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Ovarian cancer

Top questions about ovarian cancer

What you should know about ovarian cancer

Ovarian cancer is a disease commonly marked by symptoms that may mimic other, less-serious conditions, such as constipation and gallbladder issues. For a proper diagnosis, gynecologic oncologists recommend that you see a doctor for persistent symptoms, including pelvic pain or pressure, a more frequent or urgent need to urinate, a sense that you feel full too quickly after eating or you have difficulty eating, as well as constipation, bloating, or abdominal or back pain.

Because there are no available screenings for ovarian cancer and its symptoms may be overlooked or mistaken for other maladies, the disease often isn’t diagnosed until it has advanced beyond the pelvic region, when symptoms are typically more severe. Receiving your diagnosis and personalized treatment plan as early as possible may be key to your overall health and potential outcomes.

What is ovarian cancer?

Ovarian cancer develops in the ovaries, the female reproductive organs that store eggs and produce hormones. The most common type of ovarian cancer is epithelial cancer, which originates in the layer of cells that cover the ovaries and the abdominal cavity. This disease accounts for about 85 percent to 90 percent of all ovarian cancer cases.

What is the difference between ovarian cancer and an ovarian cyst?

Ovarian cysts are fluid-filled sacs that develop on one or both ovaries. Typically, ovarian cysts are not cancerous—although they may cause similar symptoms, such as pelvic pain, a feeling of pressure in the abdomen and difficulty emptying the bladder. Cysts often develop with a woman’s menstrual cycle during her reproductive years. Post-menopausal women with ovarian cysts have a higher risk of cancer.

What is the difference between fallopian tube cancer, peritoneal cancer and ovarian cancer?

The fallopian tubes are thought to be the source of some ovarian cancers. It is rare for cancers to spread from other parts of the body to the fallopian tubes; they typically spread to the ovaries. Peritoneal cancer develops in the peritoneum, the lining that covers the surface of the ovaries and other organs in the abdominal cavity.

Although these cancer types differ in origin and other factors, ovarian, fallopian tube and peritoneal cancers are often treated with the same approach and techniques.

What causes ovarian cancer?

It’s not clear why some women develop ovarian cancer while others don’t, but the risk of developing the disease increases with age. Other factors that may increase your risk of ovarian cancer include:

  • Pregnancy over the age of 35
  • A history of never carrying a pregnancy to term
  • Use of fertility drugs
  • Use of androgens
  • A family history of ovarian cancer, breast cancer or colorectal cancer
  • A personal history of breast cancer
  • A known genetic mutation (e.g., BRCA1 or BRCA2)

What type of doctor should I see if I think I have ovarian cancer?

If you are experiencing symptoms of ovarian cancer or if you have an undiagnosed pelvic mass, consider seeing a gynecologic oncologist. Gynecologic oncologists are trained and experienced in treating cancers of the female reproductive system. They typically perform the surgical aspects of ovarian cancer treatment, as well as managing chemotherapy, hormone therapy and other treatments involved.

Questions about ovarian cancer treatment

Ovarian cancer treatment is typically based on the stage of the cancer and your general health. Treatment recommendations also may depend on whether you plan to have children.

What are the typical treatment options for ovarian cancer?

Treatment for ovarian cancer typically begins with surgery to remove visible signs of cancer, as well as organs that may be affected by cancerous cells, such as the ovaries. After your initial surgery, called debulking, your treatment may include chemotherapy, hormone therapy and/or targeted therapy, which is designed to use drugs to attack cancer cells while reducing damage to normal cells.

What happens during the initial surgery?

The initial surgery to remove ovarian cancer and affected tissue is a key part of your treatment because, in addition to excising visible cancer cells, it allows your doctor to determine whether the cancer has spread beyond the ovaries. This is when the cancer is commonly staged, a critical determination that helps guide the direction and extent of treatment.

What are the potential side effects of ovarian cancer treatment?

If you haven’t gone through menopause, surgery to remove your ovaries will trigger surgically induced menopause because the body will no longer produce sufficient amounts of estrogen. Depleted estrogen levels may cause bone loss and cardiovascular disease, in addition to common menopause symptoms, such as hot flashes and vaginal dryness.

Other treatment side effects may include fatigue and neuropathy, which is a tingling, numbing sensation in the hands and feet.

How can I manage treatment-related side effects?

Hormone replacement therapy may help restore estrogen levels after your ovaries have been removed. Other therapies that may help relieve side effects include dietary changes and other nutrition support, pain management, and counseling and other therapies provided by mind-body therapists

Will ovarian cancer treatment affect my ability to have a baby?

Even if your cancer doesn’t require the removal of one or both of your ovaries, your treatment may damage the ovaries, which produce the eggs needed for reproduction. If you are of childbearing age and want to protect your ability to get pregnant, ask your gynecologic oncologist for advice on fertility preservation options like ovarian cortex cryopreservation, which involves freezing the ovarian tissue before treatment.

Questions to ask your doctor

You may have a wide range of questions for your gynecologic oncologist related to your ovarian cancer diagnosis and treatment. Some questions may revolve around maintaining your quality of life while you undergo treatment, while others may address potential options for preventative treatments. Here are a few questions to consider asking your doctor—before, during and after diagnosis and treatment.

Do I have ovarian cancer?

If you are experiencing long-lasting or severe symptoms, including bloating, pelvic pressure or pain, or a more frequent need to urinate, don’t hesitate to ask your primary care physician for a physical or pelvic exam to rule out the possibility of ovarian cancer. Because ovarian cancer symptoms are often subtle and frequently confused with less-serious conditions, many ovarian cancers aren’t caught until they have spread beyond the pelvic region. Diagnosing ovarian cancer early may increase your treatment options and improve your outcomes.

How can I preserve my quality of life during treatment?

During your treatment regimen, it is important to pay attention to how your body is responding, anticipate treatment-related side effects and take steps to manage them.

Ovarian cancer patients may experience a range of side effects from treatment, including fatigue, neuropathy, hot flashes and headaches. A number of supportive care services—such as physical therapy for neuropathy or dietary supplements for fatigue—may help you to manage side effects and alleviate pain or emotional distress.

I have risk factors for ovarian cancer. Should I have preventive surgery?

Some women have a higher risk for developing ovarian cancer than others. Women with a family history of ovarian cancer or with certain genetic mutations, such as BRCA1 or BRCA2, are at higher risk than women who don’t have these risk factors, for example.

Ask your gynecologic oncologist about whether prophylactic, or preventive, surgeries to remove your ovaries, uterus and/or fallopian tubes may be an appropriate option for you.