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Ovarian cancer happens when cells in the ovary start to grow and multiply out of control. Cancer that starts in the fallopian tubes (tubes connecting the ovaries and the uterus) and cancer of the peritoneum (the lining of the abdomen) are also usually grouped with ovarian cancer. These cancers have similar causes, symptoms, and treatments.
About 20,000 people in the United States are diagnosed with ovarian cancer each year. This number has been slowly decreasing over the past couple of decades. Women have about a 1 in 91 chance of developing ovarian cancer at some point in their lives. However, certain factors may increase or decrease each person’s individual risk.
Like all cancers, ovarian cancer is caused by genetic mutations that cause cells to become abnormal and disorganized. Some genetic mutations are passed down through families. Up to 1 in 4 cases of ovarian cancer are caused by these inherited mutations, which are present at birth.
Mutations in the BRCA1 and BRCA2 genes are often the cause. People with BRCA mutations are much more likely to get ovarian tumors, as well as pancreatic or breast cancer. Talk to your doctor about genetic testing if you have a family history of these cancers.
Other types of genetic mutations aren’t inherited — they are acquired later in life. As people get older, more of these acquired mutations build up in cells. Therefore, ovarian cancer happens more often in older people than in younger people. Half of the people who get ovarian cancer are at least 63 years old.
Other factors can also cause acquired mutations and increase ovarian cancer risk. These include:
It’s usually not clear what causes each individual case of ovarian cancer, or why some people get this disease and others don’t. Having some or even all of these risk factors doesn’t necessarily mean that you’ll be diagnosed with ovarian cancer, and some people who get ovarian cancer don’t have any of these risk factors.
Your doctor may suspect ovarian cancer during a routine pelvic exam, or you may notice symptoms that have been linked to gynecologic cancer. If there’s a possibility you have ovarian cancer, your healthcare provider may refer you to a gynecologic oncologist, a doctor who specializes in cancers of the female reproductive system. You may get a combination of tests to form a diagnosis.
A doctor will look at overall signs of health and take a close look at the different reproductive organs. The doctor will likely ask about your personal and family health histories.
If a mass or tumor is found, imaging tests — such as an ultrasound, CT scan, or MRI — may be used to get a better look at the size and location of the tumor.
A biopsy involves removing a small piece of the tumor to get a better look at cells under a microscope. It’s usually performed after a tumor has been surgically removed. Biopsies are the only way to know for sure whether a tumor is cancerous.
A healthcare professional may take a blood sample to look for certain biomarkers of cancer, such as cancer antigen 125 (CA-125).
Those who have an increased risk of this condition, such as people with a family history of ovarian cancer, may need some tests even before there are any signs of cancer. For example, they may have CA-125 blood tests performed regularly or have genetic testing for gene mutations that increase their personal risk of ovarian cancer.
Many people don’t have ovarian cancer symptoms in the early stages, or they have symptoms that overlap with other conditions. Common signs of ovarian cancer are:
Not all of these symptoms necessarily indicate ovarian cancer. However, if these signs happen often or become more severe, it’s a good idea to see your doctor.
Because there are multiple types of cells that make up the ovary, there are multiple types of ovarian cancer. Tumors may form from any of the three main ovarian cell types:
Epithelial ovarian cancer is the most common type. Germ cell tumors are rarer but often have a good prognosis. Stromal tumors, also rather rare, tend to be slow-growing. They’re often caught at an early stage. Within each of these three cancer types, there are also several subtypes.
Doctors assign tumors a grade and stage in order to provide more information about the cancer. A tumor’s grade refers to how the cells look under a microscope compared to healthy ovarian cells. The ovarian cancer stage describes the size of the tumor and how far it’s spread in the body. Your tumor’s grade and stage help guide treatment and provide information about what your outcome may look like.
Ovarian cancer isn’t always treated the same way. Your cancer care team will consider many factors when planning ovarian cancer treatment, like your age, other medical conditions you may have, whether or not you want children, and your tumor type, grade, and stage.
Surgery is often the first step for people with ovarian cancer. Surgery allows the doctor to look inside your abdomen and see how far the cancer has spread. Your surgeon will also usually take a biopsy during this time to get a closer look at the cancer cells. One or both ovaries and/or fallopian tubes may be removed. Other organs, such as the uterus, may also be removed if cancer has spread there. Another common goal of surgery is debulking, or removing as much tumor as possible, including most reproductive organs (ovaries, fallopian tubes, uterus, and cervix).
Many people with ovarian cancer will also get chemotherapy, which damages and kills cancer cells. Other medications, including targeted therapies, may also be given depending on what type of ovarian cancer you have. These include long-term maintenance therapy with poly (ADP-ribose) polymerase inhibitors (PARP inhibitors) for certain types of ovarian cancer. Molecular testing can help you determine which targeted therapies can treat your ovarian cancer.
In some cases, clinical trials may be appropriate. Talk to your cancer care team to learn more about what to expect from your treatment plan, including possible side effects.
When someone has more than one health condition at the same time, the conditions are known as comorbidities. People with ovarian cancer may also have endometriosis and high blood pressure. Managing these conditions along with treating your cancer is important.
Comorbidities and complications may affect your treatment or your outlook. Your doctor can help you better understand your risk factors for developing related conditions and recommend steps to lower your risk.
The prognosis, or outlook, for ovarian cancer depends on many factors, including the type, the stage at the time of diagnosis, and the treatments used. Health professionals often talk about prognosis in terms of a five-year relative survival rate. This number describes how many people with a specific diagnosis will likely live for at least five years compared to people without that diagnosis.
The overall percentage of people expected to live at least five years with ovarian cancer is:
These numbers are general estimates — they don’t predict what will happen to each individual who is diagnosed, since many other factors affect a person’s outlook. Talk to your doctor to learn more about your case of ovarian cancer.
Ovarian cancer treatments have improved over the last few decades, leading to increasingly better outcomes for people with ovarian cancer. Additionally, researchers are continuing to find more effective therapies.
On MyOvarianCancerTeam, people share their experiences with ovarian cancer, get advice, and find support from others who understand.
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Yes my mom was just diagnosed with stage 3 and the way they found hers was because she ended up having a build up of fluid in her stomach but my mom is also 80 yrs old She's debating on going through… read more
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