When cancer forms in the ovaries, female reproductive organs, and fallopian tubes , symptoms can be vague. It is important to understand the risks and signs.
What is ovarian cancer?
Ovarian cancer is a disease in which malignant (cancerous) cells form in the tissues of the ovary. The ovaries are a pair of female reproductive glands located in the pelvis. Each ovary is about the size of an almond. The ovaries produce eggs (ova) as well as the hormones estrogen and progesterone.
Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.
Ovarian cancer affects about 22,000 women every year in the United States. At the AHN Cancer Institute, we know that no two cancers — and no two patients — are the same. We provide personalized, sophisticated care, every step of the way. We develop a treatment plan that considers the stage of cancer, your health, and your personal preferences — and we implement it right away. We continue to meet regularly throughout your treatment to discuss the latest, best methods to beat the cancer.
Our approach to care includes many services to support you and your family:
- Genetic testing: Because ovarian cancer is often inherited, we offer in-depth genetic screening and counseling, so you and your family can understand your risk factors.
- Navigation Team: The Navigation Team coordinates appointments, answers questions, and provides guidance. Learn more about the Navigation Team.
- Social workers: An oncology social worker helps patients and families cope with the emotional aspects of living with cancer.
- Support services: We provide a range of support services to treat the whole person, such as support groups and palliative care. Find out more about support services.
AHN Gynecologic Oncology Center of Excellence
The AHN Gynecologic Oncology Center of Excellence is a specialized center dedicated to the comprehensive care of women with gynecologic cancers and complex gynecologic conditions. We focus on cancer care from diagnosis to treatment to ringing the bell. We collaborate with specialists throughout our cancer center for customized treatment plans and exceptional care.
Why choose AHN for ovarian cancer treatment?
At the Cancer Institute, we take a collaborative approach to your care. You meet with a devoted team of cancer specialists, typically within three days of diagnosis. Your team quickly works to design an effective treatment plan tailored to the stage of the cancer. We routinely discuss your progress and determine if we should change the treatment to better meet your needs. At the Cancer Institute, you can expect:
- Patient-centered care: We meet with you and your family to discuss the details of your treatment plan so you feel confident and informed. You’ll see the same team of physicians throughout your care. Your doctors get to know you, your family, and your personal preferences. We also offer robust support services to keep you living the best quality of life during treatment.
- Sophisticated treatment: Your specific treatment will largely depend on how far the cancer has spread. We offer an array of options to stop the cancer in its tracks. Treatments include powerful chemotherapy and risk-reducing surgery, like the removal of fallopian tubes or ovaries.
- Access to clinical trials: We participate in many clinical trials, keeping you at the forefront of the latest treatment options.
Ovarian cancer symptoms and signs
Ovarian cancer can be difficult to detect early because the symptoms are often vague and can be similar to those of other, more common conditions — especially those associated with menstruation. It's important to pay attention to your body and be aware of any persistent changes. For those who have a family history or who are at higher risk, increased screening is important. Symptoms and signs of ovarian cancer can include:
- Abdominal bloating or swelling: Persistent bloating that doesn't go away or comes and goes frequently.
- Pelvic or abdominal pain: Discomfort or pain in the lower abdomen or pelvis.
- Trouble eating or feeling full quickly: Feeling full after eating only a small amount.
- Urinary symptoms: Frequent or urgent need to urinate.
- Changes in bowel habits: Constipation or diarrhea that is new and persistent.
- Fatigue: Feeling unusually tired.
Causes and risk factors
It's not always clear what causes ovarian cancer, but some factors can increase the risk of developing the disease. Be sure to talk with your AHN care team if you notice any changes in your health. Causes and risk factors of ovarian cancer can include:
- Age: The risk of ovarian cancer increases with age, with most cases occurring after menopause.
- Family history: A family history of ovarian cancer, breast cancer, uterine cancer, or colorectal cancer increases your risk. This may be due to inherited gene mutations.
- Inherited gene mutations: Certain inherited gene mutations, such as BRCA1 and BRCA2 (the same genes linked to breast cancer), as well as mutations in genes like Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2, and EPCAM), are associated with a higher risk.
- Personal history of cancer: Having a personal history of breast, uterine, or colorectal cancer may increase your risk.
- Never having children: Women who have never been pregnant may have a higher risk.
- Late first pregnancy: Having your first full-term pregnancy later in life may increase the risk.
