Ovarian cancer

Ovarian cancer is when cells in or around your ovaries stop growing normally and start growing out of control. Any woman or person with ovaries can get this type of cancer.

About ovarian cancer

Ovaries are two small, oval organs in your pelvis. Your pelvis is the lower part of your tummy, between your hip bones. Your ovaries release an egg every month. This is usually in the middle of your period (menstrual cycle).

Ovarian cancer starts inside your ovary or fallopian tubes (the tubes that lead from your ovaries to your womb).

Sometimes, ovarian cancer can spread out of your ovary and fallopian tube. It may spread more widely in your tummy. More rarely, it can spread to other organs, such as your liver, lymph nodes, and lungs.

Ovarian cancer is the sixth most common cancer in women in the UK. Around 7,500 women are diagnosed with this type of cancer every year. It’s most common in those over 50, but you can get it when you’re younger too.

Symptoms of ovarian cancer

Many ovarian cancer symptoms are quite vague, and may be similar to symptoms caused by other, less serious conditions. And you might not get any early warning signs of ovarian cancer – you might not have any symptoms at all in the early stages of the disease. This means that by the time many people see their doctor, their cancer is already at quite an advanced stage.

If you do get ovarian cancer symptoms, the most common include:

• pain or discomfort in your tummy or pelvis
• a swollen tummy
• constantly feeling bloated
• feeling full quickly and losing your appetite
• needing to pee more often or more urgently
• unexplained changes in your poo (bowel habits), such as constipation, excess wind, or diarrhoea
• other symptoms that affect your digestive system, such as feeling sick or indigestion

Other ovarian cancer symptoms include:

• losing weight for no obvious reason
• unexplained extreme tiredness
• abnormal bleeding from your vagina (such as after you’ve gone through the menopause)
• feeling short of breath

If you do have any of the above symptoms, you have them regularly, and they last for longer than a few weeks, contact your GP.

Diagnosis of ovarian cancer

Your GP will ask you about your symptoms and medical history. They’ll examine you by feeling around your tummy and pelvis. They may ask to examine you internally too. In a vaginal examination, your doctor will put some gloves on and add some lubricant, then insert their fingers into your vagina. They’ll use their other hand to press lightly on your tummy (abdomen) and will gently feel for any abnormalities in and around your womb and ovaries.

Tests for ovarian cancer

Your GP may arrange for you to have a blood test to check for a protein called CA125. A high CA125 level can be a sign of ovarian cancer. But other conditions can raise your CA125 level too. If your level of CA125 is found to be higher than normal, your GP may arrange for you to have an ultrasound scan to check your tummy and pelvis.

Referral to a specialist

Depending on your test results, your GP may refer you to a gynaecologist (a doctor who specialises in women’s reproductive health). Sometimes, your GP may refer you to a gynaecologist urgently (within two weeks), before they do any more tests. They’ll then organise any tests and scans for you.

Staging tests

Your doctor will look at your blood test results and ultrasound to see how large your cancer is and how far it’s spread. Sometimes you’ll need other tests, such as a CT scan or MRI scan. Your doctor may recommend a procedure to remove a sample (biopsy) of your ovary to test for cancer cells.

Finding out how far your cancer has spread is called staging. Staging can help doctors to estimate how your cancer is likely to progress. It can also help them to decide on the best way to treat your cancer.

If your cancer is more advanced, your doctor will need to take tissue samples from the tumour. They may look at these with the CT scan to see the stage. Tissue samples are usually taken when the tumour is removed during surgery – see our treatment of ovarian cancer section.

Genetic testing

You should be offered genetic testing after you’re diagnosed with ovarian cancer – talk to your doctor about whether you’re eligible. This will check for faulty BRCA1 and BRCA2 genes. If you have these, it can increase your risk of both ovarian and breast cancer.

If you know whether you have the faulty BRCA genes, it may help your doctor to plan your treatment better. There are lots of things to think about before you have a genetic test – your doctor will talk you through what’s involved.

Prevention of ovarian cancer

You may be able to reduce your chances of getting ovarian cancer if you:

• stop smoking
• lose excess weight
• be more physically active

If you take these steps, it may help to reduce your risk of some other cancers too. They’re also important for your general health. But making changes to your lifestyle can’t completely prevent ovarian cancer. There are many things that you can’t control, such as your age and your genes.

If you have a strong family history, your GP may refer you to a genetic counselling clinic. This is usually if you have any close relatives who have had breast or ovarian cancer. Specialists at the clinic will assess your risk. They may test for the BRCA1 and BRCA2 faulty genes.

If you test positive for these genes, your doctor will talk to you about ways to reduce your risk of both breast and ovarian cancer. For ovarian cancer, you may be advised to:

• take oral contraceptives
• have regular ultrasound scans of your ovaries
• have surgery to remove your ovaries and fallopian tubes (risk-reducing surgery), depending on your age

Help and support

If you’re diagnosed with ovarian cancer, it’s important you have support, especially while you’re having treatment. This will help you deal with the:

• emotional side of having cancer
• practical issues
• physical symptoms

Specialist cancer doctors and nurses are experts in providing the support you need – make sure you talk to them if you’re worried about anything.

Talk to your family and friends as it can help them to understand what you’re going through and how you’re feeling. Organisations and support groups that specialise in ovarian cancer (see the other helpful websites section) can also be a great source of information and support.

You may also find it helpful to speak to someone else who has had ovarian cancer and been through treatment.