Frequently Asked Questions About Ovarian Cancer

Here are some answers to questions women often have about ovarian cancer.

What are the ovaries?

The ovaries are female reproductive organs. There is one small, almond-shaped ovary on each side of the uterus. An ovary releases an egg every month in a woman who has her menstrual period. The ovaries also make most of the female hormones. These include estrogen and progesterone. These hormones control the development of certain parts of a female. These include the breasts, body shape, and body hair. They also control the menstrual cycle and pregnancy. When the ovaries stop making estrogen and progesterone, menopause starts.

What is ovarian cancer?

Ovarian cancer starts in cells within the ovaries. But not all tumors in the ovaries are cancerous. Ovarian cancer is more than one type of disease. Newer theories suggest that some cases of ovarian cancer may start in cells from the fallopian tubes or from the peritoneal lining.

What are the types of ovarian cancer?

These are the 3 main types of ovarian cancer. They include:

• Epithelial carcinoma. This is by far the most common kind of ovarian tumor. It makes up about 85– 90% of ovarian cancer cases. This tumor starts in the epithelium. This is the outer layer of cells in the ovaries.

• Germ cell cancer. This rare type of ovarian cancer starts in the cells that form eggs in the ovary. This type of cancer almost always occurs in girls, teenagers, and very young women. It’s highly curable. It can often be treated without affecting fertility.

• Stromal cell cancer. This starts in the stromal cells. These cells make up the connective tissue. This holds the ovaries together. They also make female hormones. This type of cancer is very rare.

Who is at risk for ovarian cancer?

Certain factors can make one woman more likely to get ovarian cancer than another. These are called risk factors. Just because a woman has one or more risk factors doesn’t mean she’ll get ovarian cancer.

Some risk factors are out of a woman's control. But other risk factors are lifestyle choices, which can be controlled. Here are some risks for this cancer:

• Having two or more close relatives (mother or sister) who have had ovarian or breast cancer

• Having had breast or colon cancer

• Being older than 55 years

• Never having been pregnant

• Being obese

• Using estrogen replacement therapy 

Q: What can a woman do to decrease her risk of ovarian cancer?

Every woman should know about her risk factors for ovarian cancer. Some cannot be changed, such as family history and age, but others can be. Taking these actions may decrease your risk:

• Controlling weight

• Using birth control pills for several years. Note that this causes risks of its own, though.

• Ask about genetic counseling. This is especially true if you have a family history of ovarian, breast, colon, or uterine cancer. There are genetic counselors who specialize in oncology. If a genetic risk is found, there are tactics that can reduce your risk for some of these cancers.

What are the symptoms of ovarian cancer?

A: The symptoms of ovarian cancer in its early stages are often subtle. They could be signs of other problems. Symptoms can include the following:

• Back pain

• Stomach discomfort, bloating, or swelling

• Pelvic pain

• Loss of appetite, indigestion, nausea, gas, or fullness even after eating small meals

• Diarrhea, constipation, or frequent urination

• Vaginal bleeding or irregular periods

These symptoms are not specific to ovarian cancer. They may be signs of other more common problems. A woman with these symptoms should see her healthcare provider.

How do healthcare providers diagnose ovarian cancer?

There are many ways to find out why a woman is having symptoms like those of ovarian cancer. The healthcare provider will ask about her medical and family history. He or she will also do a physical exam. This includes a pelvic exam. The healthcare provider feels the vagina, rectum, and lower abdomen for any masses or lumps. If he or she finds a mass or if a woman's pelvic exam is abnormal, she’ll need more tests. These can include:

• Ultrasound

• Blood tests to check certain protein levels

If any of these tests show signs of cancer, it's likely the healthcare provider will do a biopsy. He or she will remove suspicious areas and check them for cancer cells.

What are the treatments for ovarian cancer?

The treatments for ovarian cancer depend on the type of cancer and its stage. Surgery is used to treat all stages of ovarian cancer. In early stages of ovarian cancer, before it’s spread at all, surgery may be the only treatment. Your healthcare provider may take out all the reproductive organs or, in some cases, just the ovary. For later stages, when the cancer has spread, healthcare providers use both chemotherapy (chemo) and surgery. Radiation is rarely used to treat this cancer.

Should everyone get a second opinion for a diagnosis of ovarian cancer?

Many people with cancer get a second opinion from another healthcare provider. There are many reasons to get one. Here are some of those reasons:

• Not feeling comfortable with the treatment decision

• Being diagnosed with a rare type of cancer

• Wanting more options for how to treat the cancer

• Not being able to see a cancer expert, such as a gynecologic oncologist. It’s important that your findings be put into context by an expert. Gynecologic oncologists are specialists with advanced training in diagnosis, treatment, and surveillance of female cancers. These include ovarian cancer.

• Not being treated at a major medical center

In some cases, it may help to have a second healthcare provider review the diagnosis and treatment options before starting treatment. Some health insurance companies even require that a person with cancer seek a second opinion. Many companies will even pay for a second opinion.

How can someone get a second opinion?

There are many ways to get a second opinion:

• Contact the Society of Gynecologic Oncology. Women can find a healthcare provider who specializes in ovarian cancer.

• Get in touch with the Foundation for Women's Cancer. This is a resource created by the Society of Gynecologic Oncologists.  

• Ask a primary care healthcare provider. He or she may suggest a gynecologic oncologist or surgeon specializing in this disease. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

• Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

• Seek other options. Check with a local medical society, a nearby hospital, or medical school. Talk with women in support groups to get names of healthcare providers who can give you a second opinion. Ask other people who've had cancer for their suggestions.

What are clinical trials?

Clinical trials are studies of new kinds of cancer treatments. Experts use clinical trials to learn how well new types of treatments work and what their side effects are. Promising treatments are ones that work better or have fewer side effects than current types of treatment. People who participate in these studies get to use new treatments before the U.S Food and Drug Administration (FDA) approves them. People who join trials also help researchers learn more about cancer. They also help future cancer patients.

Here are some resources to learn more about clinical trials:

• The National Cancer Institute

• CancerTrialsHelp.org