Ovarian cancer

Last updated 25 February 2016 — Last reviewed 24 February 2014

Ovarian cancer is a cancer in one or both of the ovaries. It is important to know the signs and symptoms of ovarian cancer. These may include bloating, frequent urination (with no infection), back pain, heartburn, pain during intercourse and unexplained bleeding. Ovarian cancer is difficult to detect in the early stages. It usually starts as a painless lump on the ovary that gradually enlarges. As there is room for it to grow, it does not cause clear symptoms until it is quite large.

What is ovarian cancer?

Ovarian cancer is a cancer that forms in one or both ovaries. There are three types of ovarian cancer:

Epithelial Cancer in the surface of the ovary
Germ cell Cancer that starts in the cells that produce eggs
Sex-cord stromal Cancer that starts in the cells that produce female hormones such as oestrogen (estrogen)

Ovarian cancer is the sixth most common cause of cancer death in Australian women[1]. Every year around 1,400 women are diagnosed with ovarian cancer in Australia.

Even though it is less common than lung cancer or breast cancer it is important to be aware of the signs and symptoms of ovarian cancer as early diagnosis improves treatment outcomes.

current diagnosis rates of ovarian cancerAbout 75% of women will be diagnosed in an advanced stage and the chances of surviving more than five years are low, with only about 25% of these women living more than five years. 

For the 25% of women diagnosed in the early stages of ovarian cancer, the outlook is very good, with about 90% of patients being cured.

Currently there are no reliable early detection tests for ovarian cancer and therefore no screening programs to enable earlier detection.

Signs & symptoms of ovarian cancer

Ovarian cancer is difficult to detect in the early stages. It usually starts as a painless lump on the ovary that gradually enlarges. As there is room for it to grow, it does not cause clear symptoms until it is quite large.

The symptoms of ovarian cancer are often vague and non-specific. Almost every woman will experience these symptoms at various times and in most cases the symptoms will not be caused by ovarian cancer.

Common symptoms of ovarian cancer are:

Common symptoms of ovarian cancer

Other symptoms may include:

  • pelvic or abdominal pain or discomfort 
  • feeling full/appetite loss/weight loss
  • gastrointestinal upsets such as burping/flatulence, nausea, indigestion, heartburn 
  • cramps 
  • unusual vaginal bleeding 
  • pain during intercourse

This explains why ovarian cancer may not be diagnosed until it is quite advanced.

Known risk factors for ovarian cancer

There are some things that increase the risk of developing ovarian cancer including:

Age Most cases of ovarian cancer occur after the age of 45, however, ovarian cancer can still occur at any age, including in teenagers.
Family history One or more close relatives with ovarian or breast cancer at an early age could indicate an increase in your risk of developing ovarian cancer.
Late menopause All seem to increase the risk of developing ovarian cancer.
Infertility
Not ever having children

Having had several children, breastfeeding and using the contraceptive pill have all been shown to reduce the risk of ovarian cancer.

If you are concerned about your risk, talk to your doctor.

How is ovarian cancer diagnosed?

If you experience some of the symptoms of ovarian cancer for more than two weeks, and they are a change from the normal for you, ask your doctor about the possibility of ovarian cancer. The following steps can be taken to assess you:

  • Your doctor can perform a pelvic examination
  • If no other cause can be determined for your symptoms, a transvaginal ultrasound examination (internal ultrasound through the vagina) is a good test for identifying abnormalities on the ovary
  • Your doctor can order a simple blood test called a CA-125 but this test is not always reliable, particularly if you haven’t been through menopause, so it shouldn't be the only test

Gynaecological oncologist

If your pelvic examination, ultrasound and/or CA-125 test results suggest ovarian cancer is a possibility, seek a referral to a gynaecological oncologist as soon as possible.

Gynaecological oncologists are specialists in treating cancers such as ovarian cancer. It has been shown that women with ovarian cancer who are treated by a gynaecological oncologist have better outcomes.

See your doctor

See your doctor if you experience symptoms such as:

  • abdominal bloating
  • difficulty eating
  • constipation
  • heartburn
  • severe back pain
  • urinary frequency
  • severe fatigue

And these symptoms

  • are a change from the normal for you
  • persist for more than 2 weeks
  • and there is no other explanation for you having these symptoms

References

  1. 10 most common causes of death from cancer in Australian women (Australian Institute of Health and Welfare, 2008)

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at February 2014.

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