Ovarian cancer forms in the ovaries, which are part of the female reproductive system. Treatment is most effective when ovarian cancer is found early.

The OHSU Knight Cancer Institute offers advanced, sensitive care for ovarian cancer.

You’ll find:

• Team-based care, with a care plan tailored to your needs and wishes
• The latest diagnostic imaging, with quick results
• Scientists who apply new research to ovarian cancer treatments
• The Oregon Ovarian Cancer Registry, which shares treatment advances with people who join
• Support services, including help with fertility after cancer

Ovarian cancer forms in one or both ovaries, the organs that produce and store eggs. The ovaries also make hormones that help manage the menstrual cycle.

Most of the time, ovarian cancer starts in one ovary. When it’s found in both, most often, it spread from one to the other.

Ovarian cancer is not common. It is often diagnosed after it has spread. Early ovarian cancer may not cause symptoms. It can also be mistaken for other conditions.

Types of ovarian cancer

Epithelial ovarian cancer: This type accounts for 85% to 90% of cases. It forms in an ovary’s surface layer. It can also form in the tissue that lines the inside of a fallopian tube. Or it can form in the tissue that lines the inner surface of the abdominal cavity (peritoneum).

Sex cord-stromal tumors: This rare type forms in the part of the ovary that produces hormones. It can cause symptoms such as abnormal vaginal bleeding.

Germ cell tumors: This rare type starts in the cells that form eggs. It tends to affect younger people.

About 20,000 cases of ovarian cancer are diagnosed in the U.S. every year, according to the National Cancer Institute. Roughly 243,000 people in the U.S. are living with ovarian cancer.

Risk factors

Anyone who has ovaries is at some risk. Most women have about a 1 in 70 chance of developing ovarian cancer.  You may have a higher risk  if you have:

• A history of endometriosis or infertility
• Family members with a history of ovarian or breast cancer
• Inherited gene changes, including BRCA1 or BRCA2. We offer genetic counseling and testing to help you learn about and manage risk.

Survival rates

When ovarian cancer is found before it spreads, the five-year relative survival rate is 92%. This is the portion of people who are alive five years after diagnosis, compared with the general population. If the cancer has spread to the lymph nodes, the rate is 71%. If it has spread farther, the rate is less encouraging.

It’s important to remember that survival rates are averages. They can’t predict anyone’s outcome.

Ovarian cancer signs and symptoms

Early on, ovarian cancer may have no symptoms. When it does have symptoms, they may be vague or mistaken for something else.  

Symptoms can include:

• Bloating or swollen belly
• Pain in the belly or pelvic area
• Feeling full quickly or having trouble eating
• Frequent or urgent need to pee
• Tiredness
• Nausea, constipation or diarrhea
• Losing weight without trying

Tell your doctor if you start to have these symptoms or if they continue or get worse.

Ovarian cancer diagnosis

There is no routine screening test for ovarian cancer. If your doctor thinks you may have ovarian cancer, you may have one or more of these tests:

CA-125 blood test: This measures the level of a protein called cancer antigen 125. It is often higher in people with ovarian cancer. CA-125 testing can also help predict how well a treatment might work.

The CA-125 test cannot diagnose ovarian cancer by itself. Other conditions can raise CA-125 levels. Some ovarian cancers do not produce CA-125.

Biopsy: The only way to confirm ovarian cancer is to take a bit of tissue from an ovary and look at it under a microscope.

Imaging: Some scans help your doctor check for ovarian cancer or see where it may have spread. These include CT scans, MRI, PET scans, chest X-rays and pelvic ultrasounds.

Genetic testing: We may recommend genetic testing and counseling if you have:

• A family history of ovarian or breast cancer
• Inherited gene changes

Ovarian cancer stages

Doctors use stages to describe how much cancer is in the body and how much it has spread.

Ovarian cancer stages go from stage I to stage IV (4). Usually, a higher number means more spread. Staging is complex and varies from person to person. It’s best to talk with your doctor about your stage.

Stage I: The cancer is only in one or both ovaries or fallopian tubes.

Stage II: The cancer has spread to nearby organs, such as the uterus, colon or bladder. Or there is cancer in the lining of the abdomen (peritoneum).

Stage III: The cancer is in one or both ovaries or fallopian tubes. Or there is cancer in the peritoneum and it may have spread to nearby organs. The cancer may have spread to lymph nodes in the back of the abdomen.

Stage IV: The cancer has spread within or beyond the abdomen.

Ovarian cancer treatment

Your care team will work with you on a plan tailored to your diagnosis, health and desire to have children. For most people, the most effective treatment includes surgery and chemotherapy. Your plan can depend on:

• The type of ovarian cancer you have
• Where the cancer has spread
• If you want to have children
• Other health issues you may have that could affect treatment

Surgery

For ovarian cancer, there are two types of surgery:

Staging surgery: Doctors use this surgery to diagnose ovarian cancer and, if found, see if it has spread.

Cytoreduction or debulking surgery: This removes as much of the cancer as possible.

Based on your stage of cancer, doctors may remove:

• The ovaries and fallopian tubes (salpingo-oophorectomy)
• The uterus (hysterectomy)
• The omentum, a fatty layer covering the organs in the abdomen
• Nearby lymph nodes or parts of other organs

For patients with early ovarian cancer, fertility-saving surgery may be an option. This may mean removing one ovary and fallopian tube and leaving the other ovary and uterus.

When it’s possible and safe, you’ll have minimally invasive surgery, with smaller cuts for faster recovery. For advanced ovarian cancer, you may need open surgery through a bigger cut.

Chemotherapy

Chemotherapy puts medicines in your blood to kill or slow cancer cells. Chemo may be given:

• Before surgery, to reduce the amount of cancer for a safer and more successful procedure
• After surgery, to lower the chance the cancer comes back

Learn more

• Ovarian Cancer, American Cancer Society
• Ovarian, Fallopian Tube, and Primary Peritoneal Cancer, National Cancer Institute
• Ovarian Cancer Alliance of Oregon & Southwest Washington
• Sherie Hildreth Ovarian Cancer Foundation