Ovarian cancer is a malignant tumor that begins in a woman’s ovaries, two almond-sized organs located on each side of the pelvis that produce eggs and are the main source of the female hormones estrogen and progesterone. In ovarian cancer, ovarian cells grow out of control and form a tumor. Ovarian cancer is the fifth-leading cause of cancer death among U.S. women after cancers of the lung, breast, colon, and pancreas. About 23,000 women are diagnosed with the disease each year, and 14,000 die from it -- a relatively high fatality rate caused by the failure to catch many cases early. Women in the sunnier regions of the world have a much lower risk of ovarian cancer than those who dwell in colder climates. Perhaps sun exposure -- and, more precisely, vitamin D production in the body -- help prevent ovarian cancer? Obese women have a higher risk of developing ovarian cancer than their thinner counterparts.

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Nutrients that may be helpful for Ovarian Cancer
Women who eat plenty of vegetables, particularly carrots, tomatoes and other foods high in carotene and lycopene may reduce their risk. Flavonoids are found in fruits and vegetables. One flavonoid that has been studied is Apigenin. Tea drinkers have a lower rate of ovarian cancer.
    
Genistein is an isoflavone that looks promising in fighting ovarian cancer.
Ginkgo biloba has potential, too.
Ginger can kill ovarian cancer cells. A study on ginger was done using cells in a lab dish, which is a long way from finding that it works in actual cancer patients. Researchers tested ginger powder dissolved in solution by putting it on ovarian cancer cell cultures. Ginger killed the ovarian cancer cells in two different ways -- through a self-destruction process called apoptosis and through autophagy in which cells digest themselves. Ginger spice has been shown to help control inflammation, which can contribute to the development of ovarian cancer cells. In multiple ovarian cancer cell lines, ginger induced cell death at a similar or better rate than the platinum-based chemotherapy drugs typically used to treat ovarian cancer. Whether the same effects of ginger in test tubes occurs when humans consume ginger is not known.
Tea drinking - Woman who drink two or more cups of tea every day may cut their risk of ovarian cancer in half. Both black and green teas are rich in antioxidant chemicals called polyphenols, which have been shown to block cancer growth in lab and animal studies.

Ovarian cancer and ginkgo biloba
Studies conducted in women and in the laboratory strongly suggest that the herbal supplement Ginkgo biloba may help lower the risk of developing ovarian cancer. In a population-based study involving more than 600 women with ovarian cancer and 640 healthy control women, researchers found that the most commonly used herbals were ginkgo, Echinacea, St. John's Wort, ginseng, and chondroitin. But only ginkgo appeared to ward off ovarian cancer. According to the data, women who took ginkgo supplements had a 60 percent lower risk of ovarian cancer.

Ovarian cancer diet
After following more than 60,000 women for an average of 13 years, Swedish researchers found that those who drank at least two glasses of milk every day or consumed at least four daily servings of dairy products were twice as likely to develop serous epithelial ovarian cancer as those who consumed less than two servings of dairy a day.

Diet and ovarian cancer
Dr. Maria Rossi, of Istituto di Ricerche Farmacologiche "Mario Negri" in Milan, and her staffers found that women who ate the most isoflavones and flavonols were the least likely to have ovarian cancer. Lab studies suggest flavonoids may also have cancer fighting properties in addition to their antioxidant effects. The researchers compared flavonoid intake for 1,031 women diagnosed with epithelial ovarian cancer and 2,411 women who had been hospitalized for acute, non-cancer-related conditions, categorizing them into five groups based on their intake of each of six different flavonoids. The women with the highest flavonol intake were less likely to have ovarian cancer than women with the lowest flavonol intake. High intake of isoflavones cut ovarian cancer risk by half. Isoflavones are found in tea and soy foods, both of which have been linked to a lower ovarian cancer risk, possibly due to isoflavones' estrogen-blocking effects. International Journal of Cancer, August 15, 2008.

