What is ovarian cancer?

An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone. Cancer occurs when cells in an area of the body grow abnormally. Ovarian cancer is a disease in which these abnormal cells are found inside, near, or on the outer layer of the ovaries. 

1 in 78 women will be diagnosed with ovarian cancer in their lifetime.

Ovarian cancer is the 7th most common cancer among women. In the United States alone, there will be over 22,000 new cases of ovarian cancer diagnosed this year, and over 14,000 women will die from the disease.

If a woman is diagnosed and treated in Stage I or II, her five-year survival rate is over 90%. Unfortunately, only about 20% of all ovarian cancer cases are found at Stage I or II. Women are usually diagnosed in advanced stages and only 45% survive longer than five years.

Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile, making it impossible to provide a general prognosis.

What are the symptoms of ovarian cancer?

Ovarian cancer has been called the “silent killer” because its symptoms were thought to be undetectable until it reached the later stages. However, recent studies have shown that the following symptoms are much more likely to occur in women with ovarian cancer than women in the general population:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Several other symptoms have been commonly reported by women with ovarian cancer:

  • Unexplained change in bowel habits (constipation or diarrhea)
  • Unexplained weight gain or loss
  • Vague but persistent and unexplained gastrointestinal complaints such as gas, nausea, and indigestion
  • Unusual fatigue
  • Shortness of breath
  • Back pain
  • Pain with intercourse
  • New and unexplained abnormal postmenopausal bleeding

Women who have these symptoms persistently for more than a week or two should see a doctor, preferably a gynecologist.

Am I at risk for ovarian cancer?

Research has shown that there are some factors that influence a woman’s risk of developing the disease. They include:

  • Age: Ovarian cancer is most common in women older than 55. Young women can get ovarian cancer, but this is rare. All women can get ovarian cancer.
  • Childbirth: Not giving birth to a child raises a woman’s risk.
  • Family history: Women with a family member who had ovarian, breast, or colon cancer have a higher risk. But 90% of women who get ovarian cancer do not have a family history of the disease.
  • Genes: The most significant risk factor for ovarian cancer is an inherited genetic mutation in the genes BRCA1 or BRCA2 (although mutations in other genes can also increase a woman’s risk). The BRCA1 and BRCA2 genes are responsible for about 10-15% of all ovarian cancers. About 20-25% of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease.
  • Uninterrupted ovulation: Having never given birth or having infertility issues can increase your risk
  • HRT: Long term use of post-menopausal hormone therapy (HRT) can increase your risk.

How can I lower my risk?

There are some actions you can take that lower your risk for ovarian cancer. Talk to a doctor before taking any of these actions to lower risk. 

  • Have one or more children: Your risk drops more if you have a child before age 30.
  • Breastfeed: Your risk drops more if you breastfeed for over a year.
  • Use birth control pills: Your risk drops 50% if you take them for 5 years or more.
  • Have your tubes tied (tubal ligation surgery)
  • Remove the ovaries and fallopian tubes (salpingo-oophorectomy)

How is ovarian cancer detected?

There are no tests that can screen for ovarian cancer.

PAP smears, mammograms, and colonoscopies do not detect ovarian cancer. However, earlier detection can mean a higher chance of survival. Understand your risk, know your body, pay attention to symptoms, and if you feel that something isn’t right, work with your doctor to get the appropriate exams.

The following tests can be performed for women at a high risk for ovarian cancer or for women who have suspicious symptoms.

  • CA-125 blood test
    • This test measures the level of a protein in the blood that may increase when a cancerous tumor is present; this protein is elevated in more than 80% of women with advanced ovarian cancers and 50% of those with early-stage cancers. But because CA-125 tests miss half of early cancers and CA-125 levels can be elevated by benign conditions, it is not an effect screening test for ovarian cancer.
  • Transvaginal ultrasound
    • This test uses sound waves to create a picture of the ovaries, and can often reveal if there are masses or irregularities on the surface of the ovaries.
  • Vaginal-rectal pelvic examination (bimanual exam)
    • This exam allows the ovaries to be examined from many sides. Every woman should undergo a rectal and vaginal pelvic examination at her annual check-up with her gynecologist.

None of these tests are definitive when used on their own. They are most effective when used in combination with each other. But the only way to confirm the presence of ovarian cancer, suggested by these tests, is through a surgical biopsy of the tumor tissue.

If tests suggest the possibility of ovarian cancer, seek a referral to a gynecologic oncologist. Research suggests significant survival advantages for women who are treated, managed, and operated on by a gynecologic oncologist:

  • Gynecologic oncologists are 5 times more likely to completely remove ovarian tumors during surgery
  • 80% of ovarian cancer patients receive inadequate surgical debulking and staging from non-gynecologic oncology surgeons
  • Survival rate and outcomes vastly improve with gynecologic oncologists

I’ve been hearing about clinical trials. How can they help women with ovarian or other gynecologic cancers? 

For more information about clinical trials, visit foundationforwomenscancer.org/clinical-trials. To find a trial you may qualify for, visit sharecancersupport.org/ovarian-cancer/clinical-trial-matching-service/