Ovarian cancer originates in the ovaries, the female reproductive organs responsible for producing and storing eggs. It develops when abnormal ovarian cells divide and multiply uncontrollably.
"Ovarian cancer" is a general term for any primary malignant tumour in the ovary. It is not a single disease, but rather a collection of many types, some of which are exceptionally rare and require specialised management. Accurate and timely diagnosis is therefore paramount. The main types of ovarian cancer are named after the cells in which the disease first forms:
Constituting about 90% of cases, these cancers start in the epithelium tissue and may arise from the fallopian tube, ovarian cells, or implanted tissue like endometriosis. The risk increases with age, particularly after 50.
Subtypes include: serous, mucinous, endometrioid, clear cell, transitional, and undifferentiated types.
These tumours account for about 5% of ovarian cancers and begin in the egg-producing cells. They typically occur in younger women, with approximately 80% found in those under 30.
Main subtypes: teratoma, dysgerminoma, endodermal sinus tumour, and choriocarcinoma.
Representing about 5% of cases, these tumours develop in the connective tissue of the ovary that produces oestrogen and progesterone. They are most often found in older women but can affect girls. Stromal tumours generally spread slower than other types.
Subtypes include: granulosa, theca, and Sertoli-Leydig cell tumours.
This is a rare form of cancer whose cells resemble high-grade serous ovarian cancer. It begins in the lining of the pelvis or abdomen and can occur even in women who have had their ovaries removed. Its symptoms and treatment are similar to epithelial ovarian cancer.
Anything that increases your chance of developing ovarian cancer is considered a risk factor. These include:
The risk increases with age, with about half of all ovarian cancers diagnosed in women over 60.
Family history of ovarian cancer increases risk.
Approximately 10% to 15% of ovarian cancers are linked to inherited genes such as:
Never having children: Having more children is associated with a lower risk of developing ovarian cancer.
Having a close relative with ovarian cancer and a suspected BRCA1 or BRCA2 mutation increases risk.
Having a risk factor does not mean you will certainly develop ovarian cancer. It is advisable to discuss any risk factors with your healthcare provider.
Most women with ovarian cancer experience symptoms that are often vague, and these can overlap with signs of less serious conditions such as indigestion, weight gain, or ageing. Even in the early stages, symptoms may be non-specific.
Symptoms and signs of ovarian cancer vary but may include:
General abdominal discomfort or pain (e.g., gas, indigestion, pressure, swelling, bloating, cramps).
Bloating and/or feeling full quickly, even after a light meal.
Nausea, diarrhoea, constipation, or frequent urination.
Unexplained weight loss or gain.
Pain during sexual intercourse.
Important: While these symptoms do not automatically indicate ovarian cancer, it is strongly recommended that you consult your healthcare provider if they:
At SSCHRC, our experts utilise advanced and accurate equipment for ovarian cancer diagnosis to precisely determine if and where the cancer has spread. Our team has vast experience with all forms of ovarian cancer, including rare types. Early and accurate diagnosis significantly improves the chances for successful treatment.
If you present with symptoms that may suggest ovarian cancer, your doctor will conduct an examination and ask about your health and family medical history. One or more of the following tests may be used to diagnose the disease, assess its spread, or monitor the effectiveness of treatment:
The doctor performs a bimanual examination to feel deep within the pelvis for any masses on either side of the uterus, which can be a sign of ovarian cancer.
The specific blood tests ordered will depend on the suspected or diagnosed type of ovarian cancer. For epithelial ovarian cancer, the CA-125 test is common. This test measures the level of CA-125, a protein tumour marker often found in higher levels in women with ovarian cancer.
CA-125 testing is most reliable for monitoring cancer recurrence after treatment by tracking changes in levels over time. It can also be used to check if treatment is working or to predict its potential effectiveness. However, the CA-125 test alone cannot confirm ovarian cancer, as other conditions can raise its level, and some ovarian cancers produce low or no CA-125.
