Ovarian cancer occurs when abnormal cells in the ovary, fallopian tube or peritoneum grow in an uncontrolled way. The ovaries are a pair of organs in the female reproductive system, located on each side of the uterus. They produce eggs and hormones. Ovarian cancer cells can spread to other parts of the body to form secondary cancers, in a process called metastasis.

Estimated cases in Australia 2017

  • Ovarian cancer is estimated to be the eighth most commonly diagnosed cancer among females;
  • 1580 women diagnosed with ovarian cancer in 2017 ie. 2.5% of all new female cases of cancer diagnosed;
  • 1047 female deaths from ovarian cancer in 2017 which is 5.1% of all female deaths from cancer;
  • 44% females diagnosed survive at least 5 years with ovarian cancer.

Known risk factors

Factors that are associated with a higher risk of developing ovarian cancer include:

  • family history of ovarian cancer;
  • family history of breast or colon cancer;
  • a mutation in 1 of several known genes. Up to 15% of all cases of invasive ovarian cancer involve the inheritance of a mutated gene. Women who have inherited mutations in the BRCA1 or BRCA2 genes have a substantially increased risk of ovarian and breast cancer. Women with Lynch syndrome (also known as hereditary nonpolyposis colon cancer or HNPCC) also have an increased lifetime risk of ovarian cancer;
  • increasing age
  • medical conditions such as endometriosis
  • use of hormone replacement therapy (HRT)
  • tobacco smoking
  • obesity

Some factors reduce the risk of developing ovarian cancer. These include:

  • reproductive history – women who have had a full-term pregnancy before the age of 26 have a lower risk
  • use of oral contraceptives (the pill) – women who have used oral contraceptives for at least 3 months have a lower risk
  • gynaecological surgery – hysterectomy (removal of the uterus) and tubal ligation (having your tubes tied) reduce the risk.

Understanding your family history of breast or ovarian cancer can provide an indication of your chance of developing either disease. Cancer Australia have compiled a comprehensive information sheet that is useful to download.

Symptoms

The most common symptoms of ovarian cancer are:

  • Abdominal bloating or increased abdominal size
  • Abdominal or pelvic pain
  • Appetite loss, feeling full quickly or indigestion
  • Urinary changes, such as frequency or urgency
  • Changes in bowel habits, such as constipation
  • Unexplained weight loss or weight gain
  • Unexplained fatigue

The symptoms of ovarian cancer can be vague and similar to other common conditions. If you experience any of these symptoms, especially if they are unusual for you or persistent, see your doctor as soon as possible. 

There is no screening test for ovarian cancer.

Diagnosis

Due to the lack of early symptoms and inefficiency of screening, two out of three patients are diagnosed at advanced stages (stage three or four). For more information on diagnosis testing and stages please visit the Cancer Australia website.

Treatment

Patients with early stage disease (stage one or two) require surgical removal of the tubes and the ovaries, as well as a staging procedure to determine the extent of cancer spread. Patients with advanced stage ovarian cancer require surgical removal of as much cancer as possible. This may include removal of uterus, tubes, ovaries, omentum, bowel, spleen, diaphragm and abdominal peritoneum. The size of the tumour left behind after surgery determines the prognosis to a large extent. If large scale surgery is not feasible, patients will have some chemotherapy upfront, followed by delayed surgery and more chemotherapy thereafter. Virtually all patients require chemotherapy, to which 85% of patients respond well. However, the majority of patients with advanced ovarian cancer will relapse.

For more information on treatment options, please visit the Cancer Australia website.

Research

Current research focuses on the development of new markers indicating the earliest possible stage of ovarian cancer. Diagnosing and commencing treatment of ovarian cancer early might result in better survival outcomes. Other research addresses the selection of patients for advanced surgery as well as measures to improve recovery from treatment.

Source: Cancer Australia 2017