Ovarian cancer is a malignant turmour and occurs when abnormal cells in the ovary, fallopian tube or peritoneum grow in an uncontrolled way. While there are many types of ovarian cancer the three most common types of ovarian cancer are: the common epithelial type (90% of cases) that arises from the cells on the outside of the ovary; the germ cell type (around 4% of cases) that arises from the cells which produce eggs; and the rare stromal type arising from supporting tissues within the ovary. 

Ovarian cancer has been called a “silent killer”, because it typically causes few early symptoms and is usually not discovered until it has spread around the pelvis and abdomen.

  • An estimated 1,720 women will be diagnosed with ovarian cancer in Australia in 2021;
  • Ovarian cancer is the eighth most commonly diagnosed cancer among females in Australia;
  • Approximately 1042 women will die from ovarian cancer in 2021;
  • The 5-year survival rate for ovarian cancer is about 45%.

    Symptoms

    There are often no obvious signs of ovarian cancer, however you may have one or more of the following symptoms:

    • abdominal bloating
    • appetite loss, feeling full quickly or indigestion
    • frequent or urgent urination
    • back, abdominal or pelvic pain
    • changes in bowel habits, such as constipation or diarrhoea
    • menstrual irregularities
    • unexplained fatigue
    • pain during intercourse
    • unexplained weight loss or weight gain

    A woman’s symptoms of ovarian cancer are vague and non-specific 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.

    Known risk factors

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

    • age (risk increases for women over 50)
    • family history of ovarian, breast or bowel cancer;
    • a mutation in one 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;
    • being of Ashkenazi Jewish descent
    • early onset of periods and late menopause
    • women who have not had children or had their first child after the age of 35
    • using oestrogen only hormone replacement therapy (HRT) or fertility treatment

    Some factors that may reduce the risk of developing ovarian cancer include using the oral contraceptive pill for several years, having your fallopian tubes tied (or removed), having children before the age of 35 and breastfeeding.

    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.

    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.

    Screening

    Currently there are no tests effective enough for a population-based screening program for ovarian cancer. In addition, there is no evidence to suggest that screening will reduce the number of deaths from ovarian cancer.

    Read more here: https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-ovarian-cancer

    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 to increase the chance of survival outcomes. Other research addresses the selection of patients for advanced surgery as well as measures to improve recovery from treatment.

    Source: Cancer Australia 2021