While Ovarian cancer is the fifth most common cancer among women, it’s also one of the most difficult to screen for early detection.

Ovarian cancer is a cancerous growth that may take place in different parts of the ovary. Women have 2 ovaries, one on each side of the uterus in the pelvis. The ovaries produce eggs and they are also the main source of a woman’s hormones, estrogen and progesterone.

According to the American Cancer Society, only about 20% of ovarian cancers are found at an early stage. This is largely attributed to the ovaries being deep within the body, making it hard for physicians to feel them for any cancerous tumors.

Ovarian Cancer Symptoms
Another reason why ovarian cancer is difficult to detect at an early stage is because the symptoms are similar to those of other, more common conditions like digestive problems.

Here is a list of some typical symptoms associated with ovarian cancer:

  • Persistent Gas, Indigestion or Nausea

  • Ongoing Abdominal Pressure, Swelling or Fullness

  • Pelvic Pain or Discomfort

  • Changes in Bladder or Bowel Habits

  • Loss of Appetite or Feeling Full

  • Ongoing Lack of Energy

While many of these symptoms are generally caused by something other than ovarian cancer, if they linger it is something to let your doctor know about.

Risk Factors
The biggest risk factor for developing ovarian cancer is a family history of the disease, including breast cancer, or colorectal cancer. A woman’s risk of ovarian cancer increases with at least one first-degree relative (a mother,daughter or sister), who has experienced this cancer. Some factors in assessing a woman’s risk of ovarian cancer, may include the following:

Age – Risk of ovarian cancer goes up with age. Fifty percent of ovarian cancers are detected in women over the age of 53.
Obesity – Weight plays a contributing factor, with obese women having a body mass index of at least 30 at higher risk of incurring ovarian cancer.
Pregnancy – Women who have been pregnant and carried a baby to full-term generally experience a lower risk of cancer than women who have not. This risk also goes down for every full-term pregnancy. And breastfeeding may also lower the risk even more.
Birth Control – Women who have used birth control pills generally have a lower risk. This lower risk is seen after only 3 to 6 months of using the pill and the risk decreases the longer pills are used. This lower risk continues on for many years even after the pill is stopped.
Fertility Drugs – Some studies have shown that the use of fertility drugs for longer than one year, especially if no pregnancy occurred, may also contribute to a greater risk.
Estrogen Therapy and Hormone Therapy – some recent studies offer evidence that using estrogens provide an increased risk
Family Genetics or History of Ovarian Cancer, Breast Cancer or Colorectal Cancer – The risk of ovarian cancer runs higher the more relatives a woman has who have had it. This increased risk may from either side of the family – mother or father.
Diet – Studies also have shown that women who followed a low fat diet had a lower risk of cancer.

How to Improve Early Detection
Get Regular Health Exams – A pelvic exam will help your physician verify the size and shape of the woman’s organs, but most ovarian tumors are difficult to detect early on, as the ovaries are deep within the body, making it hard for the doctor to feel them. Pap tests help detect cervical cancer early, but these are not generally helpful for finding ovarian cancer early.

Have Symptoms? See Your Doctor
As mentioned earlier, even though many of the symptoms associated with ovarian cancer may be caused by something else, if the symptoms linger, it’s better to let your doctor know of them. Your doctor will examine you to look for any signs of ovarian cancer, which may include finding an enlarged ovary from a pelvic exam or signs of fluid in the abdomen.

Seeing a Specialist
Should your physician suspect ovarian cancer, you will meet with a specialist, such as a gynecologic oncologist, who will determine the best kind of plan for your cancer.

Testing for Ovarian Cancer
There are some tests that may be conducted to better determine whether or not ovarian cancer exists.

  • Ultrasound

  • CT scans

  • Barium Enema X-Rays

  • Magnetic Resonance Imagine (MRI)

  • PET Scans

  • Biopsy

  • Blood Tests

  • Colonoscopy

Staging
If ovarian cancer is diagnosed, the staging of the cancer is determined. This is the process to distinguish how far the cancer has spread, often referred to as metastasized. Identifying the stage of the cancer is important to determine a cancer treatment plan. Staging is usually done during surgery, which takes place to get tissue samples.

What are the Ovarian Cancer Stages?

  • Stage One refers to the cancer being only in the ovary or ovaries.

  • Stage Two refers to the cancer being in one or both ovaries and has spread to other organs in the pelvis such as the bladder, colon, rectum or uterus. It has not spread to to lymph nodes, the abdomen or distant places.

  • Stage Three refers to the cancer being in one or both ovaries and has spread to one or both of the following: the lining of the abdomen or the lymph nodes.

  • Stage Four refers to the cancer spreading from one or both ovaries to distant organs such as the liver or lungs, or there may be cancer cells in the fluid around the lungs.

Treating Ovarian Cancer
Once a stage is determined, your doctor may suggest one or more choices for cancer treatment. The choice of treatment depends largely on the type of cancer and its stage. If a patient has not had surgery at this time, an exact stage may not be known. In such cases, treatment is based on what information is known.

Besides staging, there are other factors that may also determine the patient’s treatment plan, such as age or their general state of health.

Treatment may include the following:

Surgery – This is usually involved in the treatment for most ovarian cancers and fulfills two goals. Besides determining the stage of the cancer, surgery is also used to remove as much of the malignant tumor as possible. This is referred to as debulking, which takes out any tumors larger than 1 cm.

Chemotherapy – This treatment involves using cancer drugs to shrink tumors or kill cancer cells. It is useful when cancer has spread beyond the ovaries. Chemo may involve two or more drugs and is given in a cycle, generally 3-4 weeks. Different cancer drugs use different cycles. Your oncologist will prescribe the right cycle for your chemo. Please visit our chemotherapy treatment page for more information on chemotherapy and our chemo side effects page to learn more about possible side effects.

Radiation Therapy – This treatment uses high energy x-rays to kill cancer cells or shrink tumors. The radiation may come from outside the body or from radioactive materials placed into or near the tumor. Vary rarely is this treatment used in the US as the main treatment for ovarian cancer.

Hormone Therapy – This treatment involves using hormones or drugs that block hormones to fight the cancer.

Targeted Therapy – Unlike standard chemotherapy drugs, a targeted therapy is often able to attack cancer cells without killing many of the normal cells. Lynparza (olaparib) is an example of newer FDA approved targeted cancer treatment for advanced ovarian cancer.

Whichever approach your doctor suggests, it’s important to understand all your options, as well as any risks or possible side effects that might be expected from each treatment. Don’t hesitate to ask your physician or your oncology team about any questions you have or if you feel you need more information.