Ovarian cancer is the name given to cancer affecting the ovaries. It is one of the most common types of cancer in women over the age of 50. If you have ongoing abdominal or back pain, abnormal vaginal bleeding, nausea or bloating, see your doctor for a check up.
- The ovaries are part of the female reproductive system. They produce ova (eggs) and release certain hormones, such as oestrogen.
- Ovarian cancer is when cells within the ovaries multiply rapidly and grow out of control. These cells are known as malignant or cancerous cells and the growth is known as a tumour.
- Ovarian cancer is more common as you get older and can run in families.
- There are 4 main types of ovarian cancer.
- Treatment for ovarian cancer will depend on the type of cancer you have and the stage it is at but usually, involves surgery and chemotherapy.
Warning signs and symptoms
(Dr Sarah Jarvis, Patient Info, UK, 2018)
What are the different types of ovarian cancer?
There are 4 main types of ovarian cancer. The treatment and chance of cure will be different for different types of cancer.
- Epithelial cancers start from the surface lining of the ovaries. This is the most common tumour and causes about 85-90% of all ovarian cancers. It usually occurs after menopause.
- Germ cell cancers start from the cells that develop into eggs. This is the second most common type that accounts for about 10% of ovarian cancers and usually occur in the 20–30-year-old age group.
- Stromal cancers are quite rare. They arise from the cells in the ovary that make hormones.
- Primary peritoneal cancer is rare but can occur even after a woman has had surgery to remove her ovaries. This cancer starts from the lining of the inside of the pelvic cavity and is usually considered to be a type of epithelial ovarian cancer.
(Right ovary is normal. Left ovary with ovarian cancer)
What are the symptoms of ovarian cancer?
Ovarian cancer does not usually cause any obvious symptoms until the cancer is quite advanced. Some of the symptoms of ovarian cancer are:
- Indigestion, bloating and nausea.
- A loss of appetite.
- A pressure in the lower back or pelvis.
- A change in bladder or bowel habit.
- An increase in waist size.
- Feeling tired or a lack of energy.
Most ovarian cancer occurs after a woman is 40 years old and half the cases occur before the age of 65.
How is ovarian cancer diagnosed?
- Examination: Your doctor will need to perform a gentle pelvic and abdominal examination to feel for any abnormalities.
- Ultrasound: An ultrasound is usually the first step in making a diagnosis. Almost all ovarian tumours can be seen with ultrasound. In order to be able to see the ovaries, a transvaginal ultrasound will be performed. This uses a slim ultrasound probe placed inside a woman’s vagina to see the pelvic organs clearly. The sonographer performing the scan will discuss this with you before the procedure.
- Blood tests: Your GP will arrange for a number of blood tests, but one important test is called the Ca-125. This measures a protein in the blood that is increased when a woman has ovarian cancer. This protein can be increased for other reasons, such as endometriosis or a ruptured ovarian cyst, so an increased level in the blood test does not always mean there is cancer especially if a woman is still having periods. The test needs to be interpreted along with the other information.
- CT scan: If an abnormality is found on the ultrasound scan then often a CT scan will be performed.
Can you screen for ovarian cancer?
A screening test for ovarian cancer is only offered to women who have a family history of ovarian cancer or carry a genetic abnormality called BRCA1 or BRCA2. This is because the risk of ovarian cancer is so much higher for these women.
Read more about screening and ovarian cancer risk factors
What is the treatment for ovarian cancer?
Treatment for ovarian cancer will depend on the type of cancer you have and the stage it is at. Treatment may involve a combination of surgery to remove as much of the cancer as possible and chemotherapy to kill the cancerous cells. Some people also choose to use complementary therapies. Palliative care is available for those for whom a cure is not possible.
Read more about treatment options
Who is in my treatment team?
Modern treatment of cancer is a team effort. You may have a lot of people looking after you, but you should always have one or two main people you can contact if problems arise. Some health professionals that you may see include:
- Surgeons – who undertake any necessary surgery
- Oncologists – who look after the administration of chemotherapy
- Radiologists or radiographers – who undertake and interpret the x-rays and scans
- Specialist nurses – your treatment is often supervised by nurses specialised in giving chemotherapy
- Support staff – these range from the receptionist you see when you arrive for an appointment to the orderly who collects your treatment from the pharmacy who will be involved in your care
- Dieticians – who can advise on the best foods to eat when recovering from surgery or when having chemotherapy
- Social workers – who are able to help with the support services available, especially if you are not able to work.
What support is available?
Gynaecological Cancer Foundation
Information and support for women affected by gynaecological cancers, including uterine, ovarian, cervical and vulval/vaginal cancers.
The Cancer Society of New Zealand is the country’s largest source of information about cancer and its effects. This website provides information on types of cancer, diagnosis, methods of treatment and advice on living with cancer.