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Ovarian Cancer

Ovarian cancer is an aggressive tumor that affects the ovaries. The amount that the cancer has spread to other parts of the body affects a woman’s chance of survival. Most doctors use surgery, chemotherapy or targeted medication therapy to treat ovarian cancer. Drugs and cosmetic products such as fertility drugs, hormone therapy after menopause or talcum powder may increase ovarian cancer risk.

cancer patient with support

Ovarian cancer starts when cells in the ovaries grow out of control and form tumors. More women die of ovarian cancer than any other type of reproductive cancer.

In 2019, about 22,530 women were diagnosed with ovarian cancer. About 13,980 women died from it. Some drugs, surgeries and cosmetic products can affect the risk of ovarian cancer.

Fact
A woman’s chance of getting ovarian cancer is 1 in 78.

New cases and deaths from ovarian cancer have declined since 1992.

Detecting ovarian cancer early increases chances of survival. Gynecologic oncologists are doctors who specialize in treating ovarian cancer. There are also several treatment options for ovarian cancer.

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ovarian cancer symptoms illustration

What Are the Symptoms of Ovarian Cancer?

Symptoms of ovarian cancer vary depending on how serious it is. Many times, ovarian cancer has no symptoms. If there are symptoms, they are mild. This makes ovarian cancer difficult to detect.

Symptoms of ovarian cancer include
  • Pelvic or abdominal pain
  • Unexplained back pain
  • Vaginal bleeding
  • Abnormal periods
  • Urinating often and with more urgency
  • Difficulty eating, less appetite
  • Bloating
  • Gas, nausea or vomiting
woman explaining her symptoms
Questions to Ask Your Doctor
  1. Could these symptoms mean I have cancer?
  2. Are there tests to check for cancer?
  3. Could these symptoms be from another health issue?
  4. Do I need to see a specialist?

How Doctors Diagnose Ovarian Cancer?

Often, early ovarian cancer doesn’t have symptoms. If there are symptoms, the doctor will ask questions and do a physical exam. Then, he or she will run some tests. A biopsy is the only way to tell for sure if a tumor is cancerous.

Fact
70 percent of ovarian tumors are not found until cancer has spread.
Common tests for diagnosing ovarian cancer
Ultrasound
uses sound waves to make pictures of the ovaries.
CT scans
are X-rays that take pictures of the ovaries. The pictures are then put together to create a 3-D image.
MRI
uses magnetic fields to create pictures of the ovaries
Laparoscopy
is a type of surgery that uses a small camera attached to a tube to look at the ovaries and other body parts.
Blood tests
detect certain protein levels in the blood. Cancer cells cause proteins to go up.
Biopsies
use samples of ovarian tissue to check for cancer cells. This is the only way to tell for sure if you have cancer.
Molecular tests
detect certain features of a tumor, including mutations. The information from these tests can help guide treatment.
Questions icon
Questions to Ask Your Doctor
  1. What tests will I need to have?
  2. How long with these tests take?
  3. Can you explain the tests to me?
  4. When will I get results?

What Are the Types of Ovarian Cancer?

There are several types of ovarian cancer, but they fall into three main types. The type of cancer determines the treatment. It also affects survival rates.

Fact
About 85 to 90 percent of ovarian cancers are epithelial carcinomas.
Three types of Ovarian Cancer
Epithelial Cancer

Epithelial ovarian cancer
is a tumor that starts on the outside of the ovary. The majority of cancer-causing ovarian tumors are epithelial.

stromal cancer diagram

Stromal cancer
starts from ovarian cells that make hormones. Doctors can typically diagnose these early. They make up about 1 percent of ovarian cancer.

Germ Cell Cancer diagram

Germ cell cancer
starts in the egg cells. These tumors are very rare, making up less than 2 percent of ovarian cancers. They occur in younger women and girls.

middle aged woman consulting a doctor
Questions to Ask Your Doctor
  1. Can you write down what type of cancer I have?
  2. What is the next step?
  3. What should I know about this type of cancer?
  4. How do you know I have cancer?

Ovarian Cancer Staging and Survival Rates

Doctors use tumor staging to determine how serious ovarian cancer is. The stage depends on 3 things: the size of the tumor, if the cancer has spread to lymph nodes and if the cancer has spread to other parts of the body, also called metastasis.

Stages range from 1 to 4. Stage 4 cancer is the most serious. The stage of cancer determines how likely it is that someone will survive five years or more.

Stromal tumors and germ cell tumors have better survival rates than epithelial tumors. Stromal tumors have an 88 percent 5-year survival rate. Germ cell tumors have a 93 percent survival rate. Epithelial tumors have a 47 percent survival rate.

STAGE LOCATION AND/OR SIZE OF TUMOR 5-YEAR SURVIVAL RATE
1 Limited to ovaries 90%
1A In one ovary, tumor is not on outside surface of ovary 94%
1B In both ovaries, tumor is not on outside surface of ovary 92%
1C In one or both ovaries, AND the tissue around the tumor ruptured, tumor on ovary surface OR cancer cells in peritoneal (abdominal) fluid 85%
2 Spread to other nearby organs in the pelvis 70%
2A Spread to uterus or fallopian tubes 78%
2B Spread to other organs in pelvis (bladder, colon, rectum) 73%
3 Spread to organs in the abdomen, also known as peritoneum 39%
3A Spread to surface of peritoneum but cells are microscopic OR spread to lymph nodes around the peritoneum only 59%
3B Spread to peritoneum, but tumors are less than or equal to 2 cm 52%
3C Peritoneal metastasis greater than 2 cm, may have spread to lymph node or the surface of the liver or spleen 39%
4 Distant metastasis 17%
4A Spread to fluid around the lung
4B Spread to other organs outside of the abdomen
Questions icon
Questions to Ask Your Doctor
  • What stage is my cancer?
  • Can you explain the stage to me?
  • How does this affect my treatment options?
  • How long will I likely live?

