Cancer can happen anywhere in the body, starting when cells begin to grow out of control. Ovarian cancer is a type of cancer that was once thought to only begin in the ovaries, but recent studies have suggested that it may also start in the fallopian tubes.
A woman has two ovaries, one on each side of the uterus, and each about the size of an almond. The ovaries are where the hormones estrogen and progesterone are found. As part of the reproductive system, the ovaries are responsible for producing the egg, which travels from the ovaries through the fallopian tubes and into the uterus, where, if fertilized, it can grow into a fetus.
Symptoms of ovarian cancer
The challenge with ovarian cancer is that often there are no symptoms and so it goes undetected and spreads. Ovarian cancer may spread to the pelvis and abdomen before it’s noticed. Even advanced-stage ovarian cancer does not have many symptoms. However, early detection is important because early-stage ovarian cancer often can be treated with a high success rate. The key is knowing and listening to your body and telling your doctor if something feels off.
Symptoms of ovarian cancer may include:
- Bloating or swelling in the abdominal region
- Feeling very full, quickly, after eating
- An increased need to go to the bathroom and urinate
- Changes in your bowel movements and becoming constipated
- Losing weight
- Pain or discomfort in your pelvis or abdominal region
- Vaginal bleeding (of particular concern in postmenopausal women) or discharge that is unusual
While there’s no way to know if you’ll get ovarian cancer, there are certain factors that may increase a woman’s risk for developing it. However, be aware that most women who get ovarian cancer are not considered high risk. But, if any of the risks relate to you, it’s good to be more vigilant about your body and the changes you see.
Ovarian cancer risk factors include:
- Being older. Ovarian cancer is more common in women who are middle-aged or older.
- Having a family history of ovarian cancer. This means a close member of your family — a mother, aunt, sister or grandmother — had ovarian cancer.
- Having had a hard time getting pregnant or having never given birth.
- Having endometriosis, a condition in which the tissue that lines the uterus grows elsewhere in the body.
- Having had another type of cancer, such as breast, uterine or colon cancer.
- Having a genetic abnormality called BRCA1 or BRCA2, or one associated with Lynch syndrome.
- Being of Eastern European or Ashkenazi Jewish descent.
Some research suggests that women who take estrogen (without progesterone) for 10 years or longer also may have a higher risk for ovarian cancer.
Remember: Having a risk factor does not mean that you will develop ovarian cancer. Talk with your doctor about your specific risk and the possibility of genetic counseling if there is a history of ovarian cancer in your family.
Reducing your risk
Though you can’t prevent ovarian cancer, several factors have been linked to having a lower chance of getting it. For instance:
- Women who have been on birth control pills for five or more years have a lower risk.
- Women have a reduced risk if they have had a tubal ligation, had both ovaries removed or had a hysterectomy, which is an operation in which the uterus, and sometimes the cervix, is removed.
- Women who have given birth are at a lower risk
- Some research suggests that women who breastfed for at least a year may have a modestly reduced risk for ovarian cancer.
It’s important to note that while these factors may help reduce your risk, they are not recommended for everyone. There are risks and benefits involved. The Centers for Disease Control and Prevention notes the importance of talking with your doctor about ways of reducing your personal risk.
When to see a doctor
A challenging part of the development of ovarian cancer is that there may be few or no symptoms. And while women sometimes think that a pap smear will test for ovarian cancer, it actually tests only for cervical cancer. In fact, cervical cancer is the only gynecological cancer that has a simple and reliable screening test.
This makes it even more important to be vigilant about your body and to talk to your doctor if you notice any unusual changes. Your doctor may have you undergo diagnostic tests, the type of testing that's done when a person has symptoms. Diagnostic testing helps your doctor determine what is causing the symptoms so you can be accurately diagnosed and treated. Diagnostic tests also may be recommended for someone at a high risk for cancer.
If you experience symptoms of ovarian cancer, you can check with your doctor about whether you should have a diagnostic test like a rectovaginal pelvic exam, a transvaginal ultrasound or a CA 125 blood test. These tests may help discover or rule out ovarian cancer.
It’s important to note that the CA 125 blood test is not recommended for all women, especially those with an average or below-average risk for ovarian cancer. That's because women with ovarian cancer generally have elevated levels of CA 125, but an elevated CA 125 level does not mean that a woman has ovarian cancer. In fact, some women with ovarian cancer don’t have elevated CA 125 levels at all, while some women with elevated CA 125 levels may not have ovarian cancer but may have another condition that causes the elevated level, such as endometriosis, liver cirrhosis, pelvic inflammatory disease or uterine fibroids.
If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your personal risk. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk for breast and ovarian cancers.
How is ovarian cancer diagnosed?
If your doctor suspects that you may have ovarian cancer, the doctor may suggest further diagnostic testing, including having a pelvic exam. The pelvic exam is done to feel the organs in your pelvis. Your doctor will press down on your abdomen while inserting two fingers into your vagina. Your cervix, vagina and genitals also will be examined.
Your doctor may also suggest blood tests or imaging studies, such as an ultrasound or CT scan of your pelvic and abdominal area.
Surgical procedures are another diagnostic option. Your doctor may recommend a biopsy to remove tissue for testing in a lab or removal of an ovary to have it tested for cancer.
The next steps
If cancer is found, your doctor will assign a stage to the cancer, depending on the results of the tests and procedures. The stages for ovarian cancer range from 1 to 4, with severity increasing as the numbers increase. Stage 1 means the cancer has not spread beyond the ovaries. Stage 4, the most serious, means the cancer has spread to other organs or tissue throughout the body.
Surgery and chemotherapy are generally used to treat ovarian cancer.
Outlook for ovarian cancer
Catching ovarian cancer early is key to long-term survival. This type of cancer is the fifth leading cause of death from cancer in women, according to the Ovarian Cancer Coalition. The American Cancer Society (ACS) estimates that 13,940 women will die from ovarian cancer in 2020. However, the five-year survival rate for women diagnosed and treated when ovarian cancer is in an early stage (1 or 2) is more than 90 percent. And, as the ACS notes, treatments continue to improve, giving women diagnosed today a potentially better outlook.
- American Cancer Society, What Is Ovarian Cancer? https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html
- Mayo Clinic, Ovarian Cancer, Overview https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941
- Centers for Disease Control and Prevention, Ovarian Cancer, What are the Risk Factors https://www.cdc.gov/cancer/ovarian/basic_info/risk_factors.htm
- Centers for Disease Control and Prevention, Ovarian Cancer, What Can I Do to Reduce My Risk? https://www.cdc.gov/cancer/ovarian/basic_info/prevention.htm
- Centers for Disease Control and Prevention, Ovarian Cancer, What Are the Symptoms? https://www.cdc.gov/cancer/ovarian/basic_info/symptoms.htm
- Centers for Disease Control and Prevention, Ovarian Cancer, What Should I Know About Screening? https://www.cdc.gov/cancer/ovarian/basic_info/screening.htm
- Centers for Disease Control and Prevention, Ovarian Cancer, How Is Ovarian Cancer Treated? https://www.cdc.gov/cancer/ovarian/basic_info/treatment.htm
- Mayo Clinic, CA 125 test: A screening test for ovarian cancer? https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ca-125/faq-20058528
- Mayo Clinic, Ovarian Cancer, Diagnosis https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/diagnosis-treatment/drc-20375946
- National Ovarian Cancer Coalition, What Is Ovarian Cancer? http://ovarian.org/about-ovarian-cancer/what-is-ovarian-cancer
- American Cancer Society, Ovarian Cancer Stages https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/staging.html