Estrogen and Ovarian Cancer - Hormone use increases risk for Ovarian Cancer
There's an increased risk of ovarian cancer risk with postmenopausal estrogen use. The risk of ovarian cancer is increased in women who use unopposed estrogen for 10 years or more, and in those taking estrogen and progestin for 5 years or more. Women who have endometriosis have are more likely to have ovarian cancer in the future.

Ovarian Cancer Symptoms - Ovarian Cancer Sign
Ovarian cancer, called the silent killer because it often goes undetected, does present with symptoms. Symptoms of ovarian cancer to look out for include: A bloated abdomen, difficulty eating or feeling full quickly, pelvic pain and an urgent need to urinate, which some associate with menstruation, especially if the symptoms are severe, frequent and simultaneous, and last more than 2 or 3 weeks. The importance of early diagnosis is illustrated in five-year survival rates that approach 90 percent if the disease is caught early versus 20 percent if diagnosed after it has progressed. Vague symptoms (reported by noncancerous women are less severe and less frequent when compared with women with ovarian cancer. Women with ovarian cancer typically have symptoms of recent onset and have multiple symptoms that coexist.
   Abdominal swelling, pain, and other target symptoms are common in the months before ovarian cancer is diagnosed. Some patients with ovarian cancer do report signs and symptoms many months before their ultimate diagnosis, and some ovarian cancer patients could have had an earlier diagnosis if pelvic imaging was included in their workup.

Types of Ovarian Cancer
There are three main types of ovarian tumors – some of which are benign and some are malignant -- named for the kind of cells they start from. The most common type of tumor, an epithelial tumor, begins in the cells that cover the surface of the ovary. Ovarian tumors can also begin in the egg-producing cells (germ cell tumors) and in the supportive tissue surrounding the ovaries (stromal tumors), but these types of cancer are rare. Cells from an ovarian tumor can break away and spread to other parts of the body.

Ovarian Cancer Treatment
Although surgery followed by paclitaxel / carboplatin (TJ) therapy is a standard modality for the initial treatment of ovarian cancer, the majority of patients require additional treatment.

Hereditary Ovarian Cancer
Family history is the strongest risk factor for ovarian cancer. Three clinical manifestations of hereditary ovarian cancer have been recognized: (1) "site-specific" ovarian cancer, (2) the breast and ovarian cancer syndrome, and (3) the hereditary nonpolyposis colorectal cancer (HNPCC; Lynch II) syndrome.

Ovarian cancer diagnosis
Annual screening with a technique called transvaginal ultrasound, coupled with a blood test for CA125, a protein that can be elevated in the setting of ovarian cancer, does not reliably detect ovarian cancer early at a more curable stage.

Screening
Annual screening with ultrasound and a blood test called CA 125 usually misses early cases of ovarian cancer. In addition, ovarian cancer screening often leads to unnecessary biopsies and other surgical procedures. The U.S. Preventative Services Task Force recommends against such screening. Early-stage ovarian cancer often has only mild or no symptoms. Because results of early screening to detect this cancer in the early stage is not precise, it is usually diagnosed after it has progressed and become more deadly. Less than 20 percent of all ovarian cancers in the U.S. are diagnosed before they spread outside of the ovary. Obstetrics and Gynecology, April 2009.

Dr. Gordon Rustin from Mount Vernon Cancer Center, Hertfordshire, UK, says Initiating second-line chemotherapy for ovarian cancer recurrence based on an increase in the tumor marker CA125 alone does not improve overall survival compared to waiting until clinical symptoms of recurrence arise. American Society of Clinical Oncology meeting in Orlando, June 2009.

Ovarian Cancer Research studies
Woman who drink two or more cups of tea every day may cut their risk of ovarian cancer in half. Both black and green teas are rich in antioxidant chemicals called polyphenols, which have been shown to block cancer growth in lab and animal studies. To investigate whether tea drinking might protect against ovarian cancer, 61,057 women - ranging in age from 40 to 76 - participating in a mammography screening program were followed for an average of 15 years. Compared with women who never drank tea, those who drank less than a cup a day had an 18-percent lower risk of developing ovarian cancer. One cup daily cut risk by 24 percent, while two or more cups lowered risk by 46 percent. Tea drinkers were thinner and ate more fruits and vegetables, the researchers report, so they may have had a healthier overall lifestyle that led to reduced ovarian cancer risk. Nevertheless, investigators add, the fact that risk declined steadily as tea consumption increased-known scientifically as a dose-response relationship-suggests the tea itself is a factor. SOURCE: Archives of Internal Medicine December 12/20, 2005.

