastasis of endometrian cancer.

●Clear cell carcinomas (10 percent)  Similar to endometrioid carcinoma, clear cell ovarian carcinoma is often associated with, and likely arises from, endometriosis.

●Mucinous carcinoma (3 percent) Approximately 80 percent are benign mucinous cystadenomas, and the majority of the rest are mucinous borderline neoplasm. In addition, most mucinous carcinomas within the ovary are metastases, frequently from the gastrointestinal tract.

●Low-grade serous carcinoma (<5 percent) Slower-growing than high-grade serous carcinoma. 

The above photo illustrates the progression that ovarian cancer takes as it develops. First in stage 1 it affects only the ovary. Next it progresses, and then finally in stage 3 it can be seen metastasizing to other secondary sites. 

For more information on the pathophysiology of ovarian cancer, please see these informative sites: 

www.uptodate.com/contents/epithelial-carcinoma-of-the-ovary-fallopian-tube-and-peritoneum-histopathology (This is a great information on the different types of ovarian cancer)

http://www.ovarian.org/what_is_ovarian_cancer.php (This is an easy-to-ready, informative site on how cancer starts in the body)