September is Ovarian Cancer Awareness Month, a time to discuss a relatively rare yet particularly dangerous disease. Ovarian cancer is a type of gynecological cancer, the cancers that originate in a woman’s reproductive system. Other types of gynecological cancer include cervical, uterine, vaginal and vulvar.
Ovarian cancer is the deadliest form of gynecological cancer. In the most recent years for which data are available, there were more than 21,000 new cases of ovarian cancer in the United States in 2023; more than 12,000 women died from the disease in 2024. Ovarian cancer is the fifth-leading cause of cancer death in women.
Ovarian cancer can be treated effectively in its early stages; however, it is challenging to diagnose. In addition, it generally produces no symptoms early on, so is often diagnosed at later stages.
“Immediately reporting to your doctor any symptoms or unexplained changes in your body is the single biggest key to detecting and successfully treating ovarian cancer,” explains Dr. Melissa Bailey, an obstetrician and gynecologist in Frisco. “Early detection – before the cancer spreads beyond the ovaries – gives us the best opportunity to defeat ovarian cancer.”
In fact, the five-year survival rate for ovarian cancer detected while it is still localized is now more than 90%, whereas survival rates for cases detected after it has spread is as low as 30%.
What is Ovarian Cancer?
Ovarian cancer can affect one or both ovaries, the organs in the female reproductive system that produce eggs and certain hormones. There are several types of ovarian cancer, but the most common is known as epithelial ovarian cancer, which develops on the surface of the ovary. Roughly 90% of ovarian cancers are caused by epithelial tumors.
Ovarian Cancer Risk Factors
There are several known risk factors associated with ovarian cancer. These include:
- Being 55 or older. The median age of diagnosis is 63.
- Race: While Black women are slightly less likely than white women to get ovarian cancer, mortality rates are slightly higher.
- Being related to someone – such as a mother, sister, aunt or grandmother – who had ovarian cancer, breast cancer, colon cancer or endometrial cancer
- Having ever had certain other types of cancer, such as breast, colon or uterine
- Having never given birth
- Infertility
- Having had endometriosis, a condition that causes tissue from the lining of the uterus to grow outside the uterus
- Having mutations in the BRCA1 or BRCA2 genes – these are inherited gene characteristics that are known as breast cancer genes. BRCA genes increase risk for ovarian cancer as well as breast cancer.
- Being of Ashkenazi Jewish ancestry
In addition, the following are known to help reduce risk of ovarian cancer:
- Taking birth control pills for five years or longer
- Breastfeeding
- Removal of fallopian tubes (many epithelial ovarian cancers originate in the fallopian tubes)
- Complete removal of the ovaries and/or fallopian tubes.
Women who have one or more risk factors, such as a family history of the disease, may discuss with their physician the pros and cons of genetic testing for cancer risk.
Ovarian Cancer Symptoms
While ovarian cancer does not typically cause symptoms in early stages, the following may be indicative of the disease:
- Vaginal bleeding
- Pain in the pelvic or abdominal area
- Back pain
- Bloating or feeling full; difficulty eating
- Increase in the size of the abdomen
- Urgent or frequent need to urinate
- Constipation
All of these symptoms can be caused by conditions other than ovarian cancer, but any one of them is reason to see your doctor for examination.
Diagnosing Ovarian Cancer
Unlike breast cancer or colorectal cancer, there is no standard screening test for ovarian cancer. Products and services that are marketed as ovarian cancer screening should be ignored, as they are not approved by the U.S. Food & Drug Administration (FDA).
Women should see their physician for an annual pelvic exam and report any unexplained symptoms quickly. If ovarian cancer is suspected, your doctor may recommend an imaging exam of the ovaries, such as an ultrasound. A blood test may also help diagnose or rule out the disease.
Treatment
Treatment for ovarian cancer typically includes a combination of surgery and chemotherapy. A surgeon will remove the cancerous ovaries, and depending at what stage the cancer is, may also remove the fallopian tubes, uterus and lymph nodes located near the reproductive system. Chemotherapy is then used to kill remaining cancerous cells.
Fortunately, ovarian cancer treatment continues to advance – in recent years, the FDA has approved new treatments for the disease. One is a glucocorticoid receptor antagonist that blocks cortisol, making cancerous cells more vulnerable to chemotherapy treatments. Additionally, there are new immunotherapy treatments and medicines targeted to cancer types that are more resistant to chemotherapy.
Biomarker testing – a process in which a sample of the cancerous tumor is tested for specific proteins that cause the cancer to grow – is also helping advance treatment for ovarian cancer. Biomarker testing allows for more targeted treatments aimed specifically at those proteins or gene mutations.
“Even though ovarian cancer is relatively rare, it is quite serious,” says Dr. Bailey. “If you have known risk factors for ovarian cancer, such as a family history of the disease, other cancers or a BRCA gene mutation, you should discuss with this with your physician. The earlier ovarian cancer is diagnosed, the more effective treatment will be.”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The U.S. Centers for Disease Control & Prevention
