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Ovarian Cancer: Symptoms, Stages, Causes, Treatment and Survival Rates

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Ovarian cancer is one of the most dangerous and fatal gynecological cancers. Early diagnosis and treatment can save your life in gynecological cancer.

Written byDr. Lochana. K

Medically reviewed byDr. Neha Rathod

Published At March 25, 2021
Reviewed AtMay 29, 2026

What Is Ovarian Cancer?

Ovarian cancer is when there is abnormal growth of cancer cells in the ovaries. It is the eighth most common cancer in women, affect 1% women. Almost 10 out of every 10,000 women are affected by this cancer.

Due to its nature and location, it can affect many areas silently. As a result, an undetected ovarian cancer can spread all over your body. In such a situation, it becomes difficult to treat it due to the involvement of multiple organs. That is why this is the most dangerous gynecological cancer.

What Are the Causes of Ovarian Cancer?

Doctors still do not know what causes ovarian cancer. However, like every other cancer mutation in the DNA (Deoxyribonucleic Acid) is the main cause of ovarian cancer. Inherited gene mutations in BRCA1 and BRCA2 are linked with ovarian cancer.

  1. The Increasing age is one of the major risk factors. Ovarian cancer is more common after menopause, especially in women above 50 years.

  2. Early onset of menstruation or late menopause may increase lifetime exposure to estrogen, raising the risk.

  3. Hormone replacement therapy, especially long-term estrogen use after menopause, may contribute to risk.

  4. Endometriosis has been linked with certain types of ovarian cancer.

  5. Lynch syndrome, an inherited genetic condition, can also increase the risk.

What Are the Symptoms of Ovarian Cancer?

  • You can sense fullness in the abdomen after having a very small amount of food.

  • Bloating or swelling of your abdomen.

  • Discomfort or pain in the pelvic area persists for more than 2 weeks.

  • You will notice unnatural and rapid weight loss.

  • You will notice an increased urge of the urination.

  • Bleeding after menopause.

  • A change in bowel habits or movement. It can lead to constipation.

  • Nausea and vomiting.

  • A change in the food habits due to loss of appetite.

  • Back pain.

What Are the Stages of Ovarian Cancer?

The stages of ovarian cancer are categorized below:

Stage 1: There are three sub-categories of stage 1. They are:

  • Stage 1A: Cancer cells are present in only one ovary.

  • Stage 1B: Cancer is present in both ovaries.

  • Stage 1C: Here, cancer cells have reached outside the ovaries due to the rupture of their covering.

Stage 2: In stage 2, doctors can see involvement of other pelvic organs such as the fallopian tubes, bladder, and rectum.

  • Stage 2A: The fallopian tubes and the uterus are affected by cancer.

  • Stage 2B: The rectum, bladder, sigmoid colon, and ureters are affected by this stage of cancer.

Stage 3: There are three sub-categories for stage 3.

  • Stage 3A: The cancer cells have spread to the lining of the abdomen and the lymph nodes close to the abdomen.

  • Stage 3B: Cancer that has reached the other regions of the abdomen, and the tumor size is less than two centimeters.

  • Stage 3C: The cancer tumor is more than two centimeters in size. The cancer has reached the outer parts of the liver and the spleen.

Stage 4: This is the most serious stage of cancer, where it has spread to organs like the liver, spleen, and lungs.

  • Stage 4A: Cancer cells have spread to the lungs, and they can be detected in the outer covering of the lungs. Cancer cells are present within the fluid of the lung covering.

  • Stage 4B: This is a more severe form of cancer. Cancer has reached the lungs, liver, and bones.

What Are the Types of Ovarian Cancer?

The various types of ovarian cancer are:

  1. Epithelial Tumors: This is the most serious and aggressive form of ovarian cancer. 90% cases belong to these types.

  2. Stromal Tumors: This is a very uncommon ovarian cancer. Connective tissue that produces hormones such as estrogen and progesterone is related to this.

  3. Germ Cell Tumors: This rare form of ovarian cancer is seen among young girls. Tissue that produces eggs is related to these types of cancer.

What Are the Risk Factors for Ovarian Cancer?

  • Hormone Replacement Therapy: Patients suffering from a hormonal imbalance of a particular hormone would be advised to go for hormone replacement therapy.

