Ovarian cancer

Published by Bupa’s Health Information Team, August 2011.

This factsheet is for women who have ovarian cancer, or for anyone who would like information about it including the symptoms, causes and treatments.

Ovarian cancer is an abnormal and uncontrolled growth of cells that starts in the ovaries. It’s the fifth most common cancer in women.

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About the ovaries

The ovaries are two small organs that are part of the female reproductive system. They produce eggs every month in women of childbearing age, and the female hormones oestrogen and progesterone.

About ovarian cancer

In ovarian cancer, cells in your ovaries start to grow abnormally and out of control.

Ovarian cancer can sometimes spread more widely in your abdomen (tummy) or more rarely, to other organs through your bloodstream or lymphatic system. The lymphatic system is the tissues and organs, including your bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. The channels that carry lymph are also part of this system. If ovarian cancer spreads to other parts of your body, it can form secondary tumours. The spread of cancer through your body is called metastasis.

Around 6,700 women in the UK are diagnosed with ovarian cancer each year. It's the fifth most common cancer in women and mostly affects women over 50.

Types of ovarian cancer

There are different types of ovarian cancer. The most common is epithelial ovarian cancer, which affects the lining of the ovaries. Nine out of 10 ovarian cancers are epithelial. There are several different types of epithelial ovarian cancer; the most common type is called ‘serous’.

Non-epithelial ovarian cancer is much less common. This type includes germ cell cancers that form from the cells in the ovary that make the eggs. These usually affect younger women.

Symptoms of ovarian cancer

Many women don’t have any symptoms or only vague symptoms in the early stages of ovarian cancer. Many of these symptoms can occur in other conditions as well and are not necessarily a sign of cancer. If you do have symptoms, they may include:

• stomach pain or pain in your pelvis
• a persistent bloated feeling
• feeling full quickly and losing your appetite

Other possible symptoms include:

• unexplained weight loss
• swelling of your abdomen
• changes in bowel or bladder habits – constipation, excess wind, diarrhoea or needing to pass urine more often
• back pain
• extreme tiredness
• rarely, abnormal vaginal bleeding

These symptoms aren't always caused by ovarian cancer but if you have them, or you’re in any doubt, see your GP. The earlier you are diagnosed, the better your chance of survival.

Causes of ovarian cancer

The exact reasons why you may develop ovarian cancer aren't fully understood at present. However, there are some things that can make it more likely. It's more common in women who live in developed countries for example, and in those who have gone through the menopause. It’s also known that inheriting faulty genes called BRCA1 and BRCA2 increase the risk of ovarian cancer as well as breast cancer.

Other factors that may increase your risk of getting ovarian cancer include:

• certain types of hormone replacement therapy (HRT) – especially if you take them for longer than five years
• being overweight or obese
• having endometriosis or ovarian cysts
• smoking
• starting the menopause late

A possible link to using talcum powder has been suggested but this needs to be confirmed by more research (see our common questions for more information).

Ovarian cancer is generally less common in women who have:

• used the contraceptive pill
• had children – the more children, the lower the risk
• breastfed their children
• had a hysterectomy or been sterilised

Diagnosis of ovarian cancer

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history and whether anyone else in your family has had breast or ovarian cancer.

Your GP will ask you to have a blood test to check the levels of certain proteins, such as CA125, that can be high if you have ovarian cancer. He or she may also examine you internally to check your womb and ovaries. 

Your GP may refer you to a specialist for further tests, such as an ultrasound scan or a CT scan to view the inside of your abdomen and pelvis.

If the results of your tests show you have cancer, you may need to have more tests to assess if the cancer has spread. The process of finding out the stage of a cancer is called staging.

Further tests may include a gynaecological laparoscopy – this is a procedure used to examine your fallopian tubes, ovaries and womb. You may also have a small sample of tissue taken (a biopsy), which will be sent to a laboratory for testing.

If you have a build-up of fluid in your stomach, it can be drawn out through a needle and examined to see whether cancer cells are present. This is known as abdominal fluid aspiration or paracentesis.

Treatment of ovarian cancer

Your treatment will depend on the type of ovarian cancer you have and how far it has spread. Before you see a specialist, consider writing down any questions that you want to ask so that you don’t forget them on the day.

Surgery

Almost all women with ovarian cancer will need surgery. If the cancer hasn't spread beyond your ovary, it may be possible to remove just the single affected ovary and fallopian tube.

If the cancer has already spread beyond your ovary, both ovaries and your womb, together with nearby lymph nodes and surrounding tissue, may need to be removed. This is called a total hysterectomy and oophrectomy.

Other types of surgery for more advanced ovarian cancer are used to remove, or 'debulk' as much of the tumour as possible.

Non-surgical treatments

Chemotherapy

Chemotherapy uses medicines to destroy cancer cells. The type of chemotherapy treatment you have will vary depending on your type of ovarian cancer. Usually you have a course of treatment, which is given as several doses at intervals over a period of weeks. Your doctor will give you information on the type and course that is best for you.

You will probably be offered chemotherapy after surgery to destroy any remaining cancer cells that were not removed by surgery or if there is a risk the cancer may return. However, you may have it before surgery to shrink the tumour.

If ovarian cancer comes back (a relapse), you may be treated with the same chemotherapy medicine or an alternative, depending on the timing of your relapse and whether the cancer has developed resistance to previous chemotherapy medicines.

Radiotherapy

Radiotherapy uses radiation to destroy cancer cells. It's not often used to treat ovarian cancer but is very occasionally used after surgery to destroy any remaining cancer cells.

Your doctor may give you information on clinical trials that are testing new treatments for ovarian cancer. You may wish to take part in a trial as it may involve a new treatment and benefit other patients in the future.

Prevention of ovarian cancer

You may be able to reduce your risk of developing ovarian cancer by making changes to your lifestyle, such as stopping smoking and eating a healthy, balanced diet.

Help and support

Being diagnosed with cancer can be distressing for you and your family. An important part of cancer treatment is support to deal with the emotional aspects as well as the physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need. If you have more advanced cancer, further support is available to you in hospices or at home – this is called palliative care.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.