This guide is for people with ovaries, their caregivers, and anyone seeking clear, evidence-based information about ovarian (ovary) cancer — what it is, common symptoms, how it’s diagnosed, and current treatment options. Ovarian cancer is a disease in which cells in the ovary or nearby fallopian tube tissue grow abnormally and uncontrollably. Because early symptoms are often subtle or nonspecific, diagnosis can be delayed until later stages. Common early signs may include pelvic or abdominal pain, persistent bloating, changes in eating habits or early satiety, urinary urgency, and abnormal vaginal bleeding or discharge.

Treatment aims to remove or control the tumor and may include surgery, chemotherapy, targeted therapy, and occasionally radiotherapy depending on the type and stage of the cancer. If you have new, persistent, or frequently recurring symptoms, see a doctor for evaluation — early discussion with your healthcare team improves the chance of a timely diagnosis.

What is Ovarian (Ovary) Cancer?

Ovarian cancer is a disease in which abnormal cells form and grow in the ovary (or nearby tissues such as the fallopian tubes or the lining of the pelvis). The ovaries are two small reproductive organs—one on each side of the uterus—that release eggs (ova) and make hormones such as estrogen and progesterone. Because cancer is usually named for where it starts, tumors that begin in the ovary, fallopian tube, or the peritoneal lining are often grouped together for diagnosis and treatment.

Ovarian cancer can start in one or both ovaries and may spread (metastasize) to nearby tissues or more distant organs if not detected. It most often affects adults and is more common after menopause; incidence increases with age. There are several major types of ovarian cancer based on the cells involved: epithelial ovarian cancers (the most common), germ cell tumors, and stromal tumors. Recent research also shows that many high-grade serous cancers originate in the fallopian tube epithelium, which is why discussions often reference ovaries and fallopian tubes together.

What Are the Symptoms of Ovarian Cancer?

Ovarian cancer can present with subtle, non‑specific symptoms, especially early on. Many people with early disease report complaints that overlap with common gastrointestinal or pelvic conditions. If new symptoms are persistent, worsening, or occur frequently (for example, more than a few times per week or about 12 times per month), it is important to see a doctor for evaluation.

Common signs and symptoms fall into groups — recognizing patterns can help you and your clinician decide whether further tests are needed.

  • Gastrointestinal symptoms: persistent bloating, discomfort or indigestion, early satiety (feeling full quickly), changes in bowel habits such as diarrhea or constipation, and an increase in abdominal size.
  • Pelvic and back pain: new or persistent pelvic pain, abdominal pain, or lower back pain that is not explained by other conditions.
  • Urinary symptoms: increased frequency, urgency, or a sudden need to urinate more often than usual.
  • Gynecologic symptoms: abnormal vaginal bleeding (including bleeding after menopause) or unusual vaginal discharge — these may also indicate other conditions and require prompt evaluation.
  • Systemic symptoms: unexplained weight loss, loss of appetite, fatigue, or general exhaustion.

Remember: these symptoms are more often caused by benign conditions (digestive issues, urinary tract problems, hormonal changes). However, the key warning signs are new, persistent, or progressively worsening symptoms. As a practical guide, see your doctor when symptoms are new and occur more than 12 times in a month, or if you notice a clear change from your normal health.

When evaluated, your clinician will consider the pattern of symptoms, physical exam findings, and appropriate tests to distinguish ovarian cancer from other causes. If you are concerned, ask your doctor about next steps and whether referral to a gynecologic oncologist or further testing is warranted.

What Causes Ovarian Cancer?

Ovarian cancer does not have a single known cause. Instead, a mix of non‑modifiable factors (age, genetics) and modifiable or reproductive factors influence a person’s risk. Incidence rises with age and is more common after menopause. A proportion of ovarian cancers — often cited as about 10–15% — are linked to inherited gene changes such as BRCA1 or BRCA2 mutations or syndromes like Lynch; genetic counseling and testing are recommended when family history or tumor features suggest hereditary risk.

Some reproductive and lifestyle factors are associated with higher or lower risk. For example, having carried pregnancies to term, breastfeeding, and long‑term use of combined oral contraceptives are associated with a reduced risk of ovarian cancer. By contrast, factors linked with increased risk include older age at menopause, early menarche, endometriosis, obesity, and a family history of ovarian or breast cancer. Prior pelvic radiation has been reported as a possible risk factor in some studies, though the absolute risk increase is small.

