Ovarian cancer and cervical cancer are both gynecologic cancers — they affect organs within the female reproductive system. The two cancers share some similarities. However, each may lead to a different set of symptoms, be diagnosed using different tests, and require different treatment plans.
The main difference between the two cancers is where they start growing. Ovarian cancer develops in the cells of the ovaries. Ovaries are two small glands that sit on either side of the uterus (womb). Ovaries make the hormones estrogen and progesterone and produce egg cells. Ovarian cancer also includes cancer of the fallopian tubes (the tubes that connect the ovaries to the uterus) and the peritoneum (the inner lining of the abdomen).
Cervical cancer, on the other hand, begins growing in the cells of the cervix. The cervix is the lower part of the uterus that connects the uterus and vagina.
Ovarian cancer, cervical cancer, and other gynecological cancers can all cause unusual vaginal bleeding. Ovarian and cervical cancers can also both lead to pain or pressure in the abdomen, pelvis, or back, or pain during sexual intercourse.
Someone with ovarian cancer, fallopian tube cancer, or peritoneal cancer usually also have other symptoms. These may include:
Cervical cancer symptoms can include having:
Some of these symptoms can also be caused by other non-cancerous conditions. And having these symptoms doesn’t necessarily mean that you have cancer. However, if you notice any unusual feelings in your abdomen or pelvis, or experience changes to your period, make sure to talk to your doctor.
Ovarian and cervical cancers are diagnosed using different types of tests. One key difference between these cancers is that the cervix can be directly observed by a doctor during an exam, while the ovaries (being entirely internal) can only be viewed through imaging tests or surgery. Diagnosis of both ovarian and cervical cancer typically begins with a pelvic exam.
Reaching an ovarian cancer diagnosis may include getting blood tests. Blood tests determine the number of your healthy blood cells (called a blood count), if your liver and kidneys are working, and your levels of CA-125 (a protein often produced by cancer cells). Other tests that can confirm an ovarian cancer diagnosis include:
If your doctor thinks that you might have cervical cancer, they may recommend a colposcopy. In a colposcopy, your doctor closely examines the surface of your cervix to look for abnormalities. During the procedure they may also perform a biopsy to collect sample cervical cells to study under a microscope.
Another test to collect cervical cells is called an endocervical curettage. In this procedure, your doctor uses a small instrument to scrape off samples of cervical cells. In some cases your doctor may need a larger sample of tissue, one that necessitates a surgical procedure. Such a procedure might be called a cone biopsy, conization, cold knife cone biopsy, or loop electrosurgical procedure (LEEP). Each of these involves removing tissue from the cervix.
If ovarian or cervical cancer is detected, doctors may use additional imaging tests in order to determine if or how far the cancer has spread within the body.
Researchers have developed screening tests to help detect certain types of cancer. These tests may pick up signs of cancer even before symptoms develop. Such detection makes it possible to find cancer when it is still early-stage.
Doctors have developed a screening test for cervical cancer: the Pap smear or Pap test. During a Pap smear, a doctor collects cells from the cervix. The cells are sent to a lab, where they can be analyzed for cancerous or precancerous changes. Doctors recommend getting a Pap smear every three to five years. The test usually takes place during a pelvic exam. Very, very rarely can a Pap smear detect ovarian cancer on its own. Usually, though, Pap smears inform your doctor if additional testing should be performed, or if you should be monitored. Being monitored can mean simply getting another Pap smear before the usual prescribed timeframe.
Researchers have analyzed several possible screening tests for ovarian cancer. However, studies have shown that these tests don’t detect ovarian cancer well enough to help prevent ovarian cancer deaths. Therefore, most experts don’t recommend ovarian cancer screening. Still, some doctors may recommend screening for people who are high risk for ovarian cancer, including those with certain inherited gene mutations.
All cancers, including ovarian cancer and cervical cancer, form when gene changes build up within cells. These changes, or mutations, cause cells to grow too quickly in a disorganized way, leading to tumors. While some mutations are inherited (passed down from parent to child), most are acquired (they develop over a person’s lifetime).
