What is Ovarian Cancer? Symptoms, Causes, & Treatment

Ovarian cancer happens when cells in or around the ovaries begin growing uncontrollably. Your ovaries are two small organs that sit on either side of your uterus and produce eggs along with hormones like estrogen and progesterone.

This type of cancer can be challenging to catch early because symptoms often feel like common digestive issues. However, understanding the signs and getting proper medical care can make a significant difference in treatment outcomes.

What is Ovarian Cancer?

Ovarian cancer develops when normal cells in your ovaries, fallopian tubes, or the lining of your abdomen start changing and multiplying rapidly. These abnormal cells form tumors that can spread to other parts of your body if left untreated.

Most ovarian cancers actually begin in the fallopian tubes and then spread to the ovaries. The cancer cells can also originate from the peritoneum, which is the thin tissue lining your abdominal cavity.

There are several types of ovarian cancer, but epithelial ovarian cancer makes up about 90% of cases. This type starts in the thin layer of cells covering the outside of the ovaries.

What are the Types of Ovarian Cancer?

Epithelial ovarian cancer is the most common type, affecting the cells that cover the outer surface of your ovaries. Within this category, there are different subtypes including serous, mucinous, endometrioid, and clear cell cancers.

Germ cell tumors develop from the cells that produce eggs. These cancers are much less common and typically affect younger women, often in their teens and twenties.

Stromal tumors grow from the cells that produce hormones in your ovaries. These are rare and can sometimes cause unusual hormone-related symptoms like irregular bleeding or changes in body hair.

Primary peritoneal cancer behaves very similarly to ovarian cancer but starts in the lining of your abdomen rather than the ovaries themselves. It's treated much the same way as ovarian cancer.

What are the Symptoms of Ovarian Cancer?

Ovarian cancer symptoms can be subtle and easily mistaken for common digestive problems. The key difference is that these symptoms tend to be persistent, frequent, and represent a change from how you normally feel.

Here are the main symptoms to watch for:

• Bloating that doesn't go away or gets worse over time
• Pelvic or abdominal pain that feels different from menstrual cramps
• Feeling full quickly when eating, even small amounts
• Needing to urinate more often or more urgently than usual
• Changes in bowel habits like constipation or diarrhea
• Unexplained weight loss or weight gain
• Fatigue that doesn't improve with rest
• Back pain that comes and goes

Less common symptoms might include unusual vaginal bleeding, especially after menopause, or changes in your menstrual cycle. Some women also experience nausea, heartburn, or pain during intercourse.

Remember, having these symptoms doesn't mean you have ovarian cancer. Many conditions can cause similar feelings, but if you notice several of these symptoms persisting for more than two weeks, it's worth discussing with your doctor.

What Causes Ovarian Cancer?

The exact cause of ovarian cancer isn't fully understood, but researchers believe it develops when cells acquire genetic changes that make them grow uncontrollably. These changes can happen randomly over time or be inherited from your parents.

Most cases occur without any clear trigger. Your cells naturally divide and replace themselves throughout your life, and sometimes errors occur during this process that can lead to cancer.

Inherited genetic mutations play a role in about 10-15% of ovarian cancers. The most well-known are mutations in the BRCA1 and BRCA2 genes, which you might have heard about in relation to breast cancer risk.

Other less common inherited gene changes include mutations in genes like MLH1, MSH2, MSH6, PMS2, and EPCAM, which are associated with Lynch syndrome. These genetic factors can significantly increase your risk but don't guarantee you'll develop cancer.

What are the Risk Factors for Ovarian Cancer?

Several factors can influence your likelihood of developing ovarian cancer, though having risk factors doesn't mean you'll definitely get the disease. Understanding these factors can help you and your doctor make informed decisions about screening and prevention.

Age is the strongest risk factor, with most cases occurring in women over 50. The average age at diagnosis is 63, though ovarian cancer can occur at any age.

Family history matters significantly. If you have close relatives who've had ovarian, breast, or colorectal cancer, your risk may be higher. This is especially true if multiple family members were affected or if they were diagnosed at young ages.

Reproductive history also plays a role:

• Never having been pregnant or having your first pregnancy after age 35
• Starting menstruation early (before age 12) or menopause late (after age 55)
• Having fertility problems or using certain fertility treatments
• Never breastfeeding or breastfeeding for less than three months

Medical conditions that increase risk include endometriosis, where tissue similar to your uterine lining grows outside the uterus. Having had breast cancer also slightly increases your ovarian cancer risk.

