Ovarian Cancer
Ovarian Cancer

Ovarian Cancer

Ovarian cancer is a cancerous (malignant) tumor on one or both ovaries. A tumor is a mass of cells or tissue. The ovaries are the parts of the female reproductive system that produce eggs and female hormones (estrogen and progesterone). Women have two ovaries. They are located on each side of the uterus.

There are different types of ovarian cancer, depending on where the cancer develops. These include:
  • Epithelial ovarian cancer. This develops along the outer lining of the ovary.
  • Germ cell cancer. This develops within the egg-producing areas of the ovary.
  • Stromal cell cancer. This develops within the hormone-producing areas of the ovary.

What are the causes?

The exact cause of ovarian cancer is not known.

What increases the risk?

You are more likely to develop this condition if you:
  • Are age 40 or older.
  • Have gone through menopause.
  • Have a personal or family history of endometrial, colon, breast, or ovarian cancer.
  • Have the genes associated with breast and ovarian cancer (BRCA1 or BRCA2) or other gene mutations related to inherited family cancer syndromes, such as Lynch syndrome.
  • Have undergone some types of fertility treatment, including in vitro fertilization.
  • Became pregnant for the first time at age 35 or older or have never been pregnant.
  • Have had hormone replacement therapy.
  • Are overweight or obese.
  • Have tissues from the uterus growing outside of the uterus (endometriosis).

What are the signs or symptoms?

In the early stages, ovarian cancer often does not cause symptoms. As the cancer grows, symptoms may include:
  • Bloating, swelling, a lump, or pain in the abdomen.
  • Unexplained weight loss.
  • Indigestion, increased gas, and constipation.
  • Pain and pressure in your back or in the area between the hip bones (pelvis).
  • Loss of appetite or feeling full more quickly when eating.
  • Frequent urination or pressure on your bladder.
  • Pain during sex.
  • Fatigue.

How is this diagnosed?

This condition may be diagnosed based on:
  • Your medical history.
  • A physical exam to check your ovaries, uterus, vulva, cervix, vagina, bladder, rectum, and fallopian tubes.
  • Tests. These may include:
    • An imaging test that uses sound waves to take pictures of your uterus, bladder, ovaries, and fallopian tubes (transvaginal ultrasound). For this test, a sound wave probe is inserted into your vagina.
    • A biopsy. This is a test in which a tissue sample is taken from the ovary and looked at under a microscope.
    • Paracentesis. This is a procedure to remove built-up fluid from the abdomen (ascites). The fluid is then examined under a microscope.
    • Blood tests that may include genetic testing.

You may also have other tests, including:
  • X-rays of the colon and rectum.
  • CT scan, PET scan, or MRI.
  • Laparoscopy. This is a procedure in which a thin, lighted tube is inserted into a small incision in the lower abdomen to take images of your pelvic organs.

Additional tests may be done to see whether the cancer has spread to other parts of the body (what stage it is). The stages of ovarian cancer include:
  • Stage 1 (I) – The cancer is located in one or both ovaries and has not spread to other parts of the body, including nearby lymph nodes.
  • Stage 2 (II) – The cancer has spread into nearby organs, such as the uterus, bladder, colon, or lining of the abdomen (peritoneal cavity). It has not spread to nearby lymph nodes or other parts of the body.
  • Stage 3 (III) – The cancer has begun to spread to nearby lymph nodes or tissue near the lymph nodes, but not to other parts of the body.
  • Stage 4 (IV) – The cancer has spread to other parts of the body, such as the liver, bone, or lungs.

How is this treated?

Treatment for this condition depends on the type and stage of the cancer. Treatment may include:
  • Surgery to remove one ovary and its fallopian tube (oophorectomy). This may be done to treat cancer in its early stages.
  • Surgery to remove the uterus, cervix, fallopian tubes, and ovaries (hysterectomy with bilateral salpingo-oophorectomy). Lymph nodes near the tumor, and some tissue and fluid from the abdomen, may also be removed and analyzed for cancer cells. This is done to treat advanced cancer.
  • Chemotherapy. This uses medicines to kill the cancer cells. Chemotherapy may be used before or after surgery. Intravenous (IV) or intraperitoneal (IP) chemotherapy is given directly in the abdomen.
  • Hormone therapy. This uses hormones or hormone-blocking medicines to fight cancer cells.
  • Targeted therapy. This uses drugs to attack specific areas within cancer cells to kill them or stop them from growing. This does not affect normal cells.
  • Immunotherapy or biotherapy. This uses medicines to help your immune system fight cancer cells.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Ask your health care provider if the medicine prescribed to you:
    • Requires you to avoid driving or using machinery.
    • Can cause constipation. You may need to take these actions to prevent or treat constipation:
      • Drink enough fluid to keep your urine pale yellow.
      • Take over-the-counter or prescription medicines.
      • Eat foods that are high in fiber, such as beans, whole grains, and fresh fruits and vegetables.
      • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
  • Do moderate exercise regularly as told by your health care provider.
  • Try to eat regular, healthy meals.
    • Avoid or eat limited amounts of processed meats, sugary drinks, and highly processed foods.
    • Some of your treatments might affect your appetite. If you are having problems with eating or your appetite, ask to meet with a dietitian.
  • Consider joining a support group with others who have cancer. A support group may help you learn about resources and help you manage your cancer.

General instructions

  • You may need to have regular blood tests and imaging tests to monitor your response to treatment.
  • Use sunscreen (SPF 30 or higher) or wear clothes that protect you from the sun if receiving chemotherapy.
  • Keep all follow-up visits. This is important.

Where to find more information

Contact a health care provider if you:

  • Are not able to follow a prescribed treatment plan or take a medicine.
  • Have any symptoms or changes that concern you.
  • Have changes in your bowel or bladder habits.

Get help right away if you have:

  • A fever or chills. This is important.
  • Serious side effects or an allergic reaction to a treatment or medicine.
  • Increased pain, swelling, or bloating in your abdomen.
  • New or sudden symptoms that do not go away.

Summary

  • Ovarian cancer is a cancerous (malignant)tumor that develops on one or both ovaries.
  • Many people do not have symptoms in early stages. Later symptoms may include pain in the abdomen, back, or pelvis, loss of appetite, and swelling or bloating in the abdomen.
  • You are more likely to develop ovarian cancer if you are age 40 or older or have the genes associated with breast and ovarian cancer (BRCA1 or BRCA2).
  • Treatment depends on the type and stage of the cancer. Often, treatment may include a combination of surgery, radiation, and medicines that kill cancer cells (chemotherapy or targeted therapy).
  • Keep all follow-up visits. This is important.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.