Ovarian Cancer

Overview

Ovarian cancer is a type of cancer that begins in or around the ovaries, the small organs in the female reproductive system that produce eggs and hormones. Cancer can also start in nearby structures such as the fallopian tubes or the tissue lining the abdomen. Because these areas are close together, ovarian, fallopian tube and related peritoneal cancers are often discussed together.

Ovarian cancer can affect women at different ages, but it is more common after menopause. It may be difficult to detect early because symptoms can be mild, vague or similar to common digestive or urinary problems. For this reason, persistent changes in the body should be discussed with a healthcare professional.

Diagnosis and treatment are usually managed by a multidisciplinary oncology team, which may include gynecologic oncologists, medical oncologists, radiologists, pathologists, specialist nurses and other supportive care professionals.

Symptoms

Ovarian cancer may not cause noticeable symptoms in its early stages. When symptoms occur, they can be persistent and may gradually become more frequent or severe. Common symptoms can include:

• Abdominal bloating or swelling
• Pelvic or abdominal pain or pressure
• Feeling full quickly when eating
• Loss of appetite
• Changes in bowel habits, such as constipation
• Frequent or urgent need to urinate
• Unexplained weight changes
• Fatigue or low energy
• Back pain
• Unusual vaginal bleeding, especially after menopause
• Pain during sexual intercourse

These symptoms do not always mean cancer. Many non-cancerous conditions can cause similar problems. However, symptoms that are new, persistent or worsening should be evaluated.

Causes and Risk Factors

Ovarian cancer develops when cells in or near the ovaries undergo changes that allow them to grow and multiply in an uncontrolled way. In many cases, the exact cause is not known. Several factors may increase risk, but having one or more risk factors does not mean a person will develop ovarian cancer.

Possible risk factors include:

• Increasing age, especially after menopause
• A family history of ovarian, breast, fallopian tube or certain other cancers
• Inherited gene changes associated with higher cancer risk
• Personal history of breast cancer or some other cancers
• Endometriosis
• Never having been pregnant
• Starting menstruation at an early age or reaching menopause at a later age
• Use of certain hormone treatments after menopause
• Obesity

Some factors may be associated with a lower risk, but these are personal medical matters and should be discussed with a doctor. For people with a strong family history of related cancers, genetic counseling may be recommended to better understand inherited risk.

Diagnosis

There is no single test that can confirm ovarian cancer in every situation. Diagnosis usually begins with a medical history, discussion of symptoms and a physical examination, which may include a pelvic examination. The doctor may then recommend tests based on the individual’s symptoms, age, medical background and examination findings.

Diagnostic tests may include:

• Ultrasound imaging to examine the ovaries and nearby organs
• Blood tests, including tests that may help assess cancer-related markers
• Advanced imaging such as computed tomography or magnetic resonance imaging to evaluate the abdomen and pelvis
• Assessment of fluid buildup in the abdomen if present
• Surgical evaluation and tissue sampling when needed to confirm the diagnosis

A definite diagnosis of cancer usually requires examination of tissue by a pathologist. If cancer is confirmed, additional tests may be used to determine the type of ovarian cancer and how far it has spread. This process is called staging and helps guide treatment planning.

Treatment Options

Treatment for ovarian cancer depends on the cancer type, stage, location, the patient’s general health and personal preferences. The care plan is usually developed by a specialist oncology team and may involve more than one treatment method.

Common treatment options include:

• Surgery: Surgery is often used to remove as much of the cancer as possible and to help determine the stage. The extent of surgery depends on the spread of disease and whether fertility preservation is medically appropriate in selected cases.
• Chemotherapy: Anti-cancer medicines may be used to destroy cancer cells or reduce the chance of cancer returning. Chemotherapy may be given before or after surgery depending on the situation.
• Targeted therapy: Some treatments are designed to affect specific features of cancer cells. Suitability depends on tumor characteristics and genetic or molecular testing.
• Hormonal therapy: In selected types of ovarian cancer, treatment that affects hormone activity may be considered.
• Radiation therapy: This is not a common main treatment for ovarian cancer, but it may be used in certain situations to control symptoms or treat specific areas.
• Supportive and palliative care: Symptom control, nutrition support, pain management, emotional support and rehabilitation can be important at any stage of care.

Follow-up is an important part of treatment. Regular visits may include physical examinations, blood tests, imaging or symptom review. The schedule depends on the individual treatment plan and clinical situation.

When to See a Doctor

Medical advice should be sought if symptoms such as bloating, pelvic pain, feeling full quickly, urinary changes or bowel changes are new, persistent or unexplained. It is especially important to speak with a doctor if symptoms occur frequently, worsen over time or interfere with daily life.

Women who have unusual vaginal bleeding after menopause should arrange prompt medical evaluation. People with a strong family history of ovarian, breast or related cancers should also discuss their risk with a healthcare professional, even if they do not have symptoms.

If ovarian cancer is suspected or diagnosed, timely evaluation by an experienced oncology team can help clarify the diagnosis and identify appropriate treatment options. Early medical attention and clear communication with healthcare providers can support informed decisions and coordinated care.