- Fertility treatments: Some studies suggest that fertility treatments may be associated with a slightly increased risk, but more research is needed.
Ovarian cancer screening and diagnosis
Our cancer specialists have the expertise to get you the right diagnosis so you can begin treatment. We diagnose ovarian cancer by evaluating your ovaries for masses and growths, as well as by taking a thorough family history, because ovarian cancer is sometimes genetic. Initial tests for ovarian cancer include:
- Internal pelvic examination: A physician will feel for any unusual lumps or changes in the area of your uterus or ovaries.
- Transvaginal ultrasound: In this procedure, a physician gently inserts a rounded ultrasound probe into your vagina to look for abnormal conditions. Sound waves create an image of your uterus and ovaries.
- Computed tomography scan (CT scan): This procedure uses a combination of X-rays and computer technology to show details of the bones, muscles, fat, and organs.
- Magnetic resonance imaging (MRI): Using powerful magnets and radio waves, MRIs create detailed images of organs and specific areas within the body.
Types and stages of ovarian cancer
There are several types of ovarian cancer, categorized by the type of cells in the ovaries where the cancer originates. Here are some of the most common:
- Epithelial Ovarian Cancer: This is the most common type, accounting for about 90% of cases. It starts in the cells on the outer surface of the ovary. Subtypes include:
- Serous carcinoma: The most common subtype, often aggressive.
- Endometrioid carcinoma: Similar to endometrial cancer of the uterus.
- Clear cell carcinoma: Often associated with endometriosis.
- Mucinous carcinoma: This is a less common type.
- Germ Cell Ovarian Cancer: This type starts from the egg-producing cells in the ovary. It's relatively rare and tends to affect younger women. Types include:
- Dysgerminoma: Most common germ cell tumor; often highly treatable.
- Teratoma: Contains different types of cells, like skin, hair, or teeth.
- Yolk sac tumor: Produces alpha-fetoprotein (AFP), a tumor marker.
- Embryonal carcinoma: Rare and aggressive.
- Stromal Ovarian Cancer: This type develops from the structural or hormone-producing cells of the ovary. Types include:
- Granulosa cell tumor: Produces estrogen; may cause early puberty or abnormal bleeding.
- Sertoli-Leydig cell tumor: A rare type of cancer that can develop in the ovaries. It can produce testosterone.
Ovarian cancer is staged to determine how far the cancer has spread. Staging helps doctors plan the best treatment and estimate a patient's prognosis. The stages range from Stage 1 (cancer is confined to the ovaries) to Stage 4 (cancer has spread to distant organs). The stage is based on the size and location of the tumor, whether it has spread to nearby lymph nodes, and whether it has spread to distant sites.
Ovarian cancer treatment
The specialists at the Cancer Institute treat ovarian cancer with the latest technologies, so you are receiving the most effective care possible. And our collaborative, streamlined approach minimizes the stress of multiple appointments. When you arrive for an appointment, you meet with many specialists on the same day. You often begin treatment shortly after diagnosis.
Often, we can treat ovarian cancer using chemotherapy and surgery. Our goal is to treat the cancer in the most effective way possible, while keeping any side effects to a minimum.
Chemotherapy
These medicines directly kill cancer cells, much like antibiotics kill bacteria. Because the medicines also damage normal cells, side effects can occur, such as hair loss, nausea, or lowered blood counts. Fortunately, the body’s normal cells are more resilient and recover much better than cancer cells, so the side effects are usually temporary. We monitor you carefully and calculate your dose of chemotherapy to maximize effectiveness and minimize side effects. We use the latest, most innovative chemotherapy drugs.
Some chemotherapy drugs can damage the ovaries, leading to temporary or permanent infertility. The risk depends on the specific drugs used, the dose, and the patient's age. Chemotherapy can also cause menopausal symptoms like vaginal dryness, hot flashes, and decreased libido, which can impact sexual function.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
HIPEC is a highly concentrated, heated chemotherapy treatment for late-stage abdominal cancers. Doctors deliver chemotherapy directly to cancer cells in the abdomen during surgery.
Risk-reducing surgery
If you’re at risk for ovarian cancer due to genetic factors or family history, you may want to take every precaution possible. Talk to your physician about risk-reducing surgery. During this preventive surgery, we remove the ovaries and fallopian tubes. We usually use a laparoscopic approach, which is a minimally invasive form of surgery using small incisions, pioneered at the AHN Cancer Institute. It typically results in a quicker, easier recovery.
