Ovarian cancer

Each year more than 280 Queensland women are diagnosed with ovarian cancer. Receiving this diagnosis – whether it’s for yourself or someone you love – can feel overwhelming. Cancer Council Queensland has the support and resources to help guide you through your diagnosis.

The terms “women,” “woman,” and “female” used on this page reflect the language used in the research studies and data sources referenced. Unfortunately, these terms do not encompass all individuals with these reproductive organs. At Cancer Council Queensland, we remain committed to providing information that is both accurate and accessible to everyone. We acknowledge and stand in solidarity with the LGBTIQA+ community.

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About ovarian cancer

Ovarian cancer begins when cells in the ovaries, fallopian tubes, or the peritoneum (the lining of the abdomen) become abnormal, grow uncontrollably, and form a tumour. Approximately 285 Queensland women are diagnosed with ovarian cancer each year, and while it can occur at any age, it is more common in women over 50.

There are several types of ovarian cancer, but the three most common are:

  • Epithelial ovarian cancer: This is the most common type, making up about 90% of cases. It starts in the outer layer of the ovary and typically affects women over 60.
  • Germ cell ovarian cancer: A rarer type, occurring in about 4% of cases, it develops in the cells that produce eggs. This type is more likely to affect younger women under 40.
  • Sex-cord stromal cancer: Another rare form, it begins in the hormone-producing cells of the ovaries and is most commonly diagnosed between ages 40 and 60.

Risk Factors

It is not known exactly what causes ovarian cancer, but several factors can increase a woman’s risk.

  • Age – ovarian cancer is most common in women over 50 and in women who have stopped menstruating. The risk increases as you get older.
  • Genetic factors – up to 20% of serous ovarian cancers (the most common sub-type) are linked to an inherited faulty gene such as BRCA1 or BRCA2. A smaller proportion of the other types of ovarian cancer are also related to genetic faults.
  • Family history – having one or more close blood relatives diagnosed with ovarian, breast, bowel or uterine cancers, or having Ashkenazi Jewish ancestry.
  • Endometriosis.
  • Reproductive history – women who have not had children, who have had assisted reproduction, or who had children after the age of 35 may be slightly more at risk.
  • Health factors – some types of ovarian cancer have been linked to smoking or being overweight.
  • Hormonal factors – including early puberty or late menopause. Some studies suggest using oestrogen-only hormone therapy or fertility treatment may slightly increase the risk of ovarian cancer.

While these risks are important to consider, it’s worth noting that most women with these factors do not develop ovarian cancer.

Some factors may also help to reduce the risk of developing ovarian cancer, including:

  • Using the oral contraceptive pill for several years.
  • Having your fallopian tubes tied (or removed).
  • Having children before the age of 35 and breastfeeding.

Ovarian cancer and symptoms

There are few symptoms of ovarian cancer in its early stages, which is why it is typically diagnosed when the disease is more advanced and has spread to other organs.

However, some women may experience subtle signs of ovarian cancer that can be easily mistaken for other conditions.

Common symptoms of ovarian cancer include:

  • Pressure, pain or discomfort in the back, abdomen or pelvis.
  • A swollen or bloated abdomen.
  • Changes in appetite, such as not feeling like eating, or feeling full quickly.
  • Changes in toilet habits (e.g. constipation, diarrhoea, passing urine more often, increased wind).
  • Indigestion and feeling sick (nausea).
  • Feeling very tired.
  • Unexplained weight loss or weight gain.
  • Changes in pattern of periods, or vaginal bleeding after menopause.
  • Pain during sex.

These symptoms don’t necessarily mean you have ovarian cancer – they are often linked to other health conditions. However, if they are new for you, severe, or persist for more than a few weeks, it’s important to see your doctor.

Diagnosis

If you are experiencing possible symptoms of ovarian cancer, your doctor may recommend a series of tests to investigate further. These tests can identify abnormalities such as cysts or signs of ovarian tumour, but a definitive diagnosis of ovarian cancer can only be confirmed through a biopsy, where cells are examined under a microscope. This is often done during surgery, which means the diagnosis is confirmed and the cancer is treated at the same time.