Lifestyle factors like being overweight, using hormone replacement therapy for many years, or smoking may also contribute to increased risk, though the connections aren't as strong as with other factors.

When to See a Doctor for Ovarian Cancer Symptoms?

You should contact your healthcare provider if you experience persistent symptoms that concern you, especially if they represent a change from your normal patterns. Don't wait for symptoms to become severe.

Schedule an appointment within a few days if you have bloating, pelvic pain, or urinary changes that last more than two weeks. These symptoms become more concerning when they occur almost daily and don't improve with typical remedies.

Seek immediate medical attention if you have severe abdominal pain, especially if it comes with fever, nausea, or vomiting. While this could be many things, it's important to rule out serious conditions.

If you have a family history of ovarian or breast cancer, consider discussing genetic counseling with your doctor even before symptoms appear. This can help you understand your risks and options for monitoring or prevention.

What are the Possible Complications of Ovarian Cancer?

Understanding potential complications can help you recognize when to seek additional medical support and know what to expect during treatment. Remember that many people with ovarian cancer don't experience all or even most of these complications.

The cancer can spread to other organs in your abdomen, including your liver, intestines, or the lining of your abdominal cavity. This process, called metastasis, is more common with advanced-stage disease.

Fluid buildup in your abdomen, called ascites, can cause significant bloating and discomfort. This happens when cancer cells irritate the lining of your abdomen, causing it to produce excess fluid.

Bowel obstruction can occur if tumors grow large enough to block your intestines. This causes severe nausea, vomiting, and inability to pass gas or have bowel movements.

Treatment-related complications might include:

• Side effects from chemotherapy like fatigue, nausea, or increased infection risk
• Surgical complications such as bleeding, infection, or blood clots
• Nerve damage from certain chemotherapy drugs, causing numbness in hands and feet
• Kidney problems from some treatments or from the cancer itself

Rare but serious complications include severe allergic reactions to treatments, heart problems from certain chemotherapy drugs, or secondary cancers that can develop years after treatment. Your medical team will monitor you carefully for these possibilities.

How is Ovarian Cancer Diagnosed?

Diagnosing ovarian cancer usually involves several steps and tests. Your doctor will start by listening to your symptoms and performing a physical examination, including a pelvic exam to check for any unusual masses or fluid buildup.

Blood tests can measure levels of CA-125, a protein that's often elevated in women with ovarian cancer. However, this test isn't perfect since CA-125 can be high for other reasons, and some women with ovarian cancer have normal levels.

Imaging tests help your doctor see what's happening inside your body. A transvaginal ultrasound uses sound waves to create pictures of your ovaries and can often detect tumors or cysts.

CT scans or MRI scans might be ordered to get more detailed images of your abdomen and pelvis. These tests can show if cancer has spread to other organs and help plan treatment.

The only way to definitively diagnose ovarian cancer is through a biopsy, where a small sample of tissue is examined under a microscope. This is usually done during surgery, though sometimes a needle biopsy can be performed.

If ovarian cancer is confirmed, additional tests like PET scans or more blood work might be done to determine the stage and guide treatment decisions.

What is the Treatment for Ovarian Cancer?

Treatment for ovarian cancer typically involves a combination of surgery and chemotherapy, though your specific plan will depend on the type and stage of your cancer, your overall health, and your personal preferences.

Surgery is usually the first step and serves two main purposes: removing as much cancer as possible and determining how far it has spread. This procedure, called debulking or cytoreductive surgery, might involve removing your ovaries, fallopian tubes, uterus, and nearby lymph nodes.

For early-stage cancer in younger women who want to preserve fertility, sometimes only the affected ovary and fallopian tube are removed. This decision requires careful discussion with your medical team about risks and benefits.

Chemotherapy uses powerful medicines to kill cancer cells throughout your body. Most women receive chemotherapy after surgery, though sometimes it's given before surgery to shrink tumors and make the operation easier.

The most common chemotherapy drugs for ovarian cancer include carboplatin and paclitaxel. These are usually given through an IV every three weeks for about six cycles, though the exact schedule can vary.

Targeted therapy drugs work differently from traditional chemotherapy by focusing on specific features of cancer cells. Examples include bevacizumab, which blocks blood vessel growth to tumors, and PARP inhibitors like olaparib, which are especially helpful for women with BRCA mutations.

