Ovarian cancer is a type of cancer that originates in or near the ovaries—two small reproductive glands located on either side of the uterus. It occurs when cells in this region mutate and begin growing uncontrollably, forming a tumor. Because ovarian cancer often shows few noticeable signs in its early stages, it is sometimes diagnosed at a more advanced stage. However, early awareness of symptoms, understanding risk factors, and staying informed about detection and treatment options can improve outcomes significantly.

Types of Ovarian Cancer

Ovarian cancers are classified based on the type of cell in which they originate:

  • Epithelial Tumors: Arise from the cells that cover the outer surface of the ovary. These are the most common type, responsible for 85–90% of ovarian cancers.
  • Germ Cell Tumors: Begin in the egg-producing cells and typically affect younger individuals, including teens and young adults.
  • Stromal Tumors: Develop in the ovarian tissues that produce hormones. Though rare (about 1% of cases), these tumors are often detected earlier than other types due to hormone-related symptoms.

Each main type has subtypes, each with distinct behavior, genetic markers, and treatment response.

Recognizing the Symptoms

One of the reasons ovarian cancer is often diagnosed late is that its symptoms can be vague and easily mistaken for other, less serious conditions.

Common early symptoms include:

  • Persistent bloating
  • Pelvic or abdominal pain
  • Feeling full quickly when eating
  • Frequent or urgent need to urinate

Symptoms of advanced ovarian cancer may also include:

  • Back pain
  • Fatigue
  • Unexplained weight loss
  • Constipation or changes in bowel habits
  • Pain during sexual intercourse
  • Abnormal vaginal bleeding or discharge
  • Swelling in the abdomen due to fluid buildup (ascites)

Symptoms that occur more than 12 times a month should not be ignored.

What Causes Ovarian Cancer?

The exact cause of ovarian cancer is unknown, but research suggests it is typically the result of genetic mutations. These mutations may be inherited or acquired over time due to environmental or hormonal factors.

Key factors contributing to ovarian cancer include:

  • DNA damage that causes cells to divide uncontrollably
  • Inherited mutations in genes like BRCA1 and BRCA2
  • Chronic inflammation of the ovaries
  • Hormonal imbalances, particularly estrogen exposure

Not all people with risk factors will develop ovarian cancer, but recognizing these risks allows for proactive health monitoring.

Risk Factors to Consider

Genetic and non-modifiable risks:

  • Family history of ovarian, breast, or colorectal cancer
  • BRCA1 or BRCA2 gene mutations
  • Age (most cases occur after age 50)
  • Endometriosis
  • Ashkenazi Jewish or Eastern European ancestry
  • Early menarche (before age 12) or late menopause (after 55)

Lifestyle-related and modifiable risks:

  • Smoking
  • High intake of saturated fats
  • Obesity
  • Never having been pregnant
  • Not breastfeeding
  • Prolonged hormone replacement therapy (HRT) use after menopause

People with known genetic risks may consider preventive measures such as genetic counseling or prophylactic surgery.

Diagnosing Ovarian Cancer

There is currently no reliable screening test for ovarian cancer, which makes recognizing symptoms and acting on risk factors essential.

Diagnostic tools include:

  • Medical History and Physical Exam: Evaluates symptoms, family history, and risk factors.
  • Pelvic Exam: Assesses for lumps or fluid buildup.
  • Imaging Tests: Transvaginal ultrasound, CT scans, and MRIs help detect abnormalities.
  • Blood Tests:
    • CA-125: Measures levels of a protein often elevated in ovarian cancer.
    • HE4 and other tumor markers: Additional markers used to support diagnosis.
  • Biopsy: Often performed during surgery, this is the only definitive way to confirm ovarian cancer.
  • Genetic Testing: Multigene panels can identify inherited mutations and guide treatment decisions.

Understanding Cancer Staging

Ovarian cancer staging follows the TNM system, which assesses tumor size (T), lymph node involvement (N), and metastasis (M):

  • Stage I: Cancer is limited to one or both ovaries.
  • Stage II: Cancer has spread to nearby pelvic organs.
  • Stage III: Spread to the abdominal lining or lymph nodes.
  • Stage IV: Cancer has metastasized to distant organs such as the liver or lungs.

Staging is essential for developing an effective treatment plan.

Ovarian Cancer Treatment Options

Treatment depends on the type, stage, and grade of cancer, as well as overall health and fertility goals.

Surgery:

  • Removal of one or both ovaries, fallopian tubes, and possibly the uterus.
  • Debulking surgery to remove as much of the tumor as possible.
  • Tissue samples taken from lymph nodes and other areas to assess spread.

Chemotherapy:

  • Usually involves drugs like carboplatin and paclitaxel.
  • May be given before (neoadjuvant) or after (adjuvant) surgery.
  • Delivered intravenously or directly into the abdomen (intraperitoneal).
  • Maintenance chemo may reduce recurrence.

Targeted Therapy:

  • PARP Inhibitors (e.g., olaparib): Help prevent cancer cells from repairing DNA.
  • Bevacizumab: Blocks blood supply to tumors.
  • Folate-receptor alpha drugs (e.g., mirvetuximab): Attach to specific tumor proteins to deliver chemo directly.

Hormone Therapy:

  • Used in certain types like stromal tumors.
  • Drugs reduce estrogen or block its effects to slow tumor growth.

Radiation Therapy:

  • Not commonly used but may help if cancer has spread to specific body parts.

Clinical Trials:

  • Offer access to cutting-edge treatments and combination therapies.

Living With Ovarian Cancer

The journey through ovarian cancer diagnosis and treatment can be physically and emotionally taxing. Beyond treatment, survivorship and quality of life matter.

Patients may experience:

  • Emotional distress, fear of recurrence, or depression
  • Physical side effects from chemo or surgery (fatigue, neuropathy, menopause symptoms)
  • Concerns about fertility or intimacy

Supportive care includes:

  • Nutrition and fitness guidance
  • Palliative care for symptom management
  • Mental health counseling
  • Peer support or community groups

Survivorship care plans help monitor for recurrence, manage long-term effects, and support holistic well-being.

Comorbidities and Complications

Ovarian cancer can increase the risk for other health issues:

  • Secondary Cancers: People with BRCA mutations are at higher risk for breast or colon cancer.
  • Cardiovascular Disease: Survivors may develop heart conditions due to chemo or long-term inflammation.
  • Bone Health: Certain treatments can weaken bones, increasing fracture risk.
  • Leukemia: Rare, but some chemo drugs are associated with increased risk of blood cancers.

Monitoring and proactive management of comorbidities is essential during and after treatment.

Can Ovarian Cancer Be Prevented?

While not entirely preventable, there are steps you can take to lower your risk:

  • Birth Control Pills: Long-term use reduces ovarian cancer risk.
  • Breastfeeding: Hormonal changes during breastfeeding offer protective benefits.
  • Surgical Options:
    • Tubal ligation
    • Prophylactic oophorectomy for high-risk individuals
  • Healthy Lifestyle:
    • Maintain a healthy weight
    • Avoid tobacco
    • Eat a balanced, low-fat diet

Those with strong family histories should consider genetic counseling and testing.