Ovarian cancer is a disease where some of the cells in one or both ovaries start to grow abnormally and develop into cancer.

The Ovaries

The ovaries are two small almond shaped organs that are part of the female reproductive system. Each ovary measures about 2-4 cm across and they sit on either side of the uterus. Other parts of the female reproductive system include the fallopian tubes, cervix and vagina.

Each ovary contains germ cells that eventually develop into eggs (ova). The ovaries also produce the hormones oestrogen and progesterone, which regulate your menstrual cycle and affect the development of female body characteristics – such as breasts, body hair and body .

What is ovarian cancer?

Ovarian cancer is a general term used to describe a cancerous (malignant) tumour starting in one or both ovaries. The ovaries are made up of three main kinds of cells – epithelial cells, stromal cells and germ cells. Each of these cells can develop into a different type of tumour. The average age of women when they are diagnosed with ovarian cancer is age 64. It is mainly diagnosed in women over the age of 50; however, there are cases diagnosed in younger women.

Ovarian cancer is the eighth most common cancer in Australia. About 1580 Australian women are diagnosed each year.

Types of ovarian cancer

There are several types of ovarian cancers:

  • Epithelial tumours which are the most common type (account for about 90% of ovarian cancers) and is cancer that starts in the cells lining in the surface layer (epithelial) of the ovary. There are several subtypes of epithelial ovarian cancers.
  • Germ cell tumours which begin in the cells eventually developing into eggs. This type of ovarian cancer is rare and accounts for approximately 5% of ovarian cancers.
  • Stromal cell and other rare types include sex-cord stromal cell ovarian cancer, stromal tumours and sarcomas.

All these different types of ovarian cancer behave differently and are treated differently. Within these types, there are different subtypes of tumours.

If you have been diagnosed with a rare type of ovarian cancer, it may be difficult to find specific information on your cancer. This can be upsetting and feel isolating. You may find it helpful to visit the Rare Cancers website. You may find their Knowledgebase section especially helpful. It an online collection of resources covering over 200 rare cancers, specialist hospitals with cancer centres, multi-disciplinary teams, and clinician contacts with special interests in rare cancers as well as relevant clinical trial listings.

Diagnosing ovarian cancer

Your GP is usually the first person you go to if you have symptoms. If your doctor suspects ovarian cancer, there are several tests they can perform to help decide whether your symptoms are due to ovarian cancer or other causes. They will examine you, ask about your symptoms and possibly order a CA125 blood test and an ultrasound.  They may also want to do an internal vaginal examination to see if your uterus and ovaries feel normal. If you prefer, you can ask for a female doctor to do this. It is your choice: do not be afraid to ask.

The CA125 blood test is looking for a specific type of protein or a tumour marker called CA125. This protein is often higher than normal in women with ovarian cancer.

An ultrasound creates a picture of your internal organs (ovaries and uterus) on a computer by using echoes from soundwaves. This test is done by a sonographer. It can be done in two ways:

  • Abdominal ultrasound
  • Transvaginal ultrasound (preferred as it gives a clearer picture)

 

If the ultrasound and other tests indicate you have cancer, your GP will refer you to a specialist in women’s health and cancer (a gynaecological oncologist). You should be seen within two weeks. The specialist will do a physical examination and take a detailed health history. They will also ask you about your family history of cancer. They will most likely also order further tests to work out how far the cancer has grown and if it has spread to other parts of your body.  Further tests may include:

  • Computerised tomography (CT) scan is (a three-dimensional (3D) image of your internal organs
  • Biopsy (a tissue sample (biopsy) is taken and tested to help confirm cancer)
  • Chest x-ray to check if a cancer has spread to the lungs
  • Removal of fluid from your abdomen if it has built up
  • Laparoscopy to enable tissue samples to be taken for testing in the laboratory
  • Laparotomy is offered if a laparoscopy is not suitable.

If you need further tests, your doctor will discuss them in more detail with you.

Waiting for results

Waiting for the results of your tests is usually a stressful time. You and those close to you are likely to feel very nervous and worry about what your future holds. It is only natural to think the worst. However, try to take it one day at a time. Some tests will come back within a day or two but others can take much longer: up to a week or more. The waiting can feel like an eternity.

It can help to ask your doctors and nurses exactly how long it will take to get each result back. Having this information can help control your anxiety and stop waking each day hoping ‘today will be the day’. During the waiting time you may find it helps to speak with your cancer nurse at the hospital and close friends and family. You can also call the Ovarian Cancer Australia support team on 1300 660 334 during business hours.

More Information

Our Resilience Kit has more detailed information about the types of ovarian cancers, information about diagnosing ovarian cancer and the tests you may need to have.

This page was last updated in January 2019.