This is the most common type of ovarian cancer. It begins on the outside of the ovaries, and it’s named for the cells that make up the surface. Those are called epithelial cells (pronounced eh-pih-THEE-lee-al). As the cancer develops, it can spread into other organs.
Who’s More Likely to Get It?
Any woman can get ovarian cancer. Doctors don’t know what causes it. But they know about some of the things that make it more likely, such as:
- You’re above age 50.
- Your family has a history of ovarian cancer, breast cancer, colon cancer, rectal cancer or uterine cancer. If so, there are tests that can show whether you have certain genes that put you at risk.
- You have had breast cancer.
- You have a mutation in the BRCA1 or BRCA2 gene.
- Lynch syndrome runs in your family. This condition can contribute to many kinds of cancer.
- You got your first period before you were 12 years old or stopped after you were 52.
- You have had estrogen hormone replacement therapy, especially if it was for a long time and in large doses.
- You’ve never been pregnant.
- You smoke.
- Your BMI (body mass index) is in the obese range.
Ovarian cancer often doesn’t have any symptoms until it’s in its later stages. But if you do have symptoms, you might:
- Feel bloated.
- Feel pain in the abdomen or pelvic area.
- Have trouble eating.
- Feel full before you eat much.
- Need to pee a lot.
These are very common problems, and they don’t mean that you have ovarian cancer. Lots of other things can cause them. With ovarian cancer, they tend to linger and be something that’s not usual for you. If you feel any of those symptoms for more than a few weeks, go to your doctor. If it does turn out to be ovarian cancer, finding it as early as possible is best.
There’s no single test for ovarian cancer. Your doctor will do a pelvic exam and try to feel whether anything isn’t normal in the area around the ovaries. After that, you may get one or more of these tests:
Ultrasound. This test bounces sound waves off one or more organs. That creates a visual image that your doctor can study.
Blood test. Your medical team will check for substances that can signal the presence of cancer. These tests aren’t enough to diagnose ovarian cancer on their own.
X-rays. There are several tests that use them. For instance, in a CT scan, a computer combines several X-ray images so your team can study them.
Surgery. Your doctor will take out tiny samples of the tissue of the ovaries and examine them. If cancer is there, the surgeon may start taking it out right then.
If you do have cancer, your doctor will check on how far it has developed. Based on that, they’ll put it into one of four categories called stages. The stages use Roman numerals.
Stage I. The cancer is one or both ovaries.
Stage II. The disease has gone beyond the ovaries into other parts of the lower belly, such as the uterus.
Stage III. Your ovarian cancer has spread farther into the belly, such as to the small intestine.
Stage IV. The cancer has spread into distant parts of the body, such as the lungs.
Your doctor may go after this type of cancer more than one way. The main options are:
Surgery usually removes both ovaries and the reproductive organs connected with them, such as the uterus. The goal is to take out as much cancer as possible.
If the cancer hasn’t spread, your surgeon may be able to remove one ovary and stop there. That would leave the rest of your reproductive system intact, so you might still be able to get pregnant, if you’re not in menopause.
Chemotherapy medicines attack cancer. If the surgery can’t remove all the cancer, your doctor will probably recommend chemo to go after the rest. You might get it through shots into a vein or into your belly.
Radiation uses intense X-rays or other radiation to kill cancer cells. Doctors generally don’t use it for ovarian cancer. But they may bring it in to control pain or to attack the cancer if it returns after the treatment.
Targeted therapy uses drugs that attack certain proteins on cells while sparing healthy cells. This is typically used in conjunction with surgery, chemo, and radiation.
Palliative care is another important part of treating your cancer. It isn't always the same as hospice care. You still get treatment, but you also get care for pain, emotional stress, and other issues related to your cancer that can affect your quality of life.
Cancer treatments can have side effects that include:
- Nausea and vomiting
- Infections and mouth sores
- Problems with the wound from the surgery
- Less appetite
- Bleeding or bruising easily
- Hair loss
If you have these or any other problems, tell your medical team so they can help you feel better.
Throughout your treatment, your medical team, family, friends, and community are very important. They can give you the support you need for your health, emotions, and day-to-day needs.
You and your doctor can check to see if there are any clinical trials that you could join. These trials test new treatments to see how well they work and what the side effects are.
Some trials are for people who haven’t yet started their treatments. Others include those whose cancer isn’t getting better despite treatment, or whose cancer has come back.
Your medical team can help you find out about any trials that might be open to you and explain what’s involved. You can also check the website of the federal government’s National Cancer Institute. Another federal agency, the National Institutes of Health, keeps an online listing of trials called clinicaltrials.gov.
Can You Lower Your Risk?
Researchers have found that women's chances of getting ovarian cancer can be lower if they have:
- Used birth control pills, especially for several years
- Had and breastfed one or more children, especially if they had the first before age 26
- Had surgery to remove their ovaries, and the fallopian tubes that connect them to the uterus, before getting cancer. Some high-risk women, such as those with BRCA gene mutations, consider this.
- Had their uterus removed but left the ovaries
- Had their fallopian tubes tied. This may also help, but doctors aren’t sure why.
Finding out that you have ovarian cancer can be very hard. In addition to the care you get from your loved ones, you may want to join a support group or talk with a counselor if the diagnosis brings up tough emotions that get to you. Your doctor may be able to put you in touch with a support group. Or you may want to check with groups such as the National Ovarian Cancer Coalition and the Ovarian Cancer Research Fund Alliance.