Understanding Your Diagnosis

Planning your treatment

Ovarian cancer patients interact with many doctors during the course of their treatment, but rarely do they meet the specialist who plays a critical role in planning your treatment—the pathologist who diagnoses their cancer by analyzing samples of, tissue and body fluid.

Why does it matter what kind of ovarian cancer I have?

Precise diagnosis is what drives decisions about your individualized cancer care plan. To determine which treatments and procedures will be most effective for your cancer, your doctor will rely on the findings of the pathologist who examines and tests your biopsies to identify your cancer’s type, subtype and grade, in addition to other individual characteristics of your cancer such as its genetic profile and immune biomarkers.

At Roswell Park, we have pathologists who focus exclusively on gynecologic cancers. Ovarian cancer type is refers to the ovarian cell type in which the cancer begins:

  • Epithelial cells which cover the ovaries’ surface. Epithelial ovarian cancer is the most common type, accounting for nine out of ten cases. Epithelial cell ovarian cancer, cancer is classified into four subtypes, based on features of the cancer cell:
    • Serous (most common)
    • Mucinous
    • Endometrioid
    • Clear cell
  • Germ cells are the cells that make up individual eggs. Ovarian germ cell tumors typically occur in teenage girls or young women and affect just one ovary.
  • Stromal cells which produce the female hormones, estrogen and progesterone, are found in the supporting connective tissue of the ovary.

Both germ cell and stromal cell tumors are rare and together account for less than 10 percent of ovarian cancer cases.

Your cancer’s grade refers to how different the tumor cells look compared to normal cells:

Grade 1 cancer cells look similar to normal cells; these are often called low grade; they tend to grow slowly and are less likely to spread.

Grade 2 cancer cells are intermediate, between grades 1 and 3. They look more abnormal, grow faster, and are more likely to spread than grade 1 cells, but not as much as grade 3 cells.

Grade 3 cancer cells look very different from normal cells; these are called high grade; they grow faster and are most likely to spread.

The Roswell Park Advantage

Most importantly, we test ovarian cancer tumors using two diagnostic tests developed at Roswell Park, to determine which therapies or clinical trials offer you the very best option, based on:

  • Tumor Genetic Profile. OmniSeq Comprehensive tests the tumor’s DNA and RNA to identify genetic alterations caused by the cancer, which are actionable, meaning there is a drug or anti-cancer agent available that targets that specific genetic mutation. This test looks at 144 potential mutations in all. Patients can then be matched with a targeted therapy, or a clinical trial that offers a new agent, that is personalized for their tumor’s genetic profile.
  • Unique immune system features. OmniSeq Immune Analysis examines multiple biomarkers to learn of unique abnormalities of a patient’s immune system and predict which immunotherapies would provoke the best response.

In addition we test all ovarian cancer tumors to learn if the cancer cells express a specific protein type called NY-ESO-1. Apart from the adult male testis, this protein is not found in normal body cells. Roswell Park has a number of clinical trials that offer new anti-cancer agents, an ovarian cancer vaccine and immunotherapies that find cancer cells by targeting the NY-ESO-1 protein.