Ovarian cysts and cancer
Ovarian cysts are fluid-filled sacs that develop within or on the surface of the ovaries and are commonly associated with the menstrual cycle. While most ovarian cysts are benign and typically resolve on their own, there are various types, including functional cysts, endometriomas, cystadenomas, and dermoid cysts, each with different characteristics and potential complications. The formation of ovarian cysts is common, with a significant percentage of women experiencing them during their reproductive years.
The link between ovarian cysts and ovarian cancer is a concern, particularly for women over the age of fifty, as larger cysts and increasing age can elevate the risk of malignancy. Symptoms of ovarian cysts may include abdominal pain and pressure, irregular menstruation, and nausea, although many women remain asymptomatic. Diagnosis often involves pelvic exams and imaging tests, such as ultrasounds, alongside blood tests to assess for cancer markers. Treatment options vary but may include monitoring or surgical intervention, especially for cysts that are large or exhibit suspicious features. Regular health check-ups are essential for early detection and management of any potential issues related to ovarian cysts or cancer.
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Subject Terms
Ovarian cysts and cancer
ALSO KNOWN AS: Functional ovarian cysts, physiologic ovarian cysts
RELATED CONDITIONS: Ovarian cancer, uterine cancer, lymphatic cancer, peritoneal cancer
DEFINITION: Ovarian cysts are growths that develop within or on the surface of an ovary. They may consist of fluid-filled sacs, semisolid material, or solid material. Fluid-filled, simple cysts are unlikely to be cancerous. Most cysts that develop during a woman’s childbearing years are not cancerous.
Risk factors: No specific risk factors have been identified. Most ovarian cysts develop as part of the ovulation process. The likelihood of an ovarian cyst causing cancer increases with the size of the growth and the woman's age. Women over fifty with ovarian cysts have a higher risk of developing ovarian cancer.
Etiology and the disease process: Functional ovarian cysts, which are not disease related, commonly occur during a woman’s normal menstrual cycle. Tiny cysts develop to hold the eggs. When an egg matures, the cyst breaks open to allow the egg to move through the fallopian tube. Typically, the cyst dissolves. When the cyst continues to grow and does not break open to release the egg, it is termed a follicular cyst. Follicular cysts usually disappear within sixty days. If follicular cysts continue to grow inside an ovary during repeated menstrual cycles, the patient is said to have polycystic ovaries. If a cyst continues to grow after the egg is released, it is called a corpus luteum cyst. This type of cyst can grow as large as four inches in diameter and sometimes twist the ovary, causing pelvic or abdominal pain. These cysts can also fill with blood and rupture, causing internal bleeding and intense pain. Corpus luteum cysts typically disappear within a few weeks.
Other types of ovarian cysts include endometriomas, cystadenomas, and dermoid cysts. If tissue from the uterine lining grows outside the uterus, a condition known as endometriosis, it sometimes attaches to an ovary and forms a cystic growth known as an endometrioma. These growths can be very painful during menstruation or sexual intercourse. Growths that develop from the outer epithelial cells of an ovary, known as cystadenomas, typically filled with a fluid, can become twelve inches in diameter or larger and generate much pain by twisting the ovary. Dermoid cysts form from the germ cells that produce eggs. They can grow rather large and produce painful twisting of an ovary. They are seldom cancerous.
Incidence: Virtually all women who have menstrual periods will develop ovarian cysts of one type or another. Between 4 and 20 percent of women have polycystic ovaries, and between 17 and 44 percent of women with endometriosis have endometriomas. Most ovarian cysts are not cancerous. Ovarian cancer is rare, accounting for around 20,000 diagnoses annually.
Symptoms: Although many women experience no symptoms associated with ovarian cysts, signs may include abdominal pressure or pain, backache, incomplete urination, unexplained weight gain, painful menstrual periods and abnormal bleeding, pelvic pain during sexual intercourse, tender breasts, and nausea and vomiting. If sudden, severe abdominal or pelvic pain occurs or pain accompanied by fever and vomiting develops, medical attention should be sought immediately.
Screening and diagnosis: Ovarian cysts are usually found during routine pelvic exams. If a cyst is found, ultrasonic imaging determines its shape, size, location, and content. A cancer antigen 125 (CA 125) blood test helps determine whether the cyst is malignant. For some women with ovarian cancer, this protein occurs in increased levels. Functional uterine fibroids and endometriosis can also increase the CA 125 level. CA 125 tests coupled with transvaginal ultrasounds are recommended for high-risk patients.
Treatment and therapy: For women still in their childbearing years who have fluid-filled cysts, the most common approach is to wait and watch. If a cyst persists, gets larger, looks unusual, causes too much pain, or the patient goes through menopause, surgical removal may be the best option. A laparoscopy may be performed for smaller cysts that do not look abnormal in ultrasound images. A small incision near the navel and a scope are used to investigate the cyst further. If nothing unusual is found, the cyst is removed. For larger, suspicious-looking cysts, a laparotomy is done. Through larger openings in the stomach, the cyst is removed and tested for cancer by the pathologist. If the cyst is malignant, the doctor will remove the affected ovary and associated uterine tissues and lymph nodes.
Prognosis, prevention, and outcomes: Although ovarian cysts cannot be prevented, regular pelvic examinations are important to diagnose any problems as early as possible. Any abnormal or persisting menstrual cycle changes should be discussed with a medical doctor. For women who frequently develop ovarian cysts, a doctor may prescribe birth control pills to reduce the risk of their formation by preventing follicle formation. In most cases, fluid-filled cysts are benign.
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