Moderate physical activity may help women lower their chances of developing ovarian cancer. A possible explanation for the beneficial effects is enhancement of the immune and antioxidant systems, and lower risk of obesity. Too much exercise may cause immune suppression.

For a woman who undergoes hysterectomy for benign disease such as fibroids, leaving both ovaries in place has long-term survival benefits, at least if she is no older than 65 years and at average risk for ovarian cancer. Ovary removal is often recommended along with hysterectomy, on the thinking that it prevents the possibility of ovarian cancer developing. However, women who undergo ovary removal before age 55 are nearly 9 percent more likely to die before age 80. Those who have their ovaries removed before age 59 have a nearly 4 percent high risk. Gynecologists who have been looking at the issue of (ovary removal) have focused on one thing -- ovarian cancer. Women are living longer and the major killer of women is heart disease, taking 25 times more women's lives than ovarian cancer.

Association of dietary vitamin A, carotenoids, and other antioxidants with the risk of ovarian cancer.
Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):669-76.
Antioxidants may protect the ovaries from oxidative damage and reduce the risk of ovarian cancer. Although a few studies have examined the relation of antioxidant intake to the risk of ovarian cancer, the results have been inconclusive. Questions still remain regarding the effects of confounding factors, such as menopause, tobacco smoking, and alcohol drinking, on the association between antioxidants and ovarian cancer development. To examine the association of the consumption of micronutrients from foods and supplements with the risk of ovarian cancer. A structured questionnaire was administered to 558 histologically confirmed epithelial ovarian cancer cases and 607 population controls from a multiethnic, population-based case-control study conducted between 1993 and 1999 in Hawaii and Los Angeles. Overall, vitamin A and carotene intakes were modestly associated with a reduced risk of ovarian cancer. Inverse gradients in ovarian cancer risk with increasing dietary intake of vitamin A and beta-carotene were somewhat stronger among women with mucinous histologic types, smokers, and nondrinkers. A significant positive trend in risk associated with increasing beta-cryptoxanthin intake was observed among postmenopausal women, among women with nonmucinous tumors, and among nonsmokers. The intake of other carotenoids and antioxidants, either from foods or supplements, was unrelated to ovarian cancer risk. Our findings suggest that dietary vitamin A and beta-carotene are modestly protective against ovarian cancer, particularly among smokers. Our data suggest a role for retinoic acid signaling pathways in ovarian carcinogenesis.

Apigenin inhibits VEGF and HIF-1 expression via PI3K/AKT/p70S6K1 and HDM2/p53 pathways.
FASEB J. 2005 Mar;19(3):342-53. Fang J, Xia C, Cao Z, Zheng JZ, Reed E, Jiang BH.
The Mary Babb Randolph Cancer Center, Department of Microbiology, Immunology and Cell Biology, West Virginia University, Morgantown, West Virginia
Apigenin is a nontoxic dietary flavonoid that has been shown to possess anti-tumor properties and therefore poses special interest for the development of a novel chemopreventive and/or chemotherapeutic agent for cancer. Ovarian cancer is one of the most common causes of cancer death among women. Here we demonstrate that apigenin inhibits expression of vascular endothelial growth factor (VEGF) in human ovarian cancer cells. VEGF plays an important role in tumor angiogenesis and growth. We found that apigenin inhibited VEGF expression at the transcriptional level through expression of hypoxia-inducible factor 1alpha (HIF-1alpha). Apigenin inhibited expression of HIF-1alpha and VEGF via the PI3K/AKT/p70S6K1 and HDM2/p53 pathways. Apigenin inhibited tube formation in vitro by endothelial cells. These findings reveal a novel role of apigenin in inhibiting HIF-1 and VEGF expression that is important for tumor angiogenesis and growth, identifying new signaling molecules that mediate this regulation.

