Ovarian Cancer

What is ovarian cancer?

Ovarian cancer is cancer in one or both ovaries. Only women can have it, because ovaries are part of the female anatomy. Women have two ovaries with one on each side of the pelvis. They are similar to the shape and size of an almond. Your ovaries produce hormones, regulate your menstrual cycle, and release eggs for ovulation.

Ovarian cancer can occur in women at any age. Most women who have ovarian cancer are 40 years of age or older. It is the leading cause of death among cancers of the female reproductive system.

Symptoms of ovarian cancer

Many women do not suspect ovarian cancer. However, you can develop ovarian cancer at any age. The symptoms are common and often are not present early on. You might have mild symptoms as the cancer develops.

Possible symptoms include:

  • Menstrual changes, such as unusual bleeding or discharge
  • Bloating or swollen stomach
  • Diarrhea, constipation, or frequent urination
  • Stomach, back, or pelvic pain
  • Lump in the pelvic area
  • Loss of appetite or quickly feeling full
  • Digestion problems.

It is good to know your body well in order to notice slight changes. Presence of 1 or more symptoms could suggest ovarian cancer or another health issue. Contact your doctor if any symptoms persist or worsen over a period of time.

What causes ovarian cancer?

According to the Centers for Disease Control and Prevention (CDC), cancer is a disease in which cells in the body grow out of control. Cancer that starts in your ovaries is called ovarian cancer.

Ovarian cancer can occur in several different areas. The most common type forms in the ovary tissue and is known as ovarian epithelial cancer. It also can begin in the peritoneum. This is the tissue that lines your stomach and covers your female organs. This is called primary peritoneal cancer. Fallopian tube cancer is when it forms in the base of the tubes that connect your ovaries to your uterus.

Germ cell cancer and stromal cell cancer are rare types of ovarian cancer. Germ cells make up your ovary’s eggs. Stromal cells are found in the connective tissue. Both types of cancer have high cure rates.

Some cases of ovarian cancer can spread to other areas in your body. You also can get cancer in your ovaries if it has spread from another area, such as your breasts or colon.

How is ovarian cancer diagnosed?

American Academy of Family Physicians (AAFP) recommends against ovarian cancer screening for women. Screening is a method to identify conditions prior to having any symptoms. AAFP has found that screening for ovarian cancer is not accurate or valuable. AAFP also recommends against genetic counseling related to ovarian cancer, unless you are high risk.

Family history is one of the biggest risk factors for ovarian cancer. Breast cancer susceptibility genes, BRCA1 and BRCA2, are hereditary. If these genes change or mutate, they can cause ovarian cancer. AAFP does recommend genetic counseling and testing for women with this family history. Talk to your doctor if you think you meet the screening requirements.

Keep in mind, being high risk for ovarian cancer genes, doesn’t mean you have it. Your doctor can perform tests to further examine potential signs. These tests can include a pelvic and vaginal exam, X-ray, ultrasound, or blood test. Your doctor will confirm ovarian cancer by doing a biopsy of your ovary cells and tissue.

If you have ovarian cancer, talk to your doctor about what type, grade, and stage of cancer you have. The range of grades is 1 to 3, with 3 being the highest or most severe. The range of stages is I to IV, with IV being the highest or most severe. Your doctor may order additional tests to see if the ovarian cancer has spread to other areas of your body. This is usually done with imaging, such as an X-ray, colonoscopy, CT (computed tomography) scan, or MRI (magnetic resonance imaging).

Can ovarian cancer be prevented or avoided?

There is no way to prevent or avoid ovarian cancer. Certain factors do put you at higher risk of getting ovarian cancer. Risk factors for ovarian cancer, include:

  • BRCA1 or BRCA2 gene mutations
  • Biological family members who have had ovarian cancer
  • Personal history of breast, cervical, colon, or melanoma cancer, or Lynch syndrome
  • Family background of Ashkenazi Jewish (Eastern European) descent
  • Difficulty getting pregnant, or delaying pregnancy until later in life
  • Endometriosis (a condition where tissue lining grows outside of your uterus)
  • Use of estrogen (postmenopausal) medicine for 5 years or more.

Talk to your doctor about screening or testing if you have any of these. It does not mean that you have or will have ovarian cancer. If you are very high-risk, your doctor might recommend removing your ovaries. This surgery is called an oophorectomy.

Despite these risk factors, any woman can develop ovarian cancer. Studies show that some things can reduce your risk, such as:

  • Giving birth
  • Breastfeeding for 1 or more years
  • Using (or previous use of) birth control pills
  • Removing ovaries, having tubes (fallopian) tied, or having a hysterectomy (surgery to remove all or part of the uterus).

Ovarian cancer treatment

It is common for your primary doctor to refer you to a specialist. You also can consult with another doctor to get a “second opinion.” If your doctor confirms you have ovarian cancer, they will talk to you about treatment options. These vary based on the type, grade, and stage of cancer. It also depends on if the cancer has spread to other areas in your body.

The goal of treatment is:

  • To remove or get rid of cancer
  • To keep cancer from spreading
  • To reduce side effects and pain related to cancer.

Most treatment programs include a mix of methods, such as:

  • Surgery to remove the cancerous cells and tissue. It also may include removal of the affected and surrounding organs.
  • Chemotherapy to help reduce or kill the cancer. Chemo medicine can be given in pill, liquid, or IV (intravenous) form. It also can be injected directly into the affected area.
  • Radiation to help reduce or kill the cancer using high-energy waves, similar to X-rays.

There are other things you can consider in addition to or in place of standard medical treatment. These are considered complementary or alternative medicine. Not all of these have been fully tested or approved. Talk to your doctor about the risks and benefits of these treatment options.

Living with ovarian cancer

Treatment is more successful if the cancer is detected early. Your outcome also depends on the type, grade, stage, and location of cancer, as well as your general health.

Your doctor will follow up with and monitor you after treatment. They will check to see if the cancer is gone. They also might perform regular tests to help detect it earlier if it does return. You might have lasting side effects from the cancer treatment, but your doctor will work with you to reduce these.

Questions to ask your doctor

  • What type, grade, and stage of ovarian cancer do I have? Has it spread to other areas?
  • Is ovarian cancer linked to any other types of cancer?
  • What are my chances of beating ovarian cancer?
  • What clinical trials are available to me?
  • What are the short-term and long-term side effects of ovarian cancer treatment?
  • Will ovarian cancer affect my ability to get pregnant and have a baby?
  • If I have ovarian cancer, will my relatives (daughter, mother, sister) have it too?
  • If I have ovarian cancer, what are my chances of it coming back a second time?