Tests and Scans

  • Pelvic examination: The doctor will check for any masses or lumps by feeling your abdomen. While it may be uncomfortable, it’s usually not painful.
  • Digital rectal examination: This checks the tissue behind the uterus where cancer cells may grow.
  • Blood tests: These look for signs of ovarian tumour markers like CA125.
  • Pelvic ultrasound: Uses echoes from soundwaves to create a picture of the ovaries and uterus.
  • CT scan: Uses x-ray beams to take pictures of the inside of your body.
  • MRI scan: Uses magnetism and radio waves to build up very detailed cross-section pictures of the body.
  • PET scan: Highlights abnormal tissues.
  • Colonoscopy: Some women may have a bowel examination to check their symptoms are not caused by a bowel problem.

Waiting for test results can be stressful. Talking to someone close to you, your healthcare team, or Cancer Council Queensland 13 11 20 can help.

Treatment

Treatment for ovarian cancer varies depending on the type, stage, and individual factors such as your overall health, plans to have children, and whether you carry a genetic mutation like BRCA. While your doctor will recommend a tailored treatment plan for you, here is how ovarian cancer is commonly treated:

  • Epithelial ovarian cancer stage 1 – usually treated with surgery alone, however you may be offered chemotherapy after surgery if there’s a high risk of the cancer returning.
  • Epithelial ovarian cancer stages 2, 3 and 4 – usually treated with a combination of surgery and chemotherapy. New targeted therapy drugs are being offered to people with the BRCA gene fault. In some cases radiation therapy is offered.
  • Germ cell – usually treated with surgery and/or chemotherapy.
  • Stromal cell – usually treated with surgery, sometimes followed by chemotherapy or targeted therapy.
  • Borderline tumours – usually treated with surgery only.

Your care team may include gynaecological oncologists, medical and radiation oncologists, radiologists, cancer nurses, and other specialists to support you.

Prognosis

It’s natural to want to understand what to expect from your experience with ovarian cancer. Your doctor can offer a prognosis based on your test results, the type, stage and grade of cancer, genetic factors, your overall health, and how well you respond to treatment. However, it’s important to remember everyone’s experience with cancer is different and no one can predict the exact course of the disease.

It can be confronting to think about your prognosis. Chatting with your doctor, family and friends can help. If you’re feeling unsure or need emotional support, organisations like Cancer Council Queensland are here to provide information, guidance and a listening ear when you need it.

Questions you may have

How to check for ovarian cancer at home

There is no at-home test for ovarian cancer. However, you can be aware of the signs of ovarian cancer so you can seek medical advice if you notice any. Symptoms of ovarian cancer can include abdominal bloating, feeling full quickly, frequent urination, pelvic pain, bowel changes, menstrual irregularities, fatigue, indigestion, pain during sex, and unexplained weight changes. It is important to understand many symptoms can be linked to other less worrying conditions, and do not always mean you have cancer.

How do I get tested for ovarian cancer?

If your doctor suspects ovarian cancer, they’ll likely perform a pelvic examination and recommend tests or scans. The only way to confirm ovarian cancer is through a biopsy, usually done during surgery, where tissue or fluid samples are taken and examined by a pathologist.

A diagnosis can only be made after these samples are carefully analysed.

What does ovarian cancer look like on ultrasound?
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Can a pap smear detect ovarian cancer?

There is currently no test to detect ovarian cancer early. Screening methods like the Pap smear test or HPV test do not identify ovarian cancer. The best approach is to be familiar with your body, recognise any changes, and stay alert to the symptoms of ovarian cancer, which may include a bloated abdomen, pain in the abdomen, pelvis, or back, loss of appetite or feeling full quickly, changes in bowel habits, unexplained weight changes, indigestion, and pain during sex.

These symptoms are often linked to other conditions, and most women with them won’t have ovarian cancer. However, if these symptoms are unusual for you or persist, it’s important to see your doctor for a check-up.

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