For recurrent ovarian cancer, treatment options might include different chemotherapy drugs, targeted therapies, hormone therapy, or participation in clinical trials testing new treatments.

How to Take Care of Yourself During Ovarian Cancer Treatment?

Taking care of yourself during treatment is just as important as the medical treatments themselves. Your body needs extra support while fighting cancer and recovering from treatments.

Nutrition plays a crucial role in your recovery. Try to eat regular meals even when you don't feel hungry, focusing on protein-rich foods to help your body heal. Small, frequent meals often work better than large ones if you're experiencing nausea.

Stay as active as your energy allows. Gentle activities like short walks, stretching, or yoga can help reduce fatigue, improve mood, and maintain muscle strength. Always check with your medical team before starting any exercise program.

Managing side effects is an ongoing process. Keep a symptom diary to track how you're feeling and what helps. Don't hesitate to contact your healthcare team about any concerns, even if they seem minor.

Here are some practical self-care strategies:

• Rest when you need to, but try to maintain some daily structure
• Stay hydrated by sipping water throughout the day
• Use gentle, fragrance-free products on your skin
• Practice stress-reduction techniques like deep breathing or meditation
• Accept help from family and friends with daily tasks
• Connect with support groups or counselors if you're feeling overwhelmed

Taking care of your emotional health is equally important. It's normal to feel scared, angry, or sad during this time. Consider talking to a counselor who specializes in working with cancer patients, or joining a support group where you can connect with others who understand what you're going through.

How Can Ovarian Cancer Be Prevented?

While there's no guaranteed way to prevent ovarian cancer, certain factors may help reduce your risk. These strategies are particularly important if you have a family history of ovarian or breast cancer.

Birth control pills have been shown to lower ovarian cancer risk, especially when used for several years. The protective effect seems to last for years after stopping the pills, though you should discuss the overall risks and benefits with your doctor.

Pregnancy and breastfeeding appear to be protective. Each pregnancy reduces risk, and breastfeeding for at least three months may provide additional protection. However, these are personal decisions that involve many factors beyond cancer risk.

For women at very high risk due to genetic mutations, preventive surgery to remove the ovaries and fallopian tubes is sometimes recommended. This is typically done after childbearing is complete and usually after age 35-40.

Some lifestyle choices may help reduce risk:

• Maintaining a healthy weight through balanced diet and regular exercise
• Limiting hormone replacement therapy use, especially long-term use
• Not smoking, or quitting if you currently smoke
• Eating a diet rich in fruits and vegetables

Regular gynecologic checkups can help detect problems early, though routine screening for ovarian cancer in average-risk women isn't currently recommended because available tests aren't reliable enough.

How Should You Prepare for Your Doctor Appointment?

Preparing for your appointment can help ensure you get the most out of your time with your healthcare provider. Start by writing down all your symptoms, including when they started and how often they occur.

Make a list of all medications you're taking, including prescription drugs, over-the-counter medicines, vitamins, and supplements. Also note any allergies you have to medications or other substances.

Gather information about your family health history, particularly any cancers in your family. Include information about which relatives were affected, what type of cancer they had, and how old they were when diagnosed.

Write down questions you want to ask your doctor. Some important ones might include:

• What could be causing my symptoms?
• What tests do I need, and what will they show?
• Should I see a specialist?
• What are my treatment options if cancer is found?
• How will treatment affect my daily life?
• What support resources are available?

Consider bringing a trusted friend or family member with you to the appointment. They can help you remember information and provide emotional support during what might be a stressful conversation.

Don't be afraid to ask your doctor to explain things in simpler terms if you don't understand something. It's important that you feel comfortable and informed about your health.

What's the Key Takeaway About Ovarian Cancer?

Ovarian cancer can be a serious diagnosis, but understanding the signs and getting prompt medical attention can make a significant difference in outcomes. Many women with ovarian cancer go on to live full, active lives after treatment.

The most important thing to remember is to trust your body and seek medical care if you notice persistent symptoms that concern you. While ovarian cancer symptoms can be subtle, being aware of changes in your body and advocating for yourself is crucial.

If you're diagnosed with ovarian cancer, remember that you have options and support available. Treatment continues to improve, and many people find strength they didn't know they had during this journey.

Stay connected with your healthcare team, lean on your support system, and take things one day at a time. With proper medical care and self-care, you can navigate this challenge and focus on your health and well-being.