  • Genetic Mutations: Changes in the genes are the most common cause of ovarian cancer. The main genetic mutations involved in ovarian cancer are BRCA1 and BRCA2. Other than this, mutations of genes like TP53, RAD51C, and RAD51D are related to ovarian cancer.

  • Lynch syndrome: Lynch syndrome is inherited through the family. It causes several types of cancers. Genetic mutations of genes like MLH1, MSH2, MSH6, PMS2, and EPCAM are responsible for cancer like ovarian cancer, colorectal cancer, and endometrial cancer.

  • Onset of Menstrual Cycle: If the menstrual cycle has started at an early age, it can increase the risk of ovarian cancer.

  • Obesity is another common risk factor for ovarian cancer.

  • A lot of Ovarian cancer patients have a history of excessive smoking or consuming alcohol.

How Is Ovarian Cancer Diagnosed?

The doctor may recommend a pelvic exam to diagnose ovarian cancer. This will help the doctor to identify the abnormality. If the tumor is very small, then it is difficult to find it. In that case, the doctor will suggest the following test.

  1. Transvaginal Ultrasound: Doctors use a probe-type device in this case. This probe uses ultrasonics to evaluate your vaginal tissues.

  2. CT (Computed Tomography): A scan of the pelvis and abdomen is done to detect any abnormality.

  3. MRI (Magnetic Resonance Imaging): MRI scans provide an image of the soft tissues through magnetic waves.

  4. Blood Examination: Blood examination can detect antigen such as CA 125 (cancer antigen 125), and HE4 (human epididymis protein 4), which are linked to ovarian cancer.

  5. Biopsy: A biopsy is the confirmatory test for any type of cancer. Here, a sample is taken from the tumor site and examined. The presence of the cancer cells confirms the diagnosis of ovarian cancer.

What Are the Treatment Options?

The doctor will control the treatment according to the extent of the cancer and the age of the patient. Ovarian cancer most commonly recommended treatment options are:

  • Hormone therapy is used for low-grade, or hormone receptor-positive ovarian cancers. It can effectivly block or lower the action of hormones like estrogen. Doctors use it for long term disease control also.

  • Chemotherapy for ovaian cancer is used after surgery. Medicines like Carboplatin, and Paclitaxel help kill cancer cells.

  • PARP inhibitor therapy, especially in patients with BRCA mutations or homologous recombination deficiency. Commonly used medicines include Olaparib, Niraparib, and Rucaparib.

  • Anti-angiogenic therapy, which helps block the blood supply to the tumor. Bevacizumab is commonly used in advanced ovarian cancer.

  • Antibody drug conjugate therapy in selected recurrent cases. Mirvetuximab Soravtansine is a newer treatment used in folate receptor alpha-positive ovarian cancer.

  • HIPEC (Hyperthermic Intraperitoneal Chemotherapy), this is a new chemotherapy technique where, after removal of the cancer cells, a heated chemotherapy solution is given. This chemotherapy can kill the remaining cancer cells.

  • Surgical options: Surgery is done to remove the diseased cancer tissues. Also, doctors remove the uterus, cervix, both ovaries, and fallopian tubes. The extension of the surgery depends on the involvement of the cancer.

Is Preservation of Fertility Necessary for Ovarian Cancer Patients?

In most of the cases, ovarian cancer involves multiple organs in the reproductive system. As a result, treatment becomes difficult to preserve the form and functions of those organs. Several factors are considered in such cases;

  1. Age of the patient.

  2. Extension of the cancer.

  3. Hormonal status of the patient.

Based on this the type of preservation techniques are planned. Mostly, preservation techniques are used for young women. Techniques like, fertility-sparing surgery (FSS), cryopreservation, and ovarian tissue freezing constraints are effective.

Conclusion

Ovarian cancer is a common gynecological cancer. Due to its silent nature, it can spread without any symptoms and may cause late diagnosis. That is why early diagnosis and treatment can improve the quality of life of the patient. As the 5-year survival rate of ovarian cancer is only 50% ingnoring the signs and symptoms of ovarian cancer can have a negative impact. With modern tests like genetic testing, doctors can identify ovarian cancer easily. If you have any queries regarding ovarian cancer, talk to a medical oncologist for information.

