Ovarian Cancer

What is ovarian cancer?

Ovarian cancer is cancer in one or both ovaries. Only women have ovaries. One ovary is located on each side of the pelvis. They are similar to the shape and size of an almond. Your ovaries produce sex hormones, regulate your menstrual cycle, and produce eggs. Ovarian cancer is not common. However, it is serious. If it progresses too far, it can be fatal. Ovarian cancer can occur in women at any age.

Symptoms of ovarian cancer

Most symptoms don’t appear until after the cancer has spread outside the ovary. This makes it hard to diagnose it early. Also, symptoms are similar to other non-serious conditions. By the time it has spread, symptoms include:

  • Menstrual changes (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

Most women don’t suspect they have ovarian cancer. That’s why it’s good to know your body. This will help you notice slight changes. The presence of 1 or more symptoms could suggest ovarian cancer or another health issue. Contact your doctor if symptoms persist or worsen.

What causes ovarian cancer?

Ovarian cancer has been linked to several risk factors. These include family history, inherited genes, your pregnancy and reproductive history, hormone replacement therapy, poor diet, and inactivity.

The most common type of ovarian cancer is known as epithelial cancer. It forms in your ovary tissue.  The other type is called primary peritoneal cancer. It starts in the peritoneum. This is the tissue that lines your stomach and covers your female organs. 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.

You can get cancer in your ovaries if it has spread from another area, such as your breasts or colon.

How is ovarian cancer diagnosed?

Ovarian cancer is hard to detect. Most symptoms don’t appear until after the cancer spreads outside the ovary. Confirming ovarian cancer requires a biopsy of your ovary cells and tissue.

American Academy of Family Physicians (AAFP) does not recommend ovarian cancer screening. Screening is used to identify conditions prior to having any symptoms. AAFP has found that ovarian cancer screening 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. The breast cancer genes, BRCA1 and BRCA2, are hereditary. If these genes change, 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.

Being high risk for ovarian cancer genes doesn’t mean you have it. Your doctor can perform tests to examine potential signs. These tests include a pelvic and vaginal exam, X-ray, ultrasound, or blood test.

If you have ovarian cancer, talk to your doctor about your cancer type, grade, and stage. The range of grades is 1 to 3. Grade 3 is the highest or most severe. The range of stages is 1 to 4. Stage 4 is 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?

Ovarian cancer cannot be prevented or avoided. Certain risk factors increase your chances of getting it. These include:

  • BRCA1 or BRCA2 genes
  • Family history of ovarian cancer
  • Personal history of breast, cervical, colon, or melanoma cancer
  • Personal history of Lynch syndrome (a medical condition)
  • Ashkenazi Jewish decent (Eastern European)
  • Infertility or pregnancy later in life
  • Endometriosis (a medical condition that causes tissue to grow outside your uterus)
  • Hormone replacement therapy 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 extremely high-risk, your doctor might recommend removing your ovaries. This surgery is called an oophorectomy.

Any woman can develop ovarian cancer. Studies show that some things can reduce your risk, such as:

  • Giving birth (and not having children at a later age)
  • 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

Treatment requires a team of specialists. This might include a surgeon and oncologist. An oncologist is a cancer specialist. It is common for your primary doctor to refer you to a specialist. You can seek a “second opinion.” If you have ovarian cancer, your doctor will discuss treatment. Treatments vary based on the type, grade, and stage of cancer. They also depend 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:

  • Surgery to remove the cancerous cells and tissue. It also may include removal of the affected and surrounding organs.
  • Chemotherapy to reduce or kill the cancer. Chemo medicine can be given in pill, liquid, or IV (intravenous) form. Also, it can be injected directly into the affected area.

Radiation to reduce or kill the cancer using high-energy waves, similar to X-rays.

Living with ovarian cancer

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

Your doctor will monitor your treatment. He or she will check to see if the cancer is gone. Your doctor also might perform regular tests to detect its return. You might have lasting side effects from the cancer treatment. Your doctor will work with you to reduce these.

Questions to ask your doctor

  • What is my cancer type, grade, and stage?
  • Has my cancer spread?
  • Is ovarian cancer related to other cancers?
  • What is the prognosis for a positive outcome (by stage)?
  • What clinical trials are available to me?
  • What are the side effects of treatment?
  • Will ovarian cancer affect my ability to get pregnant?
  • If I have ovarian cancer, can my close relatives could get it?
  • What is the ovarian cancer recurrence rate?