What Are the Treatments for Ovarian Cancer?

A doctor will determine the treatment plan depending on the stage and type of ovarian cancer. The health of a patient and treatment side effects also affect treatment options.

“Although ovarian cancer is a highly fatal cancer…there is hope. There is a substantial portion of women who live a long time after diagnosis.”

Source: Rosemary D. Cress, University of California (UC) Davis Medical Center

Surgery

Most of the time, doctors recommend surgery. Oncologists will remove as much of the cancer as they can. Sometimes, the doctor will have to remove the ovary or other organs affected by the tumors.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells or shrink tumors, but it can also kill healthy cells. Some ovarian cancer chemotherapy drugs have serious side effects. For example, Taxotere may cause temporary or permanent hair loss.

Other chemotherapy side effects include, but are not limited to: decreased appetite, bleeding and bruising, diarrhea, fertility issues and infection.

Targeted Therapy

Targeted therapy uses drugs to attack cancer cells and reduce harm to healthy cells. This is a newer treatment. There are several kinds of targeted therapy.

Hormone Therapy

Hormone therapy uses hormones or hormone-blocking drugs to fight cancer. This is more common for stromal tumors.

Radiation Therapy

Radiation therapy uses high-energy rays to shrink or kill tumors. It is less effective than chemotherapy, but it is useful for tumors that have spread.

Questions to Ask Your Doctor
  1. What is the best treatment for me?
  2. What are the side effects or complications with this treatment?
  3. Will vitamins, herbs or certain foods help?
  4. What happens if this treatment doesn’t work or the cancer comes back?

Ovarian Cancer Risk Factors and Prevention

Certain factors can increase or decrease the risk of getting ovarian cancer. The number one risk factor for getting ovarian cancer is age, according to the American Cancer Society. There are also certain drugs or products that may increase ovarian cancer risk.

Fact
Studies show women who use talcum powder in the genital area may develop ovarian cancer.
Risks that may increase ovarian cancer include:
Age
Cancer risk goes up with age. About half of all ovarian cancers affect women 63 or over.
Fertility drugs
The use of fertility drugs and in vitro fertilization (IVF) may increase the risk of ovarian tumors.
Gene mutations
Women who have BRCA1 or BRCA2 genes have a higher risk of ovarian cancer.
Hormone therapy
Women who take estrogen after menopause have an increased risk of ovarian cancer.
Male hormones
Drugs referred to as androgens, such as testosterone, may increase ovarian cancer risk.
Obesity
Women with a body mass index of 30 or higher are at increased risk of developing ovarian cancer.
Talcum powder
Some studies have linked long-term genital talcum powder use to an increased risk of ovarian cancer.
Talcum Powder & Ovarian Cancer
The American Cancer Society lists talcum powder as a risk factor for ovarian cancer. Read about the studies that link the two.
Learn More
Factors that may decrease ovarian cancer risk include:
Diet
Women who eat high vegetable, lower fat diets may lower their risk of ovarian cancer.
Surgeries
Women who have undergone a hysterectomy or tubal ligation (also referred to as getting tubes tied) may have a reduced risk of ovarian cancer.
Birth control
Women who use birth control pills or an IUD (intrauterine device) have a lower risk for ovarian cancer.
Reproductive history
Women who had babies before age 26 have the lowest risk of ovarian cancer. The risk goes down with each child born.

Please seek the advice of a medical professional before making health care decisions.

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Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for seven years. She specializes in fluoroquinolone antibiotics and products that affect women’s health such as Essure birth control, transvaginal mesh and talcum powder. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • American Medical Writers Association (AMWA) Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Edited By
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13 Cited Research Articles

  1. American Cancer Society. (2018, April 11). Ovarian Cancer Risk Factors. Retrieved from https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html
  2. American Cancer Society. (2018, April 11). Ovarian Cancer Stages. Retrieved from https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/staging.html
  3. American Cancer Society. (2020, January 9). Survival Rates for Ovarian Cancer. Retrieved from https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/survival-rates.html
  4. American Society of Clinical Oncology. (2019, April). Ovarian, Fallopian Tube, and Peritoneal Cancer: Diagnosis. Retrieved from https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/diagnosis
  5. Cress, R. et al. (2015, September). Characteristics of Long-Term Survivors of Epithelial Ovarian Cancer. Retrieved from https://journals.lww.com/greenjournal/Fulltext/2015/09000/Characteristics_of_Long_Term_Survivors_of.7.aspx
  6. Lowry, F. (2015, August 17). Long-term Survival for Ovarian Cancer Higher than Thought. Retrieved from https://www.medscape.com/viewarticle/849604
  7. National Cancer Institute. (2018, June 8). Ovarian Cancer Staging. Retrieved from https://training.seer.cancer.gov/ovarian/abstract-code-stage/staging.html
  8. National Cancer Institute. (2019, March 27). Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention. Retrieved from https://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq
  9. National Cancer Institute. (2019, May 22). Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Retrieved from https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156
  10. National Cancer Institute. (n.d.). Cancer Stat Facts: Ovarian Cancer. Retrieved from https://seer.cancer.gov/statfacts/html/ovary.html
  11. Office of Women’s Health. (2019, June 10). Ovarian Cancer. Retrieved from https://www.womenshealth.gov/cancer/ovarian-cancer
  12. Ovarian Cancer Research Alliance. (n.d.). Staging Ovarian Cancers. Retrieved from https://ocrahope.org/patients/about-ovarian-cancer/staging/
  13. U.S. National Library of Medicine. (n.d.) Ovarian Cancer. Retrieved from https://medlineplus.gov/ovariancancer.html
View All Sources
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