THE SURMENO
CONNECTION

Women with Borderline Ovarian Cancer or Borderline Ovarian Tumors often end up in Surgical Menopause, as this kind of semi-malignant tumor often grows bilaterally, meaning on both ovaries. In most cases, the affected and diseased ovaries are surgically removed. About 15 out of 100 of all ovarian tumors (15%) are classified as Borderline Ovarian Cancer or Borderline Ovarian Tumors. Borderline Ovarian Tumors (BOT) is also referenced as Borderline Ovarian Cancer and tumors of low malignancy potential.  As such, in most but not all cases, this form of cancer has a more favorable outcome than do other ovarian cancers. Borderline Ovarian tumors often affect women aged 20 to 40, in their most fertile years. The mean age of occurrence is approximately 10 years younger than that of women with frankly malignant ovarian cancer.

 

Surgery is the standard treatment that currently exists for this condition. Once ovaries are removed there is a small chance of recurrence, and even more rarely, do these borderline tumor cells convert into malignant cancer cells. However in some women, if their Borderline Ovarian cancer has a more advanced staging, it can spread to other organs and areas and become metastatic

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Borderline Ovarian Cancerous Tumors grow at a more controlled (slower) rate than cancer cells and they typically don’t grow in the supportive tissue of the ovaries. While Borderline Ovarian Tumors are usually contained within the ovary,  rarely some of these abnormal cells migrate to other areas of the body, prompting the need for further excision surgery and chemotherapy.

 

Symptoms:

 

Although a large segment of women with Borderline Ovarian Tumors (approximately 23%) do not have noticeable symptoms unless it has advanced and thus grown large in size, some common symptoms women with BOTs experience are:

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• Protruding abdomen or abdominal distention

• Abdominal pain (aching, cramping)

• Pain during or shortly after sex

• Vaginal spotting or bleeding (not during a woman’s period)

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Causes:

 

Though there is no definitive cause that can be currently linked to Borderline Ovarian Tumors, barring further medical research, factors reportedly linked to the occurrence of Borderline Ovarian Tumors include:

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• Family history of ovarian cancer

• Genetic predisposition

• Smoking history

• Oral Contraceptive use

• Menarche

• Menstrual history (painful or irregular menses)

• Age at first pregnancy

• Age at first delivery of child

 

Diagnosis:

 

The first stage of diagnosing Borderline Ovarian Tumors involves an in office visit to your doctor. Once there doctors will usually examine you externally in the area of your abdomen and reproductive organs, looking for swelling or lumps. Then they will proceed to an internal exam, using their fingers to feel for any noticeable abnormalities.  

 

The second stage of diagnosing Borderline Ovarian Tumors calls for scans of your ovaries and uterus. Most women are given a trans-vaginal ultrasound, an abdominal ultrasound, and in some cases both are used.

 

When the results of your scans come back and if a mass or a lump is revealed, the next step is surgery to diagnose the pathology of your lump or mass, and remove it.

 

Stages:

 

Doctors use the same staging system they utilize for ovarian cancer as they do with Borderline Ovarian Tumors. The following explains the staging; there are 4 stages in total, 1 is the earliest stage up to 4, which is the most advanced.

 

Stage 1: The tumor is contained within the ovary.

Stage 2: The abnormal cells have spread within the pelvic region: fallopian tubes, uterus, rectum or bladder.

Stage 3: The abnormal cells have spread into the pelvic cavity.

Stage 4: The abnormal cells have advanced and spread to another body part like the lungs.

 

Types:

 

There are only two types of Borderline Ovarian Tumors, Mucinous and Serous. Serous is the most common type of Borderline Ovarian Tumor, as 65 out of 100 BOTs are defined as Serous. Essentially Mucinous and Serous tumors are cancers of different kinds of ovarian cells. The cells that become Mucinous tumors are those that contain more mucus. Mucus is believed to make these tumors more aggressive however more Mucinous tumors are found at an earlier stage. These cells are typically the cells lining the ovary.

 

Both Mucinous and Serous tumors are epithelial tissues. One thing the epithelium does is line the ducts inside glands, and if they're serving as a lining for a gland they secrete. Serous cells secrete a clear, watery fluid akin to saliva and Mucinous cells secrete the thick, sticky stuff called mucous.

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Treatment:

 

As previously mentioned, surgery is the only treatment and in most cases cure for women who have Borderline Ovarian Tumors. For most women surgery involves either removing both ovaries and fallopian tubes (Oophorectomy) or removing the ovaries, uterus and cervix (A total abdominal Hysterectomy or TAH).

 

Women who have Borderline Ovarian Tumors contained to their ovaries and want to have a family, often opt for Fertility Sparing Surgery. This involves having eggs or embryos frozen, and following having an Oophorectomy rather than a TAH (Hysterectomy) so women can carry their own children via IVF (In vitro fertilization). This is a popular option for women with this condition as it affects them during their most fertile years, 20-40.  As such, many women are diagnosed with Borderline Ovarian Tumors before they have started or finished having their children.

 

Ongoing Care:

 

In most cases, once ovaries or ovaries and uterus are removed, women need to continue to go in for regular scans and exams to rule out recurrence. For the first 3-5 years on average following surgery, women should have scans every 3 to 6 months, depending on the staging of your BOTs. After 5 years, consult with your doctor, but most women only need to be scanned once per year.