The ovaries are part of the female reproductive system. These oval-shaped glands sit inside the pelvis and release an egg (ovum) every month. Female sex hormones are also made by the ovaries. Cancer can develop in one or both ovaries. Around 400 Victorian women are diagnosed with ovarian cancer every year and women over 40 are most at risk.
Different types
The four main types of ovarian cancer include:
- Epithelial – cancer of the epithelium, which is the outer cells covering the ovary. This is the most common type; nine out of 10 ovarian cancers are epithelial cancers.
- Germ cell – cancer of the cells inside the ovary that mature into eggs. This uncommon form of ovarian cancer usually affects women less than 30 years of age.
- Sex-cord stromal cell – cancer of the cells that release female hormones. This uncommon form of ovarian cancer can affect women of any age.
- Borderline tumours – types of epithelial tumours that are not as aggressive as other forms.
Risk factors
The exact causes of ovarian cancer aren’t known, but some of the risk factors include:
- Being Caucasian (white) and living in a Western country with a high standard of living
- Having few or no pregnancies
- Starting your menstrual cycle early (before the age of 12) and beginning menopause after the age of 50
- Taking hormone replacement therapy (HRT) after menopause – some studies suggest that this may increase your risk of developing ovarian cancer but others don’t make this connection
- Never having taken the contraceptive pill
- A history of cancer in the family especially ovarian, bowel, breast or uterine.
- Other risk factors are still being researched.
Symptoms
The symptoms of ovarian cancer will vary depending on the stage of the cancer. Many women with early stage ovarian cancer may not have any symptoms. If they do, it may be some pain in the lower abdomen or side and a bloated or full feeling in the tummy.
Some of the symptoms of later stage ovarian cancer include:
- Discomfort in the abdomen, such as bloating or a feeling of pressure
- A change in bowel habits
- Indigestion
- Vaginal bleeding that isn’t due to normal menstrual periods
- Pain, especially during sex
- Swollen abdomen as the cancer grows.
If the cancer is very advanced and spreads to other parts of the body, it can cause:
- Loss of appetite
- Sickness (nausea and vomiting)
- Constipation
- Tiredness
- Breathlessness
- More extensive abdominal swelling that may need draining.
Diagnosis
There is a range of tests to diagnose ovarian cancer, including:
- Physical examination – the doctor checks for lumps in the lower abdomen or pelvis.
- Blood tests – to search for tumour markers (for example, CA 125). These are proteins which are often higher than normal in women with ovarian cancer.
- Imaging tests – such as CT scan or ultrasound.
- Surgery – often this is the only definitive way to find out if you have ovarian cancer.
You may have a colonoscopy of the bowel to make sure that your symptoms are not caused by a bowel problem. The Pap smear test is only effective for the early detection of cancer of the cervix, not ovarian cancer.
Treatment
Ovarian cancer is often diagnosed during surgery and the affected ovary or ovaries are removed at the same time. In some cases, only one ovary is affected and conceiving a child is still possible after surgery. In other cases, parts of the reproductive system such as the fallopian tube and the uterus (womb) may also be removed. Sometimes it is necessary to take out the appendix and part of the bowel.
Chemotherapy (anti-cancer medications) is almost always given after surgery. This is to kill off any cancer cells that may have been left behind after surgery. Radiotherapy (using x-rays to kill cancer cells) is occasionally used.
All treatments have side effects. Your medical team will discuss these with you before your treatment begins.
Where to get help
Things to remember
- The Pap test is only effective for the early detection of cancer of the cervix, not ovarian cancer.
- Treatment for ovarian cancer usually involves surgery and chemotherapy. It may include radiotherapy.
- Some women can still have a child after surgery for ovarian cancer.
You might also be interested in:
Cancer.
Cancer - exercise to help you cope.
Cancer and food.
Cancer and heredity.
Cancer pain management.
Cancer treatments - chemotherapy.
Cancer treatments - radiotherapy.
Cervical cancer.
Fallopian tube cancer.
Palliative care explained.
Pregnancy related cancer.
Reproductive system.
Uterine cancer.
Vaginal cancer.
Vulvar cancer.
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