Ovarian cancer affects thousands of women each year, but greater awareness, advances in treatment, and ongoing research are helping improve outcomes and save lives. While symptoms can sometimes be subtle or mistaken for other conditions, knowing the signs and understanding risk factors empowers women to take action for their health.
By shining a light on this disease, we can give women the knowledge they need to seek care sooner and increase the chance for better outcomes.
Signs and Symptoms of Ovarian Cancer
Ovarian cancer forms in tissues of the ovary, one of a pair of female reproductive glands in which the ova (eggs) are formed, or in the fallopian tubes.
Ovarian cancer symptoms can include:
- Persistent bloating or abdominal swelling
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Frequent or urgent urination
- Changes in bowel habits
- Fatigue or back pain
- Abnormal vaginal bleeding
- Nausea
- Pain during intercourse
One of the challenges with ovarian cancer is that in many cases, the early signs are subtle. For example, symptoms such as bloating, feeling full quickly or needing to urinate more often can be attributed to PMS, digestive issues or urinary tract problems.
Because ovarian cancer symptoms are not always noticeable and can come and go, many women don’t seek medical help until the disease has progressed. This is why ovarian cancer is often diagnosed at a later stage.
If you notice persistent or worsening symptoms lasting more than two weeks, it’s important to talk with your doctor.
What Causes Ovarian Cancer?
The exact cause of ovarian cancer is not fully understood. Doctors know that it develops when healthy cells in an ovary begin to grow and divide abnormally.
Certain risk factors can increase the chance of developing ovarian cancer. While risk factors don’t guarantee cancer will occur, they do help guide screening and prevention strategies.
- Age, as most cases occur after menopause. About half of all cases are diagnosed at age 63 or older
- Family history, having close relatives with ovarian or breast cancer
- Genetic mutations, such as BRCA1 and BRCA2 gene mutations, which are linked to a higher cancer risk
- Having endometriosis
- Receiving hormone replacement therapy
- Never having been pregnant, which leads to more ovulation (women who continually ovulate throughout their lives without a break have a higher risk)
How to Test for Ovarian Cancer
If ovarian cancer is found early (stage I), the 5-year survival rate exceeds 90 percent. However, only about 25 percent or fewer of cases are diagnosed this early.
There’s currently no routine screening test for ovarian cancer like there is for breast or cervical cancer. Instead, diagnosis often involves:
- Ovarian cancer ultrasound (transvaginal ultrasound): This test creates detailed images of the ovaries to detect abnormalities.
- Blood tests (CA-125): These measure a protein that can be elevated in ovarian cancer. However, it’s not specific to ovarian cancer and can be raised by many non-cancerous conditions.
- Pelvic exam: This exam helps detect masses or changes in reproductive organs.
- Surgical biopsy: This is the only way to confirm ovarian cancer and involves removing tissue for analysis.
- Genetic counseling: Women with a strong family history may benefit from genetic counseling and testing to evaluate inherited risks.
Ovarian Cancer Treatment Options
Ongoing advances in targeted therapies, such as PARP inhibitors, are improving survival rates and offering hope for women with advanced ovarian cancer. Since the 1970s, the U.S. ovarian cancer death rate has declined by 43 percent due to improved treatments and preventive strategies.
Treatment for this type of cancer depends on the exact type and stage. It often includes a combination of therapies:
Surgery
Typically, surgery for ovarian cancer involves the removal of one or both ovaries, fallopian tubes, uterus and/or nearby tissue, depending on the individual case. Surgery types include:
- Debulking surgery: This is a surgery where the doctor makes an incision in the abdomen (called a laparotomy) to remove as much of the tumor as possible. This helps reduce the cancer load and improves the effectiveness of other treatments like chemotherapy.
- Minimally invasive laparoscopy: Instead of one large incision, the surgeon makes small cuts and uses a thin tube with a camera and light (called an endoscope) to see inside the abdomen in order to carefully remove tissue or perform procedures with less pain and a quicker recovery time.
- Robotic-assisted surgery: In some cases, especially for early-stage or recurrent ovarian cancer, surgery can be done with robotic assistance. The surgeon controls the robot using hand and foot controls, and the robot mimics every movement with extreme precision.
Medical Oncology
Medical oncology involves using drug-based treatments to kill cancer cells, stop them from spreading, or target specific weaknesses in the cancer. These therapies may be given before surgery (neoadjuvant), after surgery (adjuvant), or as the main treatment if surgery is not possible.
- Chemotherapy: Chemotherapy uses powerful drugs to kill remaining cancer cells or shrink tumors before surgery.
- Immunotherapy: Immunotherapy helps the body’s own immune system recognize and attack cancer cells. These therapies are still being studied in ovarian cancers.
- Targeted therapy: These medications focus on specific genetic or molecular changes in cancer cells. For example, PARP inhibitors are a type of targeted therapy used for some women with BRCA gene mutations or other DNA repair defects.
- Clinical trials: Clinical trials may be recommended for some patients with ovarian cancer. They are important as they often investigate ongoing advances in therapies, which may improve survival rates and offer hope, especially for women with advanced or recurrent disease.
Radiation Oncology
Radiation oncology uses high-energy x-rays or particles to damage the DNA of cancer cells, preventing them from growing and dividing. Although radiation is not typically a first-line treatment for ovarian cancer in the U.S., it can be helpful in specific situations.
Radiation may be recommended to:
- Relieve pain or symptoms caused by cancer that has spread to other areas of the body.
- Target areas of recurrence or isolated disease, such as the brain, spinal cord or bones.
Prevention and Early Detection
While ovarian cancer can’t always be prevented, women can lower their risk by:
- Knowing their family history and discussing genetic testing if at risk
- Using oral contraceptives (birth control pills), which have been shown to lower risk when taken long term
- Maintaining a healthy weight and lifestyle
- Scheduling regular gynecologic exams and reporting persistent symptoms right away to their healthcare provider
Recognizing ovarian cancer symptoms, knowing risk factors, and seeking an evaluation as soon as possible when signs are present (such as an ovarian cancer ultrasound or blood test) can lead to earlier diagnosis and more effective treatment.
At Stony Brook Cancer Center, our Gynecologic Cancer team provides comprehensive care for women with ovarian cancer, including advanced surgical options, chemotherapy, genetic counseling, and access to clinical trials. Our goal is to give women the best possible outcomes while supporting them through every step of treatment. For more information or to make an appointment, call (631) 638-1000.
