Key takeaways

Ovarian cancer, primarily affecting older women, is the fifth leading cause of cancer death among women and is difficult to detect early due to its subtle symptoms.
The most common symptoms of ovarian cancer include vaginal bleeding or discharge, pelvic pain, stomach or back pain, bloating, feeling full quickly, and changes in urination or bowel habits.
Risk factors for ovarian cancer include being middle-aged or older, having a family history or genetic mutations like BRCA1 or BRCA2, past cancers, certain ethnic backgrounds, endometriosis, and reproductive history.
Ovarian cancer treatment often involves surgery and chemotherapy, with the effectiveness and approach depending on the cancer’s stage and the patient’s desire for future fertility, emphasizing the importance of early detection for better survival rates.

By the end of 2020, nearly 22,000 women will be diagnosed with ovarian cancer. The rates of ovarian cancer diagnoses have slowly gone down over the past 20 years, but it is still the fifth leading cause of cancer death for women and is the second most common reproductive organ cancer for women.

One of the most important aspects of treating ovarian cancer successfully is catching it as early as possible. That’s why it’s so important for every woman to know the risks and symptoms.

What is ovarian cancer?

Ovarian cancer is a cancer that starts in the ovaries or the fallopian tubes. This cancer is most common in older women and often isn’t detected until it has spread outside of the ovaries, which makes it harder to treat.

There are three common types of cells that cause ovarian cancer tumors to grow: surface epithelium (cells that cover the outer lining of the uterus), germ cells (cells that will become eggs), and stromal cells (cells that release hormones and connect the structures of the ovaries).

Surface epithelial tumors are by far the most common; they account for roughly 90% of all ovarian cancers. The tumors can be classified as benign, low malignant potential (LMP), and malignant. Benign tumors are considered non-threatening. LMP tumors, which are more common in younger women, are considered borderline cancerous and grow more slowly. Malignant tumors are cancerous, and therefore dangerous.

Ovarian cancer symptoms

Ovarian cancer is sometimes called the silent killer because by the time a woman suspects that something is wrong, the disease has spread. The symptoms of ovarian cancer are also easy to blame on something else like an upset stomach.

The most common symptoms of ovarian cancer include:

Vaginal bleeding or discharge (ovarian cancer is most common in women 60 and older, so many should be post-menopausal)
Pelvic pain or pressure
Stomach or back pain
Bloating
Feeling full very quickly after eating
Needing to urinate more or less frequently or experiencing constipation

If you experience any of these symptoms, you should talk to your doctor right away.

Ovarian cancer diagnosis

Although women who are not high risk still are diagnosed for ovarian cancer, it can be useful to know some of the factors that might raise your risk. Those include:

Being middle-aged or older
Having a family history of ovarian cancer
Having a genetic mutation know as BRCA1 or BRCA2
Having had breast, uterine, or colorectal cancer in the past
Having an Eastern European or Ashkenazi Jewish background
Having endometriosis
Having never given birth or having had trouble becoming pregnant

There are some common tests and procedures used to diagnose ovarian cancer. A pelvic exam to feel for the size and shape of the ovaries might be useful to identify later stages of ovarian cancer. CT scans and ultrasounds can also be used to look at the ovaries, abdomen, and pelvis. Your doctor might also use a CA-125 blood test to look for signs of a protein that’s commonly found on the surface of ovarian cancer cells. In some cases, if your healthcare provider can’t be sure of your diagnosis, you might need to have surgery to remove one of your ovaries for testing.

Based on the results of these tests, your healthcare provider will be able to tell you what stage ovarian cancer you have. Stage 1 means the cancer hasn’t spread beyond the ovaries or fallopian tubes. Stage 4 means it has spread to more distant areas of your body, specifically outside of the peritoneal cavity.

Ovarian cancer treatment

If you are diagnosed with ovarian cancer, your treatment will depend on whether having children is still an option or desired as well as the stage of your cancer. It will likely involve some kind of surgery, potentially combined with chemotherapy. The earlier your cancer is detected, the better. Ovarian cancer treatment is much more effective in the early stages when the cancer is still contained in the ovaries or surrounding lymph nodes.

Surgery: Depending on the stage of your cancer, you might have one or both ovaries or fallopian tubes removed. If the cancer is more involved, and having children isn’t a concern, your uterus also might also be removed.
Chemotherapy: Depending on how advanced the cancer is, chemotherapy treatment might be administered before or after surgery.
Medications: There are also drugs that can be used to both help prevent the cancer from coming back, called maintenance therapy, and hormone therapy to treat low-grade tumors if they do come back.

Ovarian Cancer Awareness

September is Ovarian Cancer Awareness Month (be on the lookout for teal ribbons), a good time to learn more about the disease. World Ovarian Cancer Day, meanwhile, is May 8—but ovarian cancer awareness should be a year-round effort.

Ovarian cancer awareness is so critical because of how much a difference early detection makes in survival rates. The five-year survival rate for ovarian cancer is 48.6%, causing nearly 14,000 deaths every year. However, the survival rate is 92.6% at the localized stage, meaning when the cancer is detected at the point when it’s still contained to the ovaries, according to the National Cancer Institute. Even once the cancer has spread to the regional lymph nodes, the survival rate is still high at 74.8%.

Unfortunately, only about 16% of cases are caught in the localized state and 21% in the regional state. That’s why it’s so important to know the signs and symptoms of ovarian cancer and to talk to your healthcare provider if something doesn’t feel right.

Finding a cure for ovarian cancer

Right now, there is not a simple and reliable screening test for ovarian cancer for women who don’t already have symptoms. Screening also can be risky because of the possibility of false positives or negatives.

Some high-risk women who have a family history or presence of the BRCA1 or BRCA2 gene mutations may be advised to have surgery to remove their ovaries and fallopian tubes after age 40. Some experts, however, recommend first removing only the fallopian tubes.

There are also several promising therapies being used or studied to treat ovarian cancer:

Targeted therapy: Treatment that targets different gene mutations that can cause ovarian tumors.
Immunotherapy: Ways to boost the body’s immune system to fight cancer using drugs called checkpoint inhibitors.
Gene therapy: Research into how the damaged genes in the ovarian or fallopian tube cancer cells might be fixed or replaced.

The hope is that with additional time, and research, a more effective treatment is around the corner for ovarian cancer.