Ovarian Cancer: Symptoms, Diagnosis, Treatment, Prevention

Learn to recognize the symptoms and understand the treatment options for ovarian cancer.

Medically reviewed in December 2018

Ovarian cancer is too often found after it's already reached an advanced stage. “Unfortunately, while screening tests exist for a number of cancers out there—a mammogram for breast cancer, a pap smear for cervical cancer—a reliable screening test doesn’t yet exist for ovarian cancer,” says John Elkas, MD, a gynecological oncologist at Reston Hospital Center in Fairfax, Virginia.

That’s why it’s so important to get the facts about ovarian cancer and seek help if you’re having symptoms. Here’s what every woman should know.

What’s ovarian cancer?
Ovarian cancer develops in the ovaries, or the almond-sized glands attached to either side of your uterus. Your ovaries carry your eggs and make the sex hormones estrogen and progesterone.

Most of the time, women are diagnosed with ovarian cancer in their 50s or 60s. Younger women may develop ovarian cancer, too. However, it’s rare before age 40 and it’s typically diagnosed after menopause.

Women who have never been pregnant have a higher risk of ovarian cancer, as well. That may be because you don’t ovulate when you’re pregnant, says Dr. Elkas.

“When you ovulate, a cyst forms in one of your ovaries, and then the cyst ruptures to release the egg. That constant inflammation and repair has been potentially linked to cancer,” he explains. “That’s why decreasing the number of times you ovulate in your lifetime through pregnancy or birth control pills may decrease your risk.”

Why are the symptoms so easy to miss?
There’s no reliable screening test for ovarian cancer, so it’s up to you to tell your doctor if you’re having any of these symptoms:

  • Bleeding from your vagina that happens after menopause or that’s off-schedule for your period
  • Bloating, even though you might be losing weight or eating less
  • A poor appetite
  • Feeling full quickly
  • Pain in your lower abdomen
  • Constipation, diarrhea
  • Having to urinate often or urgently

Ovarian cancer tends to get brushed off because its symptoms can seem like they’re caused by premenstrual syndrome (PMS) or diet changes. But don’t ignore your body—keep track of your symptoms and tell your doctor if they happen more than 12 times a month or if they last longer than two weeks. If you’re having bleeding from your vagina that’s not normal for you, call your doctor immediately. 

Ovarian cancer diagnosis
If you experience any of the symptoms listed above, your obstetrician gynecologist (OBGYN) may do a pelvic exam. To do a pelvic exam, they’ll insert gloved, lubricated fingers into your vagina, while gently pressing on your belly so they can feel your ovaries.

“Usually, suspicion is raised if your doctor can feel a mass on your pelvic exam or they see a mass on any of your scans,” says Elkas.

If your OBGYN notices a change to the shape of your ovaries and you’re having concerning symptoms, they’ll most likely do a trans-vaginal ultrasound next. A trans-vaginal ultrasound involves placing a lubricated wand, called a “transducer,” inside your vagina. The transducer sends out sound waves, which create images of your ovaries on a computer.

Your doctor may also send you for a CT scan, which involves lying down inside a large tube, while a powerful x-ray machine takes pictures of your ovaries from different angles.

However, in order to make a true diagnosis, you’ll need to undergo a biopsy so that samples of the mass can be looked at under a microscope, explains Elkas.

Your doctor will probably recommend surgery so that the mass or tumor can be removed when the surgeon goes in to take the biopsy samples. That way, your doctors can both confirm your diagnosis and remove as much of the cancer as possible.

Ovarian cancer treatment
The stage of your cancer will help decide whether or not you need chemotherapy after surgery. Chemotherapy is a type of drug that’s used to kill any cancer cells that are left behind after doctors take out the tumor. It’s usually given by IV in a series of doses that are spread out over several weeks to months. 

If ovarian cancer is caught early enough, you might not need chemo. Instead, your doctor may just keep an eye on your symptoms, blood tests and imaging tests over time to see if your cancer comes back. In some cases, a healthcare provider may recommend a maintenance therapy once treatment has concluded. This may help prevent the cancer from recurring.

“If you’re undergoing treatment for ovarian cancer, studies have repeatedly shown that working with an experienced gynecological oncologist or medical oncologist is one of the most important treatment decisions you can make,” says Elkas. “Their special interest and experience will really go a long way in treating this disease,” he adds. 

Is there any way to prevent ovarian cancer?
There’s no known way to prevent ovarian cancer, but there are some things you can do to lower your risk:

  • Maintain a healthy weight: Women with a body mass index, or BMI over 30 have a higher risk of ovarian cancer.
  • Your birth control might help: “Women who have had a tubal ligation or who have taken birth control pills for at least three-to-six months have a lower risk of ovarian cancer,” says Elkas. If you’re trying to decide on a birth control method, ask your OBGYN how the different options might also lower your ovarian cancer risk.
  • Quit smoking: Quitting tobacco can decrease your risk of one type of ovarian cancer and many other diseases, including heart disease and lung cancer.

If you’d like to learn more about lowering your risk or if you’re experiencing any ovarian cancer symptoms, call your doctor—a false alarm is always better than a late diagnosis.

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