What is ovarian cancer?
Ovarian cancer is a malignant tumour in one or both ovaries.
While there are many types of ovarian cancer the three most common types of ovarian cancer are: the common epithelial type (90% of cases) that arises from the cells on the outside of the ovary; the germ cell type (around 4% of cases) that arises from the cells which produce eggs; and the rare stromal type arising from supporting tissues within the ovary.
Ovarian cancer is the eighth most common cancer affecting women in Australia.
Around 1400 new cases of ovarian cancer are diagnosed each year in Australia. The risk of being diagnosed before age 85 is 1 in 85.
The five year survival rate for ovarian cancer is 45.7%.
Learn more about how Cancer Council funded researchers are outsmarting ovarian cancer.
Ovarian cancer symptoms
There are often no obvious signs of ovarian cancer, however you may have one or more of the following symptoms:
- abdominal bloating
- difficulty eating or feeling full quickly
- frequent or urgent urination
- back, abdominal or pelvic pain
- constipation or diarrhoea
- menstrual irregularities
- tiredness
- indigestion
- pain during intercourse
- unexplained weight loss or weight gain.
These symptoms can be caused by other conditions but if you are experiencing any of these symptoms, contact your local doctor.
Causes of ovarian cancer
Some factors that can increase your risk of ovarian cancer include:
- age (risk increases for women over 50)
- family history of ovarian, breast or bowel cancer
- changes in the genes BRCA1 or BRCA2
- being of Ashkenazi Jewish descent
- early onset of periods (before 12 years) and late menopause
- women who have not had children or had their first child after the age of 35
- using oestrogen only hormone replacement therapy or fertility treatment.
Some factors that may reduce the risk of developing ovarian cancer include using the oral contraceptive pill for several years, having your fallopian tubes tied (or removed), having children before the age of 35 and breastfeeding.
Diagnosis of ovarian cancer
If you are experiencing possible symptoms of ovarian cancer your doctor may suggest several tests or scans to look for cysts, tumours or other changes. These may include:
Physical examination
In which the doctor will check your abdomen for any lumps and do an internal vaginal examination.
Blood tests
To check for a common tumour marker for ovarian cancer, CA125.
Pelvic ultrasound
A pelvic ultrasound uses echoes from soundwaves to create a picture of your ovaries and uterus.
CT scan
A CT (computerised tomography) scan uses x-rays to take images of the inside of your body to check for cancer and to see if it has spread.
PET scan
A PET (positron emission tomography) scan highlights abnormal tissues in the body.
Colonoscopy
A colonoscopy, which is a bowel examination to ensure that symptoms are not caused by a bowel problem.
These tests can show if there are any abnormalities but a biopsy (taking a tissue sample) is the only way to confirm a cancer diagnosis.
After a diagnosis of ovarian cancer
After finding out you have ovarian cancer, you may feel shocked, upset, anxious or confused. These are normal responses. It may be helpful to talk about your treatment options with your doctor, family and friends. Seek as much information as you feel you need. It is up to you how involved you want to be in making decisions about your treatment.
Find out more about after a diagnosis of ovarian cancer:
Your guide to best ovarian cancer care
Your guide to best cancer care offers cancer specific guides describing the high-quality care you should expect at every stage of your treatment and beyond.
Treatment for ovarian cancer
Staging
Ovarian cancer often presents when it has spread. A common staging system is the FIGO (International Federation of Gynaecology and Obstetrics) system, which records the extent by whether it remains in the ovary, has spread to other pelvic structures or has spread into the lining of the abdomen with or without fluid (ascites). CT scans and blood test to measure CA125 are used.
Types of treatment
Treatment depends on the extent of the cancer. Surgery is used to determine the extent of disease and, if localised, is the main treatment. If the cancer has spread, an attempt is made to remove as much as possible.
Chemotherapy uses anti-cancer drugs to destroy cancer cells. Most women will have chemotherapy after surgery (adjuvant chemotherapy) to destroy any remaining cancer cells.
Some women will have chemotherapy before surgery (neoadjuvant chemotherapy) with the aim to shrink tumours and make them easier to remove.
If you are not well enough for an operation, chemotherapy may be recommended as the main treatment.
Chemotherapy is usually given as a combination of two drugs or sometimes as a single drug, delivered as a liquid into a vein.
Radiation therapy can be used to treat the pelvis or other sites of cancer that have spread. It may be used on its own or after chemotherapy.
Palliative care
In some cases of ovarian cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.
As well as slowing the spread of ovarian cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.
Treatment Team
Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
- Gynaecological oncologist- diagnoses and treats cancers of the female reproductive system
- Medical oncologist- prescribes and coordinates the course of chemotherapy.
- Radiation oncologist- prescribes and coordinates radiation therapy treatment.
- Radiologist- interprets diagnostic scans (including CT, MRI and PET scans).
- Gynaecological pathologist- examines tissue removed from the abdomen or ovaries.
- Cancer nurses- assist with treatment and provide information and support throughout your treatment.
- Other allied health professionals- such as social workers, pharmacists and counsellors..
Screening for ovarian cancer
There is currently no national screening program for ovarian cancer available in Australia.
Preventing ovarian cancer
There is no proven method of prevention. Oophorectomy (removal of ovaries) in women with a strong family history does not always prevent cancer.
Prognosis for ovarian cancer
Prognosis refers to the expected outcome of a disease. An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease. Survival will vary between individuals and may depend on their response to treatment.
Sources
- Understanding Ovarian Cancer, Cancer Council Australia © 2020. Last medical review of source booklet: April 2020. Expert content reviewers A/Prof Sam Saidi, Senior Staff Specialist, Gynaecological Oncology, Chris O’Brien Lifehouse, NSW; A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecologic Oncologists, TAS; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Sonja Kingston, Consumer; Clinical A/Prof Judy Kirk, Head, Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, and Sydney Medical School, The University of Sydney, NSW; Prof Linda Mileshkin, Medical Oncologist and Clinical Researcher, Peter MacCallum Cancer Centre, VIC; Deb Roffe, 13 11 20 Consultant, Cancer Council SA; Support Team, Ovarian Cancer Australia; Emily Stevens, Gynaecology Oncology Nurse Coordinator, Department of Obstetrics and Gynaecology, Flinders Medical Centre, SA; Dr Amy Vassallo, Fussell Family Foundation Research Fellow, Cancer Research Division, Cancer Council NSW; Merran Williams, Consumer. We also thank the health professionals and editorial teams who have worked on previous editions of this title.
- Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.