Understanding ovarian cancer

Ovarian cancer is a cancer that begins in the ovaries, the organs that produce eggs and the hormones oestrogen and progesterone. It is sometimes described as silent, because it can grow for some time before symptoms become obvious. In fact, most women do have symptoms, but they are easy to mistake for something less serious. Understanding ovarian cancer helps you recognise the signs and act on them early.

Types of ovarian cancer

There are three main types of ovarian cancer, each starting in a different kind of cell in the ovary:

• Epithelial tumours: by far the most common, starting in the cells that cover the surface of the ovary.
• Germ cell tumours: starting in the cells that produce eggs, and more common in younger women.
• Stromal tumours: starting in the tissue that holds the ovary together and produces hormones.

Who is at risk of ovarian cancer?

Risk factors for ovarian cancer include:

• age, as most cases occur after the menopause
• a family history of ovarian or breast cancer
• inherited gene changes, such as BRCA1 and BRCA2
• hormone replacement therapy
• a history of endometriosis
• never having been pregnant

Our post on ovarian cancer risk factors explains what you can do to reduce your risk.

Symptoms of ovarian cancer

The symptoms of ovarian cancer can be vague. Common signs include bloating, pelvic or tummy pain, difficulty eating or feeling full quickly, and needing to pass urine more often. As the disease progresses, these symptoms may become more severe. What matters most is a change that is new for you, happens most days and does not go away. Cancer Research UK has a clear guide to ovarian cancer symptoms.

How is ovarian cancer diagnosed?

Diagnosis usually involves a pelvic examination, imaging such as an ultrasound or CT scan, and a blood test for a marker called CA125. A biopsy or an operation may be needed to confirm the diagnosis and find out the stage of the cancer. NICE explains how ovarian cancer should be recognised and investigated, and our ovarian cancer Q&A answers the questions women ask most often.

How is ovarian cancer treated?

Treatment often includes surgery to remove the ovaries, fallopian tubes and womb, and sometimes nearby lymph nodes, followed by chemotherapy. The aim of surgery is usually to remove all visible cancer, as explained on our debulking surgery page. For some women with advanced disease, heated chemotherapy during surgery may be an option; see ICRS and HIPEC.

Targeted treatments, such as PARP inhibitors, have also shown real promise for some patients, particularly those with BRCA gene changes. Your specialist team will explain which options are suitable for you.

Why early detection matters

Despite advances in treatment, survival from ovarian cancer depends heavily on how early it is found. Because the early symptoms are easy to overlook, ovarian cancer is often diagnosed late. That is why awareness, and acting promptly on symptoms, are so important.

What to ask your doctor

If you are worried about ovarian cancer, it can help to go to your appointment prepared. Write down your symptoms, when they started and how often they happen. Mention any family history of ovarian, breast or bowel cancer. You might also ask which tests you need, how long the results will take, and who to contact if your symptoms change while you wait.

Regular gynaecological check-ups help too. They give you the chance to discuss any changes, to keep up with screening and vaccinations, and to talk openly with your doctor about your health. Read more on our ovarian cancer page, or book an appointment with Mr Jafaru Abu at The Park Hospital, Nottingham.