Key risk factors (at a glance):

  • Non‑modifiable: increasing age, personal history of certain benign ovarian conditions, family history of ovarian or breast cancer, inherited mutations (BRCA1/BRCA2, Lynch syndrome).
  • Reproductive factors: nulliparity (never having given birth) and not breastfeeding are associated with higher risk; multiple full‑term pregnancies and breastfeeding reduce risk.
  • Hormonal/reproductive timing: early onset of menstruation or late menopause slightly increase lifetime risk.
  • Lifestyle and medical: obesity and prior pelvic radiation may increase risk; evidence varies by factor.

If you have a strong family history of ovarian or breast cancer, or a known BRCA or Lynch mutation in the family, ask your doctor about genetic counseling. Genetic testing can inform treatment decisions (for example, the use of targeted therapies) and may influence screening or preventive options such as risk‑reducing surgery for high‑risk people.

Stages of Ovarian Cancer

Staging describes how far ovarian cancer has spread in the body and is one of the most important factors used to plan treatment and estimate prognosis. Ovarian cancers are typically staged surgically (during an operation a surgeon inspects the abdomen, samples tissue, and may remove disease) and reported using the FIGO/AJCC system. Early-stage cancers confined to the ovary generally have better outcomes than advanced-stage disease that has spread beyond the pelvis.

Broadly, ovarian cancer is divided into four stages:

  • Stage I: Cancer is limited to one or both ovaries or the fallopian tubes (tumor confined to the ovary/ovaries or tube).
  • Stage II: Cancer has spread within the pelvis (for example, to the uterus, bladder, or other pelvic tissues).
  • Stage III: Cancer has spread to the abdominal cavity outside the pelvis or to regional lymph nodes (this stage includes several subcategories that describe the size and location of implants and nodal involvement).
  • Stage IV: Cancer has spread to distant organs such as the liver parenchyma, lungs, or other sites outside the abdominal cavity.

Note: FIGO staging includes substages (for example, IIIA–IIIC) that give more detail about tumor implants, peritoneal spread, and lymph node involvement. Ask your doctor which FIGO stage and substage you have — surgical staging information directly affects choices about chemotherapy, targeted therapy, and follow‑up.

How is Ovarian Cancer Diagnosed?

Diagnosing ovarian cancer usually begins with a clinician’s assessment of symptoms and a physical exam. Many ovarian tumors arise from epithelial cells that line the ovary or fallopian tube (epithelial ovarian cancer is the most common type), but symptoms are often non‑specific. When a clinician suspects an ovarian tumor, the diagnostic pathway typically combines targeted physical examination with imaging, blood tests (tumor markers), and — when needed — surgical sampling for pathology. Genetic testing is increasingly important after diagnosis to guide treatment and to assess hereditary risk.

Typical diagnostic steps

1) Clinical evaluation and physical exam

A doctor (often a primary care provider, gynecologist, or gynecologic oncologist) will take a history and perform a pelvic exam to assess for masses, organ enlargement, or tenderness. Examination findings help determine which tests to order next.

2) Imaging

Transvaginal ultrasound (TVUS) is the first‑line imaging test for an adnexal mass and helps characterize ovarian tumors (size, cystic vs solid features). CT or MRI of the abdomen and pelvis are commonly used for staging and operative planning when cancer is suspected. PET scans may have a role in certain situations (for example, to evaluate suspicious lesions or recurrence) but are not routine first‑line tests.

3) Blood tests and tumor markers

CA‑125 is the most commonly used blood marker for ovarian cancer; elevated levels can support the diagnosis or help monitor treatment response, but CA‑125 is not specific (levels may be raised in benign conditions) and is not recommended as a population screening test for average‑risk people. Other markers (for example, HE4) or panels may be used in specific clinical contexts. Tests are interpreted together with imaging and clinical findings.

