The ovaries are small, oval-shaped organs, that are part of the female reproductive system. Each woman has two ovaries, one on either side of the womb. The ovaries produce eggs and female hormones (oestrogen and progesterone), which make menstruation (periods) and pregnancy possible.

Each month, in women of childbearing age, one ovary produces an egg. The egg passes down the fallopian tube to the womb (uterus). If the egg is not fertilised by a sperm it passes out of the womb as part of the monthly period.

Most ovarian cancers are a type called epithelial cancer. Epithelial ovarian cancer means the cancer has started in the cells that cover the surface of the ovary.

There are also less common types of ovarian cancer:

• Germ cell tumours (ovarian teratomas): tend to affect younger women and behave very differently to other types of ovarian cancer. They start in the cells of the ovary that produce eggs.
• Soft tissue sarcomas: The occur in the ovaries, but very rare.

Fact: Ovarian cancer is the fourth most common cancer in women.

What causes it?

The causes of ovarian cancer are not yet completely understood, but some risk factors are believed to increase a woman’s chance of developing epithelial ovarian cancer. The most common are:

• Age: 85% of ovarian cancers happen to Women over 50 years
• Child bearing history: Women who have not had children are slightly more likely to develop ovarian cancer than women who have.
• Hormonal factors: Using oestrogen-only hormone replacement therapy (HRT) can slightly increase the risk.
• Infertility and fertility treatments: Drugs used in fertility treatment may slightly increase the risk of developing ovarian cancer.
• Endometriosis: This is where the tissue that normally lines the womb builds up in other parts of the body.
• Diet and body weight: Being overweight and having an unhealthy diet may increase your risk of developing ovarian cancer.
• Family history and genetics: Women who have had breast cancer have an increased risk of ovarian cancer. As breast and ovarian cancer can be caused by the same faulty genes. Go to our hereditary fact sheet for more information.

What are the symptoms?

Symptoms of ovarian cancer may include:

• Loss of appetite
• Vague indigestion, nausea, excessive gas (wind) and a bloated, full feeling
• Unexplained weight gain
• Swelling in the abdomen –which can cause shortness of breath
• Pain in the lower abdomen
• Changes in bowel or bladder habits, such as constipation, diarrhea or needing to pass urine more often
• Lower back pain
• Pain during sex
• Abnormal vaginal bleeding

TIP: If you have any of these symptoms you should have them checked by your doctor - but remember, they are common to many illnesses other than ovarian cancer.

How is it diagnosed?

After visiting your GP you will probably be referred to a hospital for some tests. These may include:

• X-rays
• Internal (vaginal) examination: to check for any lumps or swellings.
• Blood test: This is to check whether there are higher than normal levels of the CA125 protein in your blood. CA125 is a protein that most women have in their blood. The level may be higher in women with ovarian cancer than in most women.
• Ultrasound

If the results of the test show you have ovarian cancer, you will be referred to a doctor who specialises in the treatment of reproductive organs (called an gynaecologist).

Staging

The stage of a cancer is a term used to describe its size and whether it has spread beyond where it started in the body. It includes

• Stage 1: Cancer only affects the ovaries.
• Stage 2: Cancer has begun to spread outside the ovaries within the pelvis.
• Stage 3: Cancer has spread beyond the pelvis to the lining of the abdomen and/or to lymph nodes in the abdomen, or the upper part of the bowel.
• Stage 4: Cancer has spread to other parts of the body such as the liver, lungs or distant lymph nodes

Grading

Grading refers to the appearance of the cancer cells when they are looked at under the microscope.
There three grades

1. Low-grade: Cancer cells look very like the normal cells of the ovary.
2. Moderate-grade: Cancer cells look more abnormal.
3. High-grade: Cancer cells look very abnormal.

How is it treated?

Your team of doctors and other staff at the hospital will plan your treatment. It will depend on the size of the tumour and where it is. You may be treated by an oncologist (a doctor who specialises in treating cancer with chemotherapy) a gynaecologist (a surgeon who specialises in reproductive organs) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve

• Chemotherapy
• Radiotherapy
• Surgery

Most people have chemotherapy to shrink to size of the tumour and to get rid of any cancer cells around the body. This is usually followed with surgery to remove the tumour. More chemotherapy and radiotherapy usually follows.

Chemotherapy for ovarian cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of cancer cells.

Ovarian cancer is usually very sensitive to chemotherapy. Different chemo regimes are used with different stages of ovarian cancer

For more information about chemotherapy, go to our chemotherapy fact sheet

Surgery for ovarian cancer

The aim of surgery is to remove the tumour. The operation usually involves removing the ovaries and possibly the fallopian tubes and uterus. The surgeon might need to take samples (biopsies) to check for cancer cells nearby.

Sometimes a second operation is needed to remove more of the cancer.

Surgery may not be possible if the cancer is very advanced or the patient is not well enough for an operation. Most patients will have chemotherapy in addition to surgery.

For more information about surgery, go to our surgery fact sheet 

Radiotherapy for ovarian cancer

Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.

For more information about radiotherapy, go to our radiotherapy fact sheet

Side Effects

There are some side effects of the treatments for ovarian cancer that can be found in our side effects fact sheet

More information

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