Our Approach to Ovarian Cancer

The nationally renowned gynecologic oncology program at Siteman Cancer Center is the largest in the Midwest. Beyond our gynecologic cancer physicians, our team includes radiation oncologists, pathologists, nurses, a psychologist, a social worker and genetic counselors. These specialists meet weekly to discuss patient care, providing a collective expertise not always available at other cancer centers. Learn more about how we treat gynecologic cancers at Siteman. Experienced nurses then spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses offer patient literature on your condition, chemotherapy, radiation therapy, surgery and other related issues. As a unique feature of your care, we also offer the services of a palliative care specialist who can help you fit treatment into your own special circumstances, if needed. Counselors are also offered to help deal with the stress of the diagnosis. Ovarian cancer affects over 21,000 women a year. The ovaries are made up of four main kinds of cells, each of which can develop into a different type of tumor: Epithelial tumors start from the cells that cover the outer surface of the ovary and make up most of ovarian tumors.

  • Most epithelial ovarian tumors are benign and don’t spread. Benign epithelial tumors include serous cystadenomas, mucinous cystadenomas, and Brenner tumors.
  • Tumors of low malignant potential: These are different from typical ovarian cancers in that they don’t grow into the supporting structure of the ovary. If they spread, they do so slowly.
  • Malignant epithelial ovarian tumors: About 85-95 percent of ovarian cancers are of this type. Epithelial ovarian carcinomas are classified by one of four subtypes, as well as by grade and stage.
  • Primary peritoneal carcinoma can look much like epithelial tumors and is treated like it, but it starts outside the ovary in the peritoneal cavity, and may occur in women who have had their ovaries removed.

Germ cell tumors: Less than 2 percent of ovarian cancers are germ cell tumors. Overall, they have a good outlook, with more than 9 out of 10 patients surviving at least 5 years after diagnosis. The most common germ cell tumors are teratomas, dysgerminomas, endodermal sinus tumors, and choriocarcinomas. Germ cell tumors can also be a mix of more than a single subtype. Ovarian stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone. Only one percent of ovarian cancers are ovarian stromal cell tumors. Borderline or low-malignant potential tumors: Ovarian masses can be difficult to diagnose and manage. Most patients do well with these tumors. Siteman has special pathology expertise and surgical technique to evaluate and treat these tumors. Benign tumors can be treated by removing either the ovary or the part of the ovary that contains the tumor. Cancerous or low malignant potential ovarian tumors can spread to other parts of the body. Women with a family history of ovarian cancer may be at increased risk for developing cancer. Our genetic counselor provides an individualized assessment of cancer risk and up-to-date information regarding cancer genetics. The counseling process is based on a detailed evaluation of family and personal health history.

Fertility preservation

Siteman Cancer Center and Washington University School of Medicine offer the latest fertility preservation treatments for both men and women who undergo chemotherapy, radiation, or surgery to treat or prevent their cancer. Specialists in our Infertility and Reproductive Medicine Center offer oocyte (egg) and embryo banking as well as sperm banking through cryopreservation (freezing). As a member of the National Oncofertility Consortium, Washington University also is researching other promising fertility-preservation procedures, such as ovarian tissue cryopreservation. Siteman cancer physicians are actively involved in clinical trials that investigate new chemotherapy regimens, and other approaches to cure. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.