4) Surgical evaluation and pathology

A definitive diagnosis usually requires tissue sampling. Surgeons may perform laparoscopy or an open procedure (laparotomy) to obtain biopsies or remove an adnexal mass. Pathology of the removed tissue confirms the diagnosis, determines the histologic type (epithelial, germ cell, stromal), and provides essential staging information. Ovarian cancers are typically surgically staged during the procedure.

5) Genetic testing and counseling

After a diagnosis of ovarian cancer, genetic testing (for BRCA1/BRCA2 and other relevant genes, and assessment for homologous recombination deficiency) is often recommended because results can affect treatment choices (for example, PARP inhibitors) and have implications for family members. Genetic counseling should accompany testing to explain risks, implications, and preventive options.

Practical diagnostic pathway (simple guide): new or persistent pelvic/abdominal symptoms → see a doctor → pelvic exam + transvaginal ultrasound ± CA‑125 → if imaging or markers are suspicious, refer to a gynecologic oncologist for assessment and likely surgical evaluation.

Cautions and context: routine population screening for ovarian cancer is not recommended for people at average risk because current tests (including CA‑125 and ultrasound) have limitations. Testing strategies differ for people with increased inherited risk — discuss personalized screening or risk‑reducing options with your doctor.

How is Ovarian Cancer Treated?

Treatment for ovarian cancer depends on the type of tumor, the FIGO stage, your overall health, and molecular features of the tumor. Care is usually multidisciplinary — involving a gynecologic oncologist, medical oncologist, and often a genetic counselor and supportive‑care team. Below are the principal treatment approaches, how they are used, and practical questions to discuss with your doctor.

Surgery — goals and options

Surgery is the mainstay of treatment for most early‑stage ovarian cancers and an important part of management for many advanced cases. The goals are to obtain tissue for diagnosis and staging and, when possible, remove all visible cancer (optimal cytoreduction). For advanced disease surgeons aim to reduce tumor burden to improve outcomes: ideally no visible disease, or residual tumor nodules smaller than 1 cm. In select advanced cases, neoadjuvant chemotherapy (chemotherapy before surgery) may be recommended to shrink disease before definitive surgery.

Chemotherapy — timing and common regimens

Chemotherapy is a cornerstone of systemic treatment for ovarian cancer. For many patients with epithelial ovarian cancer, platinum‑based combinations such as carboplatin plus paclitaxel are routinely used, typically given in cycles over several months. Chemotherapy can be given after surgery (adjuvant) to reduce recurrence risk or before surgery (neoadjuvant) in selected patients. Some people also receive intraperitoneal chemotherapy in specific situations; treatment plans are individualized based on stage, performance status, and histology.

Targeted therapies and precision medicine

Targeted therapies have become integral for many patients. Examples include PARP inhibitors, which are effective particularly in tumors with BRCA mutations or homologous recombination deficiency, and anti‑angiogenic agents (such as bevacizumab) used in certain settings. Molecular testing and genetic results help guide whether these targeted options are appropriate.

Hormone therapy and other options

Hormone therapy can be considered for specific histologic subtypes (for example, some low‑grade serous tumors or stromal tumors) but has a limited role overall compared with surgery, chemotherapy, and targeted therapy. For recurrent disease, treatment options depend on the prior therapies, interval since last treatment, and tumor biology.

Supportive care, survivorship, and mental health

Treatment can be physically and emotionally demanding. Integrating supportive care — symptom control, nutrition, physical therapy, and psychological support — improves quality of life and may help people tolerate treatment better. Discuss referrals for counseling, support groups, or survivorship services with your care team.

Practical questions to ask your doctor

  • What is the exact stage and histologic type of my ovarian cancer?
  • Will surgery be able to remove all visible disease, or is neoadjuvant chemotherapy recommended?
  • Should I have genetic testing, and could targeted therapies (like PARP inhibitors) be an option?
  • What are the likely side effects of the recommended treatment, and how will they be managed?
  • Can you refer me to a gynecologic oncologist or multidisciplinary team experienced in ovarian cancer?

When faced with a diagnosis of ovarian cancer, ask for a multidisciplinary review (gynecologic oncologist, medical oncologist, genetic counselor) to ensure treatment decisions consider surgery, chemotherapy, targeted therapy options, and supportive resources. Your care team can explain the expected benefits and risks of each option and outline a personalized treatment plan.