What is ovarian cancer?

Ovarian cancer happens when cells in the ovaries grow abnormally. The ovaries are part of the female reproductive system, and ovarian cancer may or may not cause obvious symptoms before it reaches an advanced stage. That is why it is so important for women with possible symptoms to be checked: ovarian cancer that is found and treated early has the best outcomes.

How does ovarian cancer start?

The exact cause of ovarian cancer is unknown. Like all cancers, it begins when cells grow out of control instead of dividing in an orderly way. Ovarian cancer can start in three types of cell in the ovary: the germ cells, the stromal cells or the epithelial cells. Most ovarian cancers start in the epithelial cells, which cover the surface of the ovary.

As it grows, ovarian cancer can spread to other parts of the reproductive system, which may need to be removed along with the ovaries. If both ovaries or the womb are removed, pregnancy is no longer possible. Advanced ovarian cancer can also spread further, to the lining of the tummy, the lymph nodes, the bowel, the liver or the lungs.

Symptoms of ovarian cancer

Early symptoms of ovarian cancer can be vague and similar to those of many less serious conditions. In some cases, they do not appear until the cancer is advanced. Symptoms can include:

• a swollen tummy, sometimes caused by fluid build-up
• a heavy or uncomfortable feeling in the lower tummy, or pelvic pressure
• leg or back pain
• unusual bleeding between periods or after the menopause, or a change in your cycle
• indigestion, bloating, ongoing tummy pain, constipation or wind
• loss of appetite, difficulty eating, or weight loss or gain
• needing to pass urine more often or more urgently
• in some rarer types, excess hair growth

Cancer Research UK has a helpful summary of ovarian cancer symptoms. Our recent post on ovarian cancer symptoms women often miss explains which everyday feelings deserve a closer look.

How is ovarian cancer diagnosed?

If you have any of these symptoms, especially if they are new and persistent, contact your doctor. The symptoms overlap with many other conditions, such as ovarian cysts, so an accurate assessment matters. Your doctor is likely to examine you and arrange a blood test and an ultrasound scan. If ovarian cancer is suspected, you will be referred to a gynaecological cancer specialist for further tests. NICE explains how ovarian cancer should be recognised and investigated.

Keeping a note of your symptoms, how often they happen and how long they have lasted helps your doctor decide which tests you need. Symptoms that are new, frequent and persistent matter most. If you have a strong family history of ovarian or breast cancer, tell your doctor too, because inherited gene changes can raise the risk and you may be offered genetic advice.

How is ovarian cancer treated?

Treatment depends on several factors: the stage of the cancer, the type of cell involved, your general health and whether you would like to have children in the future. It usually involves surgery followed by chemotherapy. Radiotherapy is rarely used.

The aim of surgery is usually to remove all visible cancer, as explained on our debulking surgery page. For some women with advanced disease, chemotherapy is given first to shrink the cancer before an operation. You can read more on our ovarian cancer page.

If you are worried about any of these symptoms, or would like a specialist opinion, you can book an appointment with Mr Jafaru Abu at The Park Hospital, Nottingham.