Between 20 percent and 25 percent of ovarian cancers are caused by inherited gene mutations. The most commonly mutated genes associated with ovarian cancer are called the BRCA1 and BRCA2 genes. Changes in the BRCA genes can increase a person’s risk of ovarian cancer as well as their risk of breast cancer. Several other inherited mutations can also increase someone’s ovarian cancer risk.
Cervical cancer is rarely tied to inherited gene changes. It is most often thought to be caused by factors such as viral infections that might occur during a person’s life. However, researchers have learned that cervical cancer can run in families. Someone who has a parent, child, or sibling with cervical cancer is more likely to develop the condition themselves. Researchers think that some people may have inherited changes in their genes that make it harder for their immune systems to fight off viruses.
Usually, cancer-causing gene changes occur in one or a couple of cells after a person is born. Environmental or lifestyle factors that can damage a cell’s genes may increase someone's risk of developing cancer.
The main risk factor for cervical cancer is being infected by the human papillomavirus (HPV). HPV infections can’t be cured, but vaccines can help prevent them. People with HPV infections are more likely to develop cancer of the cervix, vagina, vulva, penis, anus, mouth, and throat.
There are also other cervical cancer risk factors. Those who have a weakened immune system, smoke, are exposed to secondhand smoke, have experienced a chlamydia infection, are low-income, or don’t eat enough fruits and vegetables are more at risk than their counterparts.
Ovarian cancer risk factors include getting a menstrual period before the age of 12 or going through menopause after the age of 50. Taking hormone replacement therapy (HRT) while going through menopause also increases a person’s chances of being diagnosed with this cancer.
Ovarian cancer and cervical cancer also share some of the same risk factors. Both cancers occur more commonly in older people, so a person’s chances of developing these cancers increases as they age. Additionally, smoking cigarettes makes a person twice as likely to develop cervical cancer. It also increases their risk for the mucinous subtype of ovarian cancer.
Certain risk factors are distinctly different between the two cancers. For example:
Both ovarian cancer and cervical cancer may be treated with a mixture of surgery, radiation therapy, and medication. That lineup may include chemotherapy, targeted therapy, and immunotherapy drugs. These cancers are sometimes treated with the same medications, and sometimes require different combinations of drugs.
Ovarian cancer treatment options depend on a person’s:
Ovarian cancer treatment usually begins with surgery and is followed by several rounds of chemotherapy. In some cases, a person might receive chemotherapy first, in order to help shrink tumors before they are surgically removed. The targeted drug Avastin (bevacizumab) is sometimes given along with chemotherapy. Rarely, doctors may recommend radiation therapy to treat cancer that has spread to other parts of the body.
Cervical cancer treatment also may start with surgery. This could include a cone biopsy, in which a small piece of cervical tissue is removed, or a radical trachelectomy, in which the entire cervix is removed. (In some cases, surgery may involve a radical hysterectomy, in which the tissues and lymph nodes surrounding the cervix are removed along with the uterus, ovaries, and fallopian tubes.) If cancer cells are found in tissues near the cervix, doctors will usually recommend chemotherapy and radiation therapy. For cervical cancer that is advanced or recurrent (came back after being treated), treatment options may also include immunotherapy or targeted therapy such as bevacizumab.
In some cases of early-stage ovarian or cervical cancer, doctors may be able to remove just one ovary or just the cervix. If the rest of the reproductive organs are left in place, pregnancy is still possible. However, both of these cancers often require a hysterectomy (removal of the uterus). A person will no longer be able to get pregnant after this procedure.
Ovarian cancer usually comes with a worse prognosis (outlook) than cervical cancer. This is partly because cervical cancer screening tests often detect abnormal cells before they become cancerous or when the cancer is at an early stage. Ovarian cancer, however, is much harder to detect early.
Ovarian cancer survival rates depend on a person’s type of ovarian cancer. Additionally, early-stage ovarian cancer often comes with a much better outlook than advanced-stage disease.
The American Cancer Society noted survival rates for people with ovarian cancer. Across all ovarian cancer stages, when compared to females without ovarian cancer, the organization stated:
Cervical cancer survival rates largely depend on the stage of a person’s cancer when they are diagnosed. For example:
A person’s outlook also depends on many other factors, including their age, overall health, and gene mutations. If you are diagnosed with ovarian or cervical cancer, talk to your health care team about how your individual risk factors affect your personal outlook.
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