Patient education: Ovarian cancer (The Basics)

What is ovarian cancer? — 

This is when normal cells in the ovary change into abnormal cells and grow out of control. The ovaries are part of the female reproductive system (figure 1). If you still have monthly periods, your ovaries release an egg about once a month.

Ovarian cancer occurs most often between the ages of 50 and 65, but can happen at any age. Sometimes, ovarian cancer runs in families.

What are the symptoms of ovarian cancer? — 

Symptoms can include:

●The stomach getting bigger or feeling bloated

●Stomach pain

●Feeling full or having trouble eating

●Needing to urinate often or feeling like you suddenly need to urinate urgently

These symptoms are common and, in many cases, are caused by conditions that are not ovarian cancer. But if you start having these symptoms and they continue or get worse, tell your doctor or nurse.

Many people have no symptoms of ovarian cancer, but find out they have it when a growth is found in or near 1 of their ovaries. This sometimes happens during a pelvic exam or an imaging test, like an ultrasound, that was done for another reason. If this happens, your doctor or nurse might then do more tests to check for ovarian cancer.

Is there a test for ovarian cancer? — 

Yes. If your doctor suspects you have ovarian cancer, they might order 1 or more of these:

●Ultrasound or other imaging tests – These create images of the inside of the body and can show abnormal growths.

●Blood tests – There is no blood test that can show for sure if you have ovarian cancer. But if your doctor thinks you might have it, they might order some lab tests. One test is called the "CA 125" blood test. CA 125 is a protein in the blood. When a person has ovarian cancer, their CA 125 level goes up. But it can also go up with other conditions that are not ovarian cancer.

The CA 125 test is mostly helpful in people who have already gone through menopause and no longer have monthly periods. It can't clearly show whether you have ovarian cancer. But it can help your doctor decide whether they need to do surgery to learn more. They might do also other blood tests to better understand your risk of ovarian cancer.

●Surgery – The only way to know for sure if a person has ovarian cancer is for a doctor to do surgery and remove the ovary. During surgery, another doctor will usually look at cells from the ovary under a microscope to check for cancer. If cancer is present, the doctor will usually continue surgery and treat the cancer by removing as much of it as possible. Most of the time, this involves doing a surgery called "total hysterectomy with salpingo-oophorectomy" (figure 2). For this surgery, the doctor removes the ovaries, the tubes that connect the ovaries to the uterus (called the fallopian tubes), and the uterus. If the cancer has spread to other nearby organs, the doctor might remove parts of those, too.

What is cancer staging? — 

This is a way to find out how far a cancer has spread.

How is ovarian cancer treated? — 

In most cases, having surgery to remove the cancer is the first part of treatment. Further treatment depends a lot on the stage of your cancer and your other medical problems.

Some people might not need any more treatment after surgery. Others might need further treatment, including chemotherapy. These are medicines that kill cancer cells or stop them from growing. Usually, these medicines are given into a vein. But sometimes, they can be given through a small tube into the lower part of your stomach.

What if I want to get pregnant later? — 

Talk to your doctor about this before starting treatment. It is usually not possible to get pregnant after having treatment for ovarian cancer. But in some cases, it might be possible to plan treatment so pregnancy is still possible.

What happens after treatment? — 

You will be checked regularly to see if the cancer comes back. Follow-up tests usually include blood tests, exams, and imaging tests.

You should also watch for the symptoms listed above, because having those could mean the cancer has come back. Tell your doctor or nurse if you have any symptoms.

What happens if the cancer comes back or spreads? — 

You might have more surgery or chemotherapy. You might also get a medicine called targeted therapy, which can help prevent cancer growth.

Can ovarian cancer be prevented? — 

If ovarian, breast, uterine, or colon cancer runs in your family, talk to your doctor. There might be things you can do to lower your risk of cancer.

What else should I do? — 

Follow all your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for ovarian cancer involves making many choices, such as what treatment to have. Always tell your doctors and nurses how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

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