​Gynecologic Cancer Care

Ovarian Cancer

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Our dedicated gynecologic oncology team cares for people with ovarian, fallopian tube, and primary peritoneal cancers. Your care is tailored around the type of cancer, genetic and tumor testing results, and your comfort and goals.

What Is Ovarian Cancer?

Ovarian cancer is a cancer that starts in or near the ovaries. The ovaries are two small organs in the pelvis that make eggs and female hormones. Some cancers may start in the fallopian tubes or the lining of the abdomen, called the peritoneum.

One in 70 women in the United States will develop ovarian cancer. Ovarian cancer can be difficult to find early because symptoms often feel like common stomach, bladder, or digestive problems. When ovarian cancer is diagnosed at an early stage and the disease is confined to the ovaries, surgery can result in a cure rate greater than 90%. Unfortunately, ovarian cancer is most often diagnosed at advanced stages, when the cancer has spread into the upper abdomen.

Recent surgical and technological advances have significantly improved the outlook for this cancer. Today, ovarian cancer is often characterized as a chronic disease because more women are living with this cancer for a longer period than ever before.

What Are the Types of Ovarian Cancer?

There are several types of ovarian cancer. The main types include:

  • Epithelial ovarian cancer
  • Fallopian tube cancer
  • Primary peritoneal cancer
  • Germ cell tumors
  • Sex cord-stromal tumors
  • Borderline ovarian tumors

Knowing the type of ovarian cancer helps your care team choose the right treatment.

What Causes Ovarian Cancer?

Ovarian cancer starts when cells in or near the ovaries change and grow out of control. The exact cause is not always known.

Some ovarian cancers are linked to inherited gene changes. These may include changes in the BRCA1 or BRCA2 genes, or genes linked to Lynch syndrome.

What Are the Risk Factors for Ovarian Cancer?

Risk factors for ovarian cancer may include:

  • Older age
  • A family history of ovarian, breast, colon, or uterine cancer
  • Inherited gene changes, such as BRCA1 or BRCA2
  • Lynch syndrome
  • Endometriosis
  • Never being pregnant
  • Infertility
  • Use of hormone therapy after menopause
  • Obesity

Having one or more risk factors does not mean you will get ovarian cancer. On the other hand, it is possible to develop ovarian cancer with no known risk factors.

What Are the Symptoms of Ovarian Cancer?

Ovarian cancer symptoms can be easy to overlook. They may include:

  • Vague pelvic or abdominal pain or pressure
  • Feeling full quickly when eating
  • Trouble eating or decreased appetite
  • Indigestion
  • Bloating
  • Needing to urinate often or urgently
  • Constipation or other bowel changes
  • Back pain
  • Unexplained weight loss or weight gain
  • Tiredness
  • Changes in menstrual bleeding

If these symptoms are new, happen often, or do not go away, talk with your doctor.

How Is Ovarian Cancer Diagnosed?

Ovarian cancer is diagnosed with exams, imaging tests, blood tests, and sometimes surgery.

Tests may include:

A biopsy is often needed to know for sure if cancer is present.

There is not an effective way to diagnose ovarian cancer before symptoms start, but a new test that measures proteins in the blood has shown promising results.

How Is Ovarian Cancer Treated?

Treatment depends on the type of ovarian cancer, the stage of the disease, your overall health, and your treatment goals. Your care team will develop a personalized treatment plan based on your specific diagnosis.

Treatment may include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy
  • Hormone therapy for selected tumor types
  • Fertility-preserving treatment
  • Clinical trials

Many patients receive a combination of surgery and chemotherapy. In some cases, chemotherapy is given before surgery to shrink the tumor. This approach is called neoadjuvant chemotherapy.

Surgery is often an important part of treatment. In some cases, it can be performed using minimally invasive or robotic-assisted techniques. The goals of surgery may include:

  • Staging: Determining how far the cancer has spread. This may involve removing lymph nodes, the omentum (a fatty layer of tissue in the abdomen), and obtaining biopsies from other areas of the abdomen and pelvis.
  • Cytoreduction (debulking surgery): Removing as much visible tumor as possible when the cancer has spread beyond the ovaries. This may involve removing portions of nearby organs, such as the bowel, when necessary.

Your gynecologic oncologist will discuss the treatment options that are most appropriate for your diagnoses and goals.

When Should I See a Doctor?

You should see a doctor if you have bloating, pelvic pain, abdominal pain, trouble eating, or urinary changes that last more than a few weeks.

You should also ask about genetic counseling if you have a strong family history of ovarian, breast, colon, or uterine cancer.

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