A case-control study of diet and the risk of ovarian cancer.
Cancer Epidemiol Biomarkers Prev. 2004 Sep;13(9):1521-7.
Epidemiologic studies have suggested that some dietary factors may play a role in the etiology of ovarian cancer, but the findings have been inconsistent. We assessed the association of ovarian cancer with dietary factors in a population-based case-control study in Canada. Diet information was collected on 442 incident cases of ovarian cancer diagnosed in 1994 to 1997 and 2,135 population controls via a self-administered questionnaire. We did not observe an association of ovarian cancer risk with dietary fat intake, including saturated, monounsaturated, and polyunsaturated fatty acids, protein, carbohydrate, dietary fiber, fruit, dairy products, meat products, fish, chicken, grain products, nut products, baked desserts, margarine, butter, mayonnaise, and supplement of multiple vitamins, vitamin A, vitamin C, calcium, iron, zinc, and selenium. Our findings suggested that ovarian cancer risk was positively associated with higher consumption of dietary cholesterol and eggs and inversely associated with higher intake of total vegetables and cruciferous vegetables and supplementation of vitamin E, beta-carotene, and B-complex vitamins.

Inhibitory effect of genistein and daidzein on ovarian cancer cell growth.
Anticancer Res. 2004 Mar-Apr;24(2B):795-800.
Survival from ovarian cancer has not changed significantly in the past twenty years requiring development of additional treatment protocols. We studied the effect of genistein and daidzein on ovarian cancer cell growth. Five ovarian cancer cell lines from Stage IIIC disease were evaluated. Sulforhodamine B and colony formation assays were used to analyze growth inhibitory effects of genistein and daidzein alone and with cisplatin, paclitaxel or topotecan. Apoptosis induction was studied by determining caspase-3 activity. RESULTS: Inhibition of growth (50-80%), colony formation and colony size was seen at 144 microm of genistein, 0-23% reduction was demonstrated at 9 microm. At 144 microm, the colony size was inhibited >75%; at 9 microm 4/5 cell lines had >50% reduction. Caspase-3 activity was induced with all concentrations of genistein. Cisplatin and topotecan combined with genistein resulted in a mostly additive effect, paclitaxel was slightly less than additive. We demonstrate an inhibitory effect of genistein on ovarian cancer cell growth.

Ovarian cyst
Ovarian cysts are fluid-filled, sac-like structures within an ovary. The term cyst refers to a fluid-filled structure. Therefore, all ovarian cysts contain at least some fluid. With routine obstetric ultrasound examinations, ovarian cysts are now more commonly diagnosed during pregnancy and their management is still a challenging clinical issue among obstetricians.

Ovarian cyst symptom
The majority of ovarian cysts are not noticed and resolve without women ever realizing of their existence. When a cyst causes symptoms, pain in the belly or pelvis is by far the most common one. The pain from an ovarian cyst can be caused from rupture of the cyst, rapid growth and stretching, bleeding into the cyst, or twisting of the cyst around its blood supply.

Other links of interest
AHCC supplement
Graviola herb
Mangosteen herb
Polycystic ovarian syndrome or disease, see polycystic ovary syndrome

Ovarian cancer questions
Q. I am in the 11th grade attending Santiago High School in Corona, CA. I am currently doing a research paper and I chose as my topic ovarian cancer and soon became interested by the information i gathered on how it is currently being tested and treated with ginkgo. What causes ovarian cancer? How do you feel about using herbs such as ginkgo for the treatment or prevention of ovarian cancer verses using chemotherapy?
   A. Ovarian cancer is caused by genetics, hormonal factors, the types of food people eat over a lifetime, lack of exercise, potential environmental toxins and probably other factors that are not yet fully clear. Ginkgo biloba is not a treatment for ovarian cancer, but rather may lower the risk but more studies are needed to confirm this. For the time being, a woman with ovarian cancer should follow accepted medical practice since the role of nutritional treatment is not well investigated.