Ovarian cancer is a cancer in one or both of the ovaries. It is important to know the signs and symptoms of ovarian cancer as there are no tests or screening available to detect it. These can include bloating, frequent urination (with no infection), back pain, heartburn, pain during intercourse and unexplained bleeding.
Ovarian cancer is difficult to detect in the early stages. It usually starts in cells on the surface or inside the ovary or from the fallopian tubes, and gradually enlarges. As there is room for it to grow, it does not cause symptoms until it is quite large.
What is ovarian cancer?
How common is ovarian cancer?
Risk factors
Signs & symptoms
Diagnosis
Treatment
When to see your doctor
Ovarian cancer is a cancer that forms in one or both of the ovaries. The ovaries are made up of three main kinds of cells – epithelial cells, stromal cells and germ cells. Each of these cells can develop into a different type of tumour.
Some cancers are called borderline as they usually are slow growing, confined to the ovary and are treated by surgery alone. About 15% of ovarian tumours are borderline and usually affect young women between 20 to 40 years. Very rarely do they spread outside the ovary, with a small risk of coming back or turning into a more active cancer.
The three types of ovarian cancer are:
1. Epithelial
This type of cancer starts in the cells lining in the surface layer of the ovary – epithelium
Research suggests that many epithelial ovarian cancers may start in the fallopian tubes.
These cancers can be cystic and contain watery fluid (serous) or mucous-like fluid (mucinous).
2. Germ cell
This ovarian cancer starts in the cells that produce eggs
3. Stromal cell and other rare types
Ovarian cancer that starts in the tissues that support the ovary and produce different cells. It also includes sex-cord stromal cell ovarian cancer, stromal tumours and sarcomas.
Ovarian cancer is the eighth most commonly diagnosed cancer in women in Australia. Every year around 1800 women are diagnosed with ovarian cancer in Australia.
Even though ovarian cancer is less common than lung cancer or breast cancer, it is important to be aware of its signs and symptoms as early diagnosis improves treatment outcomes. If a woman is diagnosed early, while the cancer is localised (Stage 1), survival rate is over 90%. However, only 29% of women diagnosed at a late stage will survive for more than five years.
Currently there are no reliable early detection tests for ovarian cancer and therefore no screening programs are available.
The exact causes of ovarian cancer are unknown. However, there are some factors that increase the risk of developing ovarian cancer including:
| Age |
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| Hereditary factors |
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| Other factors |
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Just as there are factors that increase your risk, there are also factors that can reduce the risk of developing ovarian cancer. These include:
If you are concerned about your risk, talk to your doctor.
There is currently no proven method of preventing ovarian cancer. Even removing the ovaries of a woman with a strong family history does not always prevent cancer with a very small risk of it occurring in the lining (peritoneum) of the abdomen.
Ovarian cancer is difficult to detect in the early stages. It usually starts as a painless lump or cyst on or in the ovary and gradually enlarges. As there is room for it to grow, it does not cause symptoms until it is quite large.
The symptoms of ovarian cancer are often vague and non-specific. Almost every woman will experience these symptoms at various times and in most cases the symptoms will not be caused by ovarian cancer.
The most commonly symptoms of ovarian cancer are:
Additional symptoms may include:
These symptoms can occur in many women at various times and be unrelated to cancer, which is why ovarian cancer might not be diagnosed until it is quite advanced.
If you experience some of the symptoms of ovarian cancer for more than two weeks, and they are a change from what is normal for you, ask your doctor about the possibility of ovarian cancer.
Your doctor will initially ask questions about your symptoms, past health history and family health history. A physical examination will then be conducted, including a pelvic examination to check your vulva, vagina and cervix, and a manual vaginal examination to check your uterus and pelvis.
If no other cause can be determined for your symptoms, a transvaginal ultrasound examination (internal ultrasound via the vagina) can be performed. This is a test for identifying abnormalities in the ovaries and in the pelvis.
Other imaging tests such as computerised tomography (CT) and positron emission tomography (PET) scans can be used to check for cancer and other abnormal tissue.
Your doctor may also order a simple blood test called a CA-125 (a common tumour marker), but this test is not always reliable.
If your assessment and investigations suggest ovarian cancer is a possibility, ask your doctor for an immediate referral to a gynaecological oncologist.
Gynaecological oncologists are specialists gynaecologists who treat cancers such as ovarian cancer. It has been shown that women with ovarian cancer who are treated by a gynaecological oncologist have better outcomes.
Treatment for ovarian cancer depends on the extent of the cancer. It may include any of, or a combination of, the following:
Detecting ovarian cancer early leads to the best outcomes. You should visit your doctor if you notice:
And these symptoms
Further information about ovarian cancer can be found at:
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at July 2021.
