Patient education: Ovarian cancer (The Basics)

What is ovarian cancer? — Ovarian cancer happens when normal cells in the ovary change into abnormal cells and grow out of control. The ovaries are part of your 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 of ovarian cancer can include:

●Your 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, let your doctor or nurse know.

Many people have no symptoms of ovarian cancer, but learn that 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 that you have ovarian cancer, they might order 1 or more of the following:

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

●Blood tests – There is no blood test that can tell for sure if you have ovarian cancer. But if your doctor thinks that 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 that can go up when a person has ovarian cancer. 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 tell your doctor whether or not you have ovarian cancer. But it can help them decide whether they need to do surgery to learn more. They might do other blood tests to better understand your risk of ovarian cancer, too.

●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. While the surgery is going on, 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? — Cancer staging is a way in which doctors 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 will depend 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 that includes chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Usually, these medicines go into a vein. But sometimes, they can go through a small tube into the lower part of your stomach.

What if I want to get pregnant later? — If you want to get pregnant later in life, 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 that pregnancy is still possible.

What happens after treatment? — After treatment, you will be checked every so often 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 symptoms could mean that the cancer has come back. Tell your doctor or nurse if you have any symptoms.

What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, you might have more surgery or chemotherapy. You might also have 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 that 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 let your doctors and nurses know how you feel about a treatment. Anytime 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?

More on this topic

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Patient education: Deciding to have a hysterectomy (The Basics)
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Patient education: Preserving fertility after cancer treatment in women (The Basics)
Patient education: Salpingectomy (The Basics)
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