Key Takeaways

  1. Ovarian cancer can affect the ovaries and other organs of the female reproductive system.

  2. This can cause persistent abdominal pain, abnormal bleeding, or an increased urge of urination.

  3. Diagnostic tests like MRI, CT-scan, PET-CT scan, and genetic testing can detect it.

  4. As the 5-year survival rate of ovarian cancer is only 50%, early detection can reduce treatment complexity and can improve the survival rate.

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Frequently Asked Questions

Survival depends on the type and stage of ovarian cancer. Women who are diagnosed to have ovarian cancer below 65 years of age can survive better than older women. Almost 95% of women in stage 1, 70% of women in stage 2, 25% of women in stage 3, and 15% of women in stage 4 will survive ovarian cancer for more than five years when they are diagnosed.
Women go undetected for ovarian cancer for years, as it is difficult to conclude with its existence. Normally, the ovarian cancer symptoms can be known about five months or only before the diagnosis as their symptoms are vague. Patients often present late in ovarian cancer with related abdominal discomfort, so there is no accurate way to identify in early cases.
Late-stage ovarian cancer signs are vague abdominal discomfort, frequent urination, low back pain, bloating, altered bowel habits, ascites, kidney pain, constipation, and weight loss. Occasionally, peritoneal deposits are palpable as an omental cake and nodules in the umbilicus.
The ovary is located in the lower abdomen, and if ovarian cancer persists, a vague abdominal discomfort followed by sharp pains below the belly button and pelvis, bloating sensations, and back pains can be experienced. There will be pelvic pain, and this pain also presents with bloating, which feels like menstrual cramps. So it is crucial to check if women start with any of these symptoms.
Ovarian cancers are not slow-growing. They grow fast and tend to spread sooner. Ovarian cancers are aggressive and spread from one stage to another within a few months. It starts to progress from early stages to advanced stages within a very assertive year than malignancies.
The signs and symptoms of ovarian cancer are bleeding before, during, or after menstruation which is not normal. Bleeding also mainly occurs after menopause. There will be a discharge from the vagina that is usually blood-colored, clear, and foul-smelling.
There are distinct smells for certain diseases which affect our metabolism. Ovarian cancer does not affect our metabolism, but cancer itself has a metabolism and produces an odor. The vaginal discharges are foul-smelling, and this kind of discharge is suggestive of ovarian cancer as cancer-specific chemicals usually circulate throughout the body.
Ovarian cancer affects menstruation. Menstrual periods include the bleeding that is heavier or can be an irregular period. Pain during the period is unusual, and the flow will be more than usual. They usually start to miss the period, and missing the period is an early symptom of ovarian cancer.
Initially, a workup for patients with ovarian cancer includes imaging in the form of ultrasound and computed tomography. Serum levels of the tumor markers are often diagnosed. Surgery plays a key role in the diagnosis, staging, and treatment of ovarian cancer. In early cases, palpation, intraoperative washing, and biopsies are generally performed to define the disease extent.
Ovarian cancer can be treated without surgery only for specific patients who have minimal pain and minimal reoccurrence. Radiation therapy is used to treat women with these symptoms as radiation therapy cannot be given for all types of cancer despite their clinical stage.
Surgery followed by chemotherapy with Carboplatin and Carboplatin plus paclitaxel is the treatment of choice. Surgery should include removal of the tumor along with total hysterectomy and omentectomy. Treatments can include further Platinum-paclitaxel combination, Liposomal doxorubicin. These regimens are associated with a response rate of 10 to 40 %, as ovarian cancers do not go away completely.
The risks of ovarian cancer can be reduced by reducing the consumption of oral contraceptives. Women who consume emergency oral contraceptives for a longer duration period of 3 or more years are likely to be affected and develop ovarian cancer.
There are fewer chances to cure stage 3 ovarian cancer as the cancer cells have spread outside the pelvis. The treatment options are surgery and chemotherapy. Chemotherapy can be given after surgery and chemotherapy before and after surgery, depending on the extent of the disease. Bevacizumab with chemotherapy is given in some cases, but all these treatments can shrink the cancer cells and slow down their mutation. It might not be possible to perform surgery as cancer cells have reached different parts of the body.
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Dr. Neha Rathod from iCliniq
Dr. Neha Rathod

Obstetrics and Gynecology

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