Immunotherapy
Targeted therapy for ovarian cancer focuses on identifying unique characteristics of your cancer cells and using medicines that specifically attack those characteristics, often leading to more precise treatment and potentially fewer side effects than traditional chemotherapy. AHN uses the latest available treatment options including antibody-drug conjugates (ADCs), immunotherapy, HER2 targeted treatments, and other therapeutics specifically chosen for your cancer.
Clinical trials
Our oncology team meets monthly to discuss new clinical trials, ensuring you have access to the latest treatment options. Ask your primary care doctor or oncologist for more information about active or upcoming clinical trials.
Fertility preservation for women with ovarian cancer
Certain cancer treatments can make it difficult or impossible to conceive a child later. At AHN, you may choose to freeze (cryopreserve) and store unfertilized eggs or fertilized embryos for later use. We’ll connect you with AHN’s fertility treatment specialists and high-risk pregnancy doctors at our Center for Reproductive Medicine.
Ovarian cancer FAQs
An ovarian cancer diagnosis can bring about questions and concerns. Your AHN care team is here to help answer those and provide you with the support and compassion needed during treatment. To help you get started, and to hopefully help you feel less overwhelmed, we’ve included answers to some of our patients’ frequently asked questions. Use these to help guide your conversations with your care team, so you can get a better understanding of your overall prognosis.
Is ovarian cancer curable?
The curability of ovarian cancer depends on several factors, including the stage at diagnosis, the type of ovarian cancer, and your overall health. When ovarian cancer is detected and treated early (Stage 1), the chances of a cure are much higher. However, ovarian cancer is often diagnosed at later stages, which can make curing it more challenging. Treatment options like surgery, chemotherapy, and targeted therapies can help control the cancer and improve the chances of long-term survival, even if a complete cure isn't possible.
What is the ovarian cancer survival rate?
Survival rates are statistics that show the percentage of people with a specific type of cancer who are alive a certain period after diagnosis (usually five years). The American Cancer Society states that for invasive epithelial ovarian cancer, the five-year survival rate for a localized case is 92%. For a regional case, it is 71% and for distant spread it is a 32% five-year survival rate. Overall, with these statistics combined, the average five-year survival rate is 51%.
What does ovarian cancer feel like?
In its early stages, ovarian cancer often causes no noticeable symptoms. As the cancer grows, some women may experience vague and nonspecific symptoms that can be easily mistaken for other conditions. These symptoms can include:
- Bloating
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Frequent urination
- Fatigue
- Changes in bowel habits
It's important to note that these symptoms can be caused by many different conditions, not just ovarian cancer. However, if you experience these symptoms frequently or if they are new and unusual for you, it's important to see a doctor.
How do you know if you have ovarian cancer?
There is no simple or reliable screening test for ovarian cancer for women at average risk. If you have symptoms that could indicate ovarian cancer, your doctor will likely perform a pelvic exam, imaging tests (such as ultrasound or CT scan), and possibly blood tests (including a CA-125 test, which measures a protein that can be elevated in women with ovarian cancer). A definitive diagnosis of ovarian cancer usually requires a biopsy, where a sample of tissue is removed and examined under a microscope.
How quickly does ovarian cancer spread?
The rate at which ovarian cancer spreads can vary greatly depending on the type of cancer, its grade (how abnormal the cells look), and individual factors. Some ovarian cancers are slow-growing, while others are more aggressive and spread more quickly.
How fast does ovarian cancer go from stage 1 to stage 4?
There is no set time frame for how long it takes for ovarian cancer to progress from Stage 1 to Stage 4. The progression rate depends on the specific characteristics of the cancer and individual factors. Some ovarian cancers may remain at an early stage for a long time, while others may progress more rapidly. Regular follow-up appointments with your doctor are essential to monitor for any signs of progression.
Contact us
Call 412-578-HOPE 412-578-4673 to speak with an AHN Cancer Institute scheduling coordinator, schedule your appointment online, or connect with a nurse navigator.
Second opinions
If you want a second opinion regarding a cancer diagnosis, treatment options, or prognosis, our team of oncology specialists can review your medical records at AHN. To get started, fill out our Second Opinion Request form. Our Navigation Team will contact you within the next 24–48 hours to discuss next steps and schedule.
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