Ovarian cancer Dr Trisha Macnair Ovarian cancer can occur at any age, but is most common after the menopause. Diagnosis at an early stage greatly improves your chances of recovery.

In this article

What is ovarian cancer? Symptoms

Causes and risk factors Treatment and recovery

Ovarian cancer can be difficult to spot, but in recent years doctors have realised there are often warning symptoms, although these may be vague and wrongly attributed to other problems.

There are several different types of ovarian cancer, but by far the most common - accounting for 90 per cent of cases - is epithelial ovarian cancer, or cancer of the surface layers of the ovary.

Nearly 7,000 women are diagnosed with cancer of the ovary every year in the UK. About 34 per cent will still be alive five years later. But this is an overall figure - when the disease is caught early, survival rates are much higher, although the particular type and severity of the cancer are also important factors. An increasing proportion of ovarian cancers now behave like many other chronic diseases.

Ninety per cent of those with stage one disease (where the cancer only affects the ovaries) will be alive at five years, while the five-year survival rate for those with stage two tumours (where the cancer has spread but not outside the pelvis) is 70 per cent.

Symptoms are usually vague, especially in the early stages. It was previously said many women had no symptoms, and that the disease went overlooked until it was discovered by chance.

In fact, when questioned carefully, many women admitted things weren’t quite right, particularly with gastrointestinal or urinary symptoms, for three to four months before they were diagnosed.

These early symptoms may include:

• Bloating, pelvic or abdominal pain (especially in the lower abdomen or side)
• Difficulty eating or early satiety (feeling full very quickly)
• Urinary urgency or frequency

Women who develop any of these symptoms, especially if they persist, should get them checked by their GP.

Screening is currently only offered to those at high risk, for example because of a family history, although positive preliminary results of a large UK ovarian cancer screening programme trial were published in March 2009.

As the disease progresses, it may cause lower abdominal pain, pain during sex, a swollen abdomen, constipation and irregular periods.

In the advanced stages of disease, there may be loss of appetite, nausea, weight loss, tiredness and shortness of breath.

The exact cause of ovarian cancer isn't clear, but some factors are known to increase the risk.

The most important is family history, because the faulty genes that increase the risk of ovarian and other types of cancer can be inherited. In particular you may be at increased risk if you have close relatives (sibling, parent or daughter) who've had one of the following types of cancer - breast, colon,prostate or endometrial (lining of the womb).

The risk of developing ovarian cancer may also be related to how many eggs the ovary releases. Each time an egg is released (ovulation) the surface of the ovary breaks open and the cells on the surface divide to repair the damage, increasing the chances of a tumour developing.

So having children and breastfeeding may reduce the risk, as may taking the contraceptive pill (as it prevents ovulation).

Other possible risk factors include fertility treatment, a high-fat diet and the use of talcum powder in the genital area.

Ovarian cancer is difficult to diagnose but if your GP is concerned you could have ovarian cancer, they will carry out an internal examination and take a blood test.

You may then be referred to a specialist who may do further blood tests and a scan of the ovaries.

The treatment someone's recommended will depend on how healthy the woman is, the type of ovarian cancer, how far it has spread and the severity or grade of the cancer.

Many cases will continue to respond to multiple courses of chemotherapy given as single agents or as combinations. Radiotherapy is used occasionally for symptom control. Ongoing trials are studying hormone treatments and biological therapies.

Overall the quality of life of ovarian cancer patients has improved considerably over the last ten years.

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This article was last medically reviewed by Dr John Green of the Clatterbridge Centre for Oncology in March 2009.
First published in February 1999.