Ovarian Cancer Symptoms

What Is Ovarian Cancer?

The ovary is a female reproductive gland where the eggs (ova) are created in the body [¹]. It is around the size of an almond and also produces progesterone and estrogen hormones. Ovarian cancer symptoms start to emerge when cells in the ovary tissue start to grow at an uncontrollable pace. These cells can start to multiply rapidly, spreading throughout the tissue [²]. This is why it is important to keep an eye on ovarian cancer symptoms and get an appointment with a doctor if you notice them.

Types of Ovarian Cancer

There are four main types of ovarian cancers that one can get. The type of cancer you have can dictate the treatment plan that will be offered to the patient.

The most common type is epithelial ovarian cancer. American Cancer Society has found that up to 90% of all cancers come from the epithelial cells that are on the outer side of the ovaries [³]. The cancer cells can spread to the organs and tissue linings in the abdomen and pelvis before they spread to other body parts.

It includes four epithelial cancers:

Serous Carcinomas
Mucinous Carcinomas
Endometrioid Carcinomas
Clear cell carcinomas

Germ cell ovarian tumors can occur in the eggs [⁴]. It only affects young girls and women up to their early 30s in age. This type of tumor is mostly benign but can turn cancerous, so it is important to get it removed with surgery.

Sex cord-stromal tumors can be benign or malignant (cancerous) [⁵]. It occurs in the stroma of the uterus, which are tissues that support the ovary and where different cells are created. They are quite rare, with only 5% of cases of ovarian cancer being this type.

Borderline ovarian tumors can form on the ovary tissue, where abnormal cells can develop. Only 15% of ovarian tumors are of this type and don’t have a high rate of malignancy [⁶].

How is Ovarian Cancer Diagnosed?

There are different types of diagnostic exams that may be given depending on the following factors:

Age and general health
What is the type of cancer you are suspected of having?
Previous test results
Symptoms and signs

You might get one or a combination of the following tests [⁷]:

Pelvic exam
Ultrasound
Biopsy
CT scan
MRI scan
PET/CT scan
Blood tests
Genetic testing
X-ray

Ovarian Cancer Staging

When ovarian cancer is diagnosed, the next step is determining its stage. Tissue samples and tests are used to determine the stage, which can help create a treatment plan for the patient. The ovarian cancer stage is based on the size of a tumor and its area of spread. There are five stages of cancer, from 0 to 4. The higher the stage of the cancer, the more the tumor has spread.

Ovarian cancer is classified on the TNM scale [⁸], which is as follows:

T= Tumor size (measured in centimeters)
N= Number of lymph nodes nearby with cancer
M= Whether the ovarian cancer has metastasized to other organs

To test the stage of cancer, the doctor may recommend some imaging procedures such as MRI, CT, PET scan, and bone scans.

Is Ovarian Cancer Hereditary?

Ovarian cancer can be hereditary. If your parent, sibling, or child had or has ovarian cancer, it increases the risk for you too. More relatives with this type of cancer mean added risk. It can also come from the father’s side of the family too. The HBOC syndrome is caused by genes BRCA1 and BRCA2 mutations that can be inherited.

Ovarian Cancer Symptoms

Make sure to note that most of the symptoms and signs of ovarian cancer are caused by benign tumors, but there is a chance that they might be cancerous. If you experience any of the ovarian cancer symptoms below, it is important to make an appointment with a doctor to get yourself checked. These signs tend to be abnormal and consistent, so keep an eye out for them.

What Are the Symptoms of Ovarian Cancer?

Symptoms of ovarian cancer could include [¹⁰]:

Back pain
Upset stomach
Fatigue
Diarrhea or constipation
Pain while having sex
Changes in menstruation, like irregular bleeding or heavier bleeding
Swelling in the abdominal
Weight loss without cause

What Are Some Signs of Ovarian Cancer?

As mentioned, signs refer to clinical manifestations; something that could be noticed during medical tests or examinations. Some early signs of ovarian cancer could include:

Bloating
Feeling full quickly or having trouble eating
Urinary problems like frequent urination or urgency to urinate
Irregular menstruations
Bleeding from the vagina after menopause has occurred

Symptoms of Ovarian Cancer in Women vs Symptoms of Ovarian Cancer in Men*

Men do not have ovaries, so they cannot get ovarian cancer. However, if your father has relatives that have ovarian cancer, it can increase the risk for you.

*Note that here, we are using the terms “women” and “men” to refer to female and male biological sex at birth, respectively.

Risk Factors for Ovarian Cancer

An increased risk for ovarian cancer does not surely mean that you will get the disease. A lot of women can also get ovarian cancer even if they aren’t at high risk for it.

Here are the risk factors for ovarian cancer that you should note [¹¹]:

Close family members with ovarian cancer
Inherited genes like BRCA1 and BRCA2 mutations
History of colon, uterine, or breast cancer
History of endometriosis or diabetes
Trouble with pregnancy or not giving birth
Ashkenazi Jewish or Eastern European background
Taking estrogen (on its own) hormones for over a decade
Smoking
Exposure to asbestos at the workplace
Obesity

Ovarian Cancer Prevention

There are some ways to reduce the risk of ovarian cancer, as noted below [¹²]:

Avoid smoking
Combined contraceptive pills
Breastfeeding and having children
Hysterectomy or getting the tubes tied

Ovarian Cancer Prognosis and Treatment

The prognosis for ovarian cancer is highly dependent on the stage and type of ovarian cancer. In general, ovarian cancer cancers caught at earlier stages (stage 0/in situ, stage 1) have a better outlook. If cancer has metastasized, treatment is more difficult, but it is important to maintain hope.

Ovarian Cancer Survival Rate

Survival rates are based on the type of cancer you have and the stage you are diagnosed at. For stage 1 cancer, the average 5-year rate of survival is 93% [¹³]. For every type of cancer, the first year is survivable for up to 78% of the cases. 60% can survive for 3 years after the diagnosis, while 50% survive for 5 years. It has been found that women who are younger than 65 years of age tend to have a better survival rate than older women.

Ovarian Cancer Treatment Options

There are two main types of treatment options for ovarian cancer: local and systematic [¹⁴]. You might get a combination of treatments depending on the size of the tumor, stage of cancer, general health, age, and response to treatments.

Local treatments include surgery and radiation. Surgery is one of the most common types of treatment options where the tumor is removed [¹⁵]. The surgery can also remove the fallopian tubes, ovaries, cervix or womb, depending on how much cancer has spread [¹⁶].

Radiation therapy is where high-energy rays are used to kill the cancerous cells. It will only target the cells in a specific part of the body (the ovaries) [¹⁷]. It is often used in conjunction with surgery to destroy any remaining mutated and cancerous cells in the region after the tumor has been removed.

Systematic treatments include drugs that can target the cancer cells. They include chemotherapy, hormone therapy, and targeted drug therapy. Chemotherapy is used to slow down or kill cancerous cells, where drugs travel through the body via the bloodstream[¹⁸].

Estrogen and progesterone are natural hormones produced in the body but might cause cancerous cells to grow. In hormone treatment, inhibitors or blockers may be used if the cancerous cells are stimulated by such hormones [¹⁹].

Targeted drug therapy is a relatively new and effective treatment when compared to chemo and hormone therapy[²⁰]. It can attack the cancer cells without hurting the normal body cells. It is often used with conventional chemo but has fewer side effects than it.

Conclusion

Takeaway

Ovarian cancer is a serious condition where women need to pay close attention to symptoms and signs early on. The earlier you get diagnosed, the better the chances of success for treatment plans. So, make sure to take a closer look at your menstruation cycles or any abnormal changes in your body.