Ovarian cancer

Definition

Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs.

Alternative Names

Cancer - ovaries

Causes

Ovarian cancer is the fifth most common cancer among women. It causes more deaths than any other type of female reproductive organ cancer.

The cause of ovarian cancer is unknown.

Risks of developing ovarian cancer include any of the following:

Symptoms

Ovarian cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.

See your doctor if you have the following symptoms on a daily basis for more than a few weeks:

Other symptoms that can occur:

Exams and Tests

A physical exam may often be normal. With advanced ovarian cancer, the doctor may find a swollen abdomen often due to accumulation of fluid (ascites).

A pelvic examination may reveal an ovarian or abdominal mass.

A CA-125 blood test is not considered a good screening test for ovarian cancer. But, it may be done if a woman has:

Other tests that may be done include:

Surgery, such as laparoscopy or exploratory laparotomy, is often done to find the cause of symptoms. A biopsy will be done to help make the diagnosis.

No lab or imaging test has ever been shown to be able to successfully screen for or diagnose ovarian cancer in its early stages, so no standard screening tests are recommended at this time.

Treatment

Surgery is used to treat all stages of ovarian cancer. For early stages, surgery may be the only treatment needed. Surgery may involve removing both ovaries and fallopian tubes, the uterus, or other structures in the belly or pelvis.The goals of surgery for ovarian cancer are:

Chemotherapy is used after surgery to treat any cancer that remains. Chemotherapy can also be used if the cancer comes back (relapses). Chemotherapy is typically given intravenously (through an IV). It can also be injected directly into the abdominal cavity (intraperitoneal, or IP).

Radiation therapy is rarely used to treat ovarian cancer.

After surgery and chemotherapy, follow instructions about how often you should see your doctor and the tests you should have.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made:

When to Contact a Medical Professional

Contact your health care provider if you are a woman 40 years or older who has not recently had a pelvic exam. Routine pelvic exams are recommended for all women 20 years or older.

Request an appointment with your provider if you have symptoms of ovarian cancer.

Prevention

There are no standard recommendations for screening women without symptoms (asymptomatic) for ovarian cancer. Pelvic ultrasound or a blood test, such as CA-125, have not been found to be effective and are not recommended.

Genetic testing for the BRCA1 or BRCA2, or other cancer-related genes, may be recommended for women at high risk for ovarian cancer. These are women who have a personal or family history of breast or ovarian cancer.

Removing the ovaries and fallopian tubes and possibly the uterus in women who have a proven mutation in the BRCA1 or BRCA2 gene may reduce the risk of developing ovarian cancer. But, ovarian cancer may still develop in other areas of the pelvis.

References

Coleman RL, Liu J, Matsuo K, Thaker PH, Westin SN, Sood AK. Carcinoma of the ovaries and fallopian tubes. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 86.

Coleman RL, Westin SN, Ramirez PT, Salvo G, Gershenson DM. Malignant diseases of the ovary, fallopian tube, and peritoneum. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 33.

National Cancer Institute website. BRCA gene mutations: cancer risk and genetic testing. www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet. Updated November 19, 2020. Accessed December 15, 2022.


Review Date: 10/10/2022
Reviewed By: Howard Goodman, MD, Gynecologic Oncology, Florida Cancer Specialists & Research Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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