Cancer is when abnormal cells start to grow out of control in the body. The disease is named after the body part that is first affected, so in the case of ovarian cancer, the cancer started in the ovaries, even if it has spread elsewhere, to say, the fallopian tubes or the uterus.
The ovaries are part of a woman’s reproductive system. A woman has two ovaries and they are about the size of an almond. The ovaries are responsible for producing an egg each month during a woman’s monthly period. The egg then passes through the fallopian tubes, which are long slender tubes, before going to the uterus. The ovaries also make female hormones.
Ovarian cancer is often found in older women. Oftentimes there are no symptoms, so it’s challenging to catch it in the early phases. Treatment is much more effective and successful when caught early. Since symptoms are evasive, it’s good to keep regular tabs on your body. If you’re feeling bloated, get full quickly after eating, have changes in your bowel movements like constipation or feel like you have to urinate more, check with your doctor.
You have an increased risk of ovarian cancer if you have mutations in breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2).
Other risk factors for ovarian cancer include being older. Most women are diagnosed after 50, although it’s important to note that ovarian cancer can happen at any time. If you have a family history of ovarian cancer, you may be at increased risk. This includes two or more close relatives—mother, aunt, sister, grandmother—on either the paternal or maternal side who have been diagnosed with the disease. Additionally, if you started your period at a young age or if you enter menopause at an older age—or both—you may be at an increased risk. Lastly, if you have taken estrogen hormone replacement therapy you may be at an increased risk. Your risk is higher if you used it long term or if you took it in large quantities.
There’s no way to completely prevent ovarian cancer, but there are things you can do to lower your risk. This includes taking birth control pills. However, make sure you talk to your doctor about the pros and cons of using oral contraceptives. While you may lower your risk by taking the pills, oral contraceptives themselves have risks, so talk to your doctor about what makes the most sense given your age, health and medical history. Your doctor may also suggest that you see a genetic counselor. Genetic testing might be a good option depending on your family history of breast or ovarian cancers. If health care providers find a gene mutation that does increase your risk for ovarian cancer, they may suggest surgery to remove the ovaries to prevent ovarian cancer from occurring.
Cells that make up the ovaries
It’s important to know about the cells that make up the ovaries, as each type of cell can develop into a specific type of tumor that may lead to cancer. There are three main cells. Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors. Germ cell tumors start from the cells that produce the eggs. Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
The challenge with ovarian cancer is that there isn’t a reliable test to screen for it. The pap smear does not test for ovarian cancer. It only tests for cervical cancer.
Cancer screening tests are especially effective when the disease is caught early, so treatment can be started. Screening is when doctors use a test to look for a disease even if there are no symptoms. Diagnostic tests are used when a person has symptoms (in the case of ovarian cancer, the woman may have felt bloated, pressure in the pelvis, constipated or a need to frequently urinate). The point of a diagnostic test is to try to find the cause of the symptoms; the doctor is trying to diagnose the problem. For people who are high cancer risks, diagnostic tests may also be used.
Some diagnostic tests include a rectovaginal pelvic exam, a transvaginal ultrasound, or a CA-125 blood test if you have any unexplained signs or symptoms of ovarian cancer. These tests can be important in either finding or ruling out a cancer diagnosis.
However, the CA-125 blood test is not recommended for all women, especially those with an average risk of ovarian cancer. While women with ovarian cancer generally have elevated levels of CA-125, having an elevated CA-125 level does not mean a woman has ovarian cancer. You can have ovarian cancer without an elevated CA-125 level, or some women with a higher CA-125 level might not have ovarian cancer but another condition like endometriosis, liver cirrhosis, pelvic inflammatory disease, uterine fibroids and normal monthly periods.
How is ovarian cancer diagnosed?
If your doctor suspects ovarian cancer, she may have you undergo testing and a pelvic exam. A pelvic exam is when your doctor checks the pelvic area to see if everything feels okay. She’ll put on a glove and insert her fingers into the vagina, and with her other hand, she’ll press down on your abdomen region. She will also look at your external genital area.
She may order imaging tests such as a CT scan or ultrasound. These imaging tests can look closely at the pelvis and abdomen to get a clear picture of the ovaries, including their size and shape.
Additionally, your doctor may order blood tests, including ones called tumor markers that may indicate or show a likelihood of ovarian cancer. The CA-125 test is a blood test that looks for a protein found when ovarian cancer cells are present. The test can’t tell if you have cancer, but it helps your doctor get an overall picture of your diagnosis.
Treatment for ovarian cancer
The most common treatment for ovarian cancer involves surgery and chemotherapy. You may be referred to a gynecologic oncologist, a doctor who specializes and has special training in cancers of the ovary, fallopian tubes or other parts of a woman’s reproductive system. Gynecologic oncologists may perform the surgery to remove the cancer tissue. Additionally, you may be given medicine—chemotherapy—to treat the ovarian cancer. Chemotherapy, or chemo, can be taken as a pill or given through a woman’s veins, or in some instances, it can be done both ways. The goal of chemo is to shrink or kill the cancer cells.
If you’re diagnosed with ovarian cancer, you may have a team of doctors to treat you, including a gynecologic oncologist, surgeons and medical oncologists, doctors who treat cancer with medicine, specifically chemotherapy.
Which treatment is right for you?
Many people get second opinions when deciding on the best treatment options. This means they will see more than one doctor to ask about the best treatment option for them. The doctor will take into consideration the patient’s type and stage of cancer. The doctor will also talk about side effects, or how your body might react to different medicines and treatment options.
Some women who are diagnosed with ovarian cancer may want to take part in a clinical trial. These trials involve experimental new treatments and medications that are being tested to see if they are safe and effective against cancer. Talk to your doctor to see if there are any medical trials available and if you would be a good fit.
- U.S. Department of Health and Human Services, Ovarian cancer https://www.womenshealth.gov/cancer/ovarian-cancer
- Centers for Disease Control and Prevention, What Should I Know About Screening? https://www.cdc.gov/cancer/ovarian/basic_info/screening.htm
- Mayo Clinic, Ovarian cancer https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941
- Mayo Clinic, CA 125: A screening test for ovarian cancer? https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ca-125/faq-20058528
- Centers for Disease Control and Prevention, How is Ovarian Cancer Treated? https://www.cdc.gov/cancer/ovarian/basic_info/treatment.htm
- Mayo Clinic, Ovarian Cancer, Diagnosis https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/diagnosis-treatment/drc-20375946