The only definitive way to confirm if a growth is cancer is through a biopsy, where tissue is removed and examined under a microscope. This can be done via:
If a mass appears confined to the ovary, surgical removal is often the most appropriate next step, with the mass being biopsied after its removal.
Various imaging exams may be used for diagnosis:
If you have a high risk due to personal or family history, your doctor may recommend tests for genes like BRCA1 or BRCA2, or those involved in Lynch syndrome. Genetic counselling and testing are routinely recommended for many types of ovarian cancer patients. You should discuss the benefits and risks of genetic testing with your doctor.
Cancer staging explains the size of the primary tumour and how far the cancer has spread. This information is crucial for understanding the disease and developing a treatment plan. The stages of ovarian cancer, along with fallopian tube and primary peritoneal cancer, are set by FIGO (International Federation of Gynecology and Obstetrics) and range from Stage I to Stage IV, where higher numbers indicate more advanced disease that is generally more challenging to treat.
Cancer is found in one or both ovaries or fallopian tubes.
Cancer is found in one or both ovaries or fallopian tubes and has spread to other areas within the pelvis (e.g., uterus, fallopian tubes) or to other pelvic organs in the peritoneal cavity.
Cancer is found in one or both ovaries or fallopian tubes, or is primary peritoneal cancer, and has spread outside the pelvis to other parts of the abdomen and/or to nearby lymph nodes.
Cancer has spread beyond the abdomen to distant organs and tissues, such as the lungs or lymph nodes in the groin.
At SSCHRC, a multidisciplinary team of experts provides customised care, collaborating at every step to ensure the highest chance for successful treatment with the least possible impact on your body. Our physicians are highly experienced in treating all types of ovarian cancer, including rare and recurring cases, offering the latest and most advanced therapies.
Treatment options will depend on several factors, including:
Surgery is the main treatment for ovarian cancer, often followed by chemotherapy. It is often performed to remove or biopsy a mass to determine if it is cancerous. Once cancer is confirmed, the surgeon stages the disease based on how far it has spread.
Debulking: If the cancer has spread, the surgeon will remove as much of the tumour as possible. This procedure, called debulking, can help other treatments work more effectively. During debulking, the ovaries, uterus, cervix, fallopian tubes, omentum (fatty tissue), and any other visible tumours in the pelvic and abdominal areas may be removed. In some cases, parts or the entirety of the spleen, lymph nodes, liver, or intestines may also be removed. If debulking is not feasible due to the patient's health or the tumour's attachment to other organs, any remaining tumour is treated with chemotherapy.
Chemotherapy drugs are used to kill cancer cells, control their growth, or relieve symptoms. Treatment may involve a single drug or a combination of two or more, depending on the cancer type and its rate of growth. Chemotherapy is typically administered after surgery to destroy any remaining cancer cells in the body.
Intraperitoneal Chemotherapy (IP Therapy): This method may be used if a small tumour is left after debulking. Highly concentrated chemotherapy drugs are delivered directly into the abdominal cavity through a catheter or implanted port. This allows for direct contact with the cancer and surrounding areas, while the drugs also enter the bloodstream and travel throughout the body.
Radiation therapy uses powerful, focused energy beams to destroy cancer cells, employing techniques that target the tumour accurately while minimising damage to healthy tissue. Although rarely used for the primary treatment of ovarian cancer, it may be beneficial for destroying any cancer cells that remain in the pelvic area.
Targeted therapy drugs are specifically designed to stop or slow the growth and spread of cancer at a cellular level. Cancer cells depend on specific molecules (often proteins) for survival, multiplication, and spread. Targeted therapies work by interfering with, or targeting, these molecules or the cancer-causing genes that produce them. SSCHRC is one of a limited number of centres offering targeted therapy for certain types of ovarian cancer.
The immune system is the body's defence against infection and disease. Cancer is a complex disease that can evade the immune system. Immunotherapy is a treatment that improves the immune system's ability to locate and eliminate cancer cells. There are various types of immunotherapy, some of which are currently available only through clinical trials.