Understanding Ovarian Cancer

*Please note: This slide show is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor about any questions you may have regarding a medical condition.

What is ovarian cancer?

The ovaries are part of a woman's reproductive system. From puberty until menopause, the ovaries store eggs and produce female hormones.

In general, the term "ovarian cancer" is often used to describe cancers that begin in the cells of the ovary, fallopian tube, or peritoneum.

What are the types of ovarian cancer?

The most common type of ovarian cancer is called epithelial ovarian cancer. It starts on the outer surface or in the lining of the ovaries.

Other types of ovarian cancer start in:

• Cells that produce hormones (called stromal tumors)
• Cells that develop into eggs (called germ cell tumors)

Ovarian cancer in the United States

Each year in the United States more than 21,000 women are diagnosed with ovarian cancer.

Who is at risk for ovarian cancer?

Ovarian cancer is most common after menopause. Older age remains a risk factor for most ovarian cancers.

All women are at risk, but some women are at higher risk if they:

• Are overweight or obese
• Have had children later in life or never had a full-term pregnancy
• Have had infertility treatment
• Have had prolonged hormone replacement therapy
• Have had breast cancer
• Have a family history of ovarian, breast, or colorectal cancer
• Are smokers
• Have inherited certain genetic mutations

What are the symptoms of ovarian cancer?

Symptoms of ovarian cancer may include:

• Bloating
• Feeling full quickly when eating
• Needing to urinate urgently or often
• Heartburn
• Fatigue
• Pain in the back, pelvis, or abdomen
• Pain during sex
• Constipation 
• Changes in your monthly period
• Vaginal bleeding or spotting after menopause

What are the symptoms of ovarian cancer?

See your doctor if you have any of those symptoms for more than two weeks. Your doctor should perform a pelvic exam and may also order an ultrasound exam of the pelvis.

When ovarian cancer is in its early stages, you may not notice any symptoms. Also, other conditions can cause the same symptoms. For these reasons, ovarian cancer is often not diagnosed until after it has begun to spread.

Genetic changes and ovarian cancer

Some ovarian cancers are caused by genetic changes that can be inherited from either parent.

BRCA1 and BRCA2 are two genes that everyone has. When they change, or mutate, they can cause cancer.

Women who inherit a mutation in BRCA1 or BRCA2 have a higher risk for getting ovarian cancer and for being diagnosed at a younger-than-average age.

Inherited changes to BRCA1 or BRCA2 also increases risk for other cancers such as breast cancer.

Genetic changes and ovarian cancer

Changes in other genes that may run in families can also increase risk for ovarian cancer and other types of cancer.

Cancer experts recommend that all women with epithelial ovarian cancer be tested for changes in BRCA1, BRCA2, and other genetic changes.

A genetic counselor can help:

• Explain risk for inherited diseases
• Discuss steps to reduce risk or detect the disease early

Can I reduce my risk for ovarian cancer?

You can take steps to reduce your risk for ovarian cancer:

• Eat a healthy diet and get regular exercise
• If you are able to have a child, consider breastfeeding
• Talk to your doctor about taking birth control pills. In studies, women who took birth control pills for 3 years or more reduced their risk for ovarian cancer

Can I reduce my risk for ovarian cancer?

When you have completed childbearing, surgery to "tie" or remove your fallopian tubes can reduce your risk for ovarian cancer.

If you have genetic risk factors and carry a genetic mutation, you may be counseled to think about risk-reducing surgery to remove the ovaries or fallopian tubes. 

If you have not yet gone through menopause, removing the ovaries will cause an immediate early menopause. Before considering this surgery, talk with your doctor about the side effects of early menopause and what you can expect.

What is ovarian cancer staging?

Ovarian cancer staging describes where the cancer is located in the body and the size of the cancer. This helps with choosing the best treatment.

Ovarian cancer has four main stages, ranging from Stage I (early disease) …

What is ovarian cancer staging?

… to Stage IV (advanced disease).

What’s the outlook for a patient with ovarian cancer?

Due to the nature of ovarian cancer, every patient may have a different experience. The outlook will depend on many factors, including the stage and type of ovarian cancer, your age and overall health.

In general, earlier detection means a better outlook.

Talk with your healthcare team about your own diagnosis to better understand your treatment options and what you can expect. If there's anything you don't understand, be sure to ask to have it better explained.

References

1. American Cancer Society. Can Ovarian Cancer Be Found Early? Last Revised: July 24, 2020.
   https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/detection.html
2. American Cancer Society. Ovarian Cancer Stages. Last Revised: April 11, 2018.
   https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/staging.html
3. Mayo Clinic. Endometriosis.
   https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
4. National Cancer Institute. BRCA Gene Mutations: Cancer Risk and Genetic Testing. Reviewed: November 19, 2020.
   https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
5. National Cancer Institute. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention (PDQ^®)–Patient Version. Updated: April 9, 2021.
   https://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq
6. National Ovarian Cancer Coalition. What is Ovarian Cancer?
   https://www.ovarian.org/about-ovarian-cancer/what-is-ovarian-cancer