FAQs

Some common FAQs.. a work in progress…. and my attempt to provide clear answers.  The information and literature about borderline ovarian cancer/borderline ovarian tumours (BOTs) is a confusing terrain to navigate.  Please let me know of key questions that you think are missing, or if the answers remain confusing at:  borderline.ovarian.tumours@gmail.com

**disclaimer:  I am not a medical doctor, the information on this blog is based on my interpretation of existing research/information, always seek advice from a professional**

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What is a BOT?

BOT stands for Borderline Ovarian Tumour.

The cells that make up a BOT are not the same as a benign ovarian growth, and they are not the same as those associated with ‘typical’ ovarian cancer.

They have a low malignant potential which means they are very unlikely to become malignant.

They are normally treated with surgery alone and prognosis is excellent.

A great factsheet produce by ovacome can be found here.

 

Is BOT ovarian cancer (OC)?

Yes.  And no.

BOTs are not the same as typical ovarian cancer (OC).

‘Typical’ ovarian cancers are graded as grade 1, 2 or 3 depending on the aggressiveness of the cancer cells.

BOTs are considered to be grade 0 ovarian cancer and many refer to borderline ovarian cancer.

BOTs have a low malignancy potential so are unlikely to become malignant.  Even if BOTs spread beyond the ovary, they do not spread like typical cancer cells and it is often possible to remove all of the disease with surgery.

Because BOTs grow more slowly than ‘typical’ OC, they do not respond to chemotherapy which is commonly used to treat typical ovarian cancer.

 

What does “borderline” actually mean?

BOTs are not benign ovarian growths but they are also not malignant, cancerous growths.  The cells making up BOTs behave somewhere in between – a grade 0 ovarian cancer.

Although the term ‘borderline’ may suggest uncertainty, it accurately describes the ambiguous histologic and biologic features of these neoplasms and remains the most appropriate term. Accordingly, it has been recommended by the World Health Organization (WHO) for the last four decades [2].

 

How are BOTs diagnosed?

BOTs – like ovarian cancers – are only properly diagnosed with surgery.  Pre-surgery, it is not possible to determine if a growth is benign, malignant or borderline.

STAGING:  During surgery, the STAGE will be determined (stage 1, 2, 3 or 4).  This determines if the tumour has spread beyond the ovary, and if yes, where it has spread to.

GRADING: The tumour will be sent for histological assessment where it will be assessed microscopically and graded.  This is when a BOT diagnosis will be made:  borderline is the grade of the tumour; BOTs are considered to be grade 0 ovarian cancer.

 

What is the treatment for BOT?

BOTs are mostly treated with surgery.  Depending on if/where your BOT has spread (remember that most are diagnosed at stage 1 meaning the tumour is confined to the ovary/ovaries), your surgeon will determine the best procedure. She will discuss this with you pre-operatively.  Sometimes staging surgery is undertaken first; the results from this surgery will help you to determine what to do next.

You can find out about the different types of surgery here.

Your surgery may involve:

– a (bilateral) oophorectomy:  removal of (both) ovary/ies

– a (bilateral) salpingo:  removal of (both) fallopian tube/s

– a sub-total hysterectomy:  removal of the womb

– a total hysterectomy:  removal of the womb and cervix

– an omenectomy:  removal of the fatty tissue that covers lower intestine

– a radical hysterectomy:  removal of womb, cervix, fallopian tubes, part of your vagina, ovaries, lymph glands and fatty tissue (omentum)

 

Will I experience the menopause?

If you are not yet menopausal and have both ovaries removed, you will experience the menopause.  If you are not yet menopausal and have one ovary removed, you may experience an early menopause.  Hormone replacement therapy can help to alleviate the symptoms of menopause.  Depending on your surgery, different options are available.

 

Where can I find out further information?

A selection of papers, clinical guidelines and fact sheets can be found here.

A closed facebook group for BOT ladies has been created here.

If you have any papers, guidelines, fact sheets or other resources that you are willing to share, please email them to:  borderline.ovarian.tumours@gmail.com