Ovarian cancer

Ovarian cancer is a type of cancer that occurs in the ovaries.

The ovaries

The ovaries are two oval-shaped organs that form part of your reproductive system. Since you started having your period, your ovaries have been producing an egg every month.

The ovaries also produce the female hormones, oestrogen and progesterone, which control your menstrual cycle.

Types of ovarian cancers
Who does it affect?
What are the symptoms?
How is it diagnosed?
How is it treated?
What are the treatment side-effects?
After treatment

Types of ovarian cancers

There are a number of different types of ovarian cancer, but young women are most commonly diagnosed with germ cell tumours.  These are also known as ‘ovarian teratomas’ and are cancers that start in the egg-producing cells of the ovaries. Depending on the type, one or both ovaries may be affected.

The information on this page refers to germ cell tumours. If you have been diagnosed with a different type of ovarian cancer, talk to your specialist for more information about your cancer and its treatment.

Who does it affect?

There are two types of germ cell tumours that are diagnosed in women:

  • Mature teratomas (sometimes called ‘dermoid cysts): these are usually diagnosed in women who having periods (from teens to people in their forties) and are non-cancerous
  • Immature teratomas: these are more commonly diagnosed in young women up to their early 20s. They are called ‘immature’ because the cancer cells are at a very early stage of their development.

What are the symptoms?

The most common symptoms of ovarian cancer are abdominal pain or swelling, and sometimes an increased need to pass urine. You also may notice that you bleed between periods, or your menstrual cycle has changed. There can be many different causes for this, so it’s important to get checked out by your GP.

How is it diagnosed?

Ovarian cancer is usually diagnosed after an internal pelvic examination at a hospital. You may also need to have blood tests, ultrasound or CT scans or a laparoscopy. In a laparoscopy, specialists make a small cut to the abdomen which allows them to look at the ovaries and surrounding area with a tiny camera.

Based on these tests, the specialist will be able to assign a stage to your cancer. This refers to the size of the tumour and whether it has spread to other organs, such as the womb or lymph nodes.

How is it treated?

Treatment for ovarian germ cell tumours usually involves surgery and chemotherapy. The exact treatment you receive will depend on the location and spread of your germ cell tumour, so it’s best to talk to your specialist for further information.

Surgery

The first stage of treatment for ovarian cancer is usually an operation to remove the affected ovary and the attached fallopian tube. This is called a ‘laparotomy’ and involves the surgeon making a small cut in your abdomen.If only one ovary needs to be removed, this won’t affect your ability to have children later in your life.

Chemotherapy

Chemotherapy is the use of anti-cancer drugs to target the cancer cells. These are usually given as an injection or through a drip in your arm every 3–4 weeks for four or more sessions of treatment.

What are the treatment side-effects?

If you are undergoing chemotherapy, you may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. You may also be at greater risk of infections. For more information about how side-effects can be managed, talk to your consultant or nurses, or see the side-effects section of our website.

You may also notice that chemotherapy affects your remaining ovary, and that your monthly periods stop or become irregular. Once the chemotherapy is finished, your periods should return to normal, although this may take several months.

After treatment

Fertility

Your specialists will do all they can to preserve your ability to have children, however the priority needs to be fighting your cancer. If you only had one ovary removed, you are likely to remain fertile and should find that your menstrual cycle gets back to normal several months after your chemotherapy treatment. However, if you have both ovaries removed, you will not be able to have a baby without specialist help. This can be really hard to deal with, so it’s important to talk things through with someone you trust.

Follow up

After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse). They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.

Long-term follow up

Once your risk of relapse has reduced, the focus of on-going follow up changes to looking out for potential long term side effects of treatment. The risk of long term side effects depends on the type of cancer you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that you require.

Many people are at low risk of future health problems but some will have significant on-going health needs. Talk to your specialist about the potential long-term side-effects of your treatment.

Updated December 2014, next review planned 2017.

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