Introduction to Ovarian Cancer

Ovarian cancer is a form of cancer that originates in the ovaries, which are reproductive organs responsible for producing eggs (ova) and hormones such as oestrogen and progesterone. This cancer occurs when abnormal cells in the ovary begin to grow and divide uncontrollably, potentially spreading to surrounding tissues or other parts of the body. Because early-stage ovarian tumours are hard to feel and symptoms are often nonspecific, early detection is challenging. The risk of developing ovarian cancer increases with age, hormone replacement therapy and inherited genetic mutations. Diagnosis may involve clinical assessment, imaging, blood tests and biopsy. Treatment options depend on the cancer stage and type but generally include surgery, chemotherapy, and targeted therapy.

General Symptoms

Early ovarian cancer often causes no symptoms or only vague symptoms, so it is often diagnosed at an advanced stage.

Common symptoms include:

  • Abdominal bloating or swelling

  • Pelvic or abdominal pain or discomfort

  • Feeling full quickly when eating

  • Loss of appetite or weight loss without a clear reason

  • Changes in bowel habits (such as constipation)

  • Increased urgency or frequency of urination

  • Fatigue and back pain

  • Unexplained vaginal bleeding, especially after menopause

Diagnosis

Ovarian cancer diagnosis involves a combination of physical exams, imaging tests, blood tests, and sometimes surgery or genetic testing to confirm the disease and determine its characteristics.

Physical examination

A pelvic exam is often the first step. During this, a doctor inserts gloved fingers into the vagina and presses on the abdomen to feel the uterus, ovaries, and other pelvic organs. They also visually examine the genital area.

Imaging tests

  • Transvaginal Ultrasound (TVU): A probe inserted into the vagina uses sound waves to create images of the ovaries.

  • CT (Computed Tomography) Scan and MRI (Magnetic Resonance Imaging): These provide detailed cross-sectional images of the abdomen and pelvis. useful to assess the size of tumours and whether cancer has spread beyond the ovaries.

  • PET (Positron Emission Tomography) Scan: A nuclear imaging tool that measures uptake of radioactive sugar.

Blood tests

  • Tumour marker (CA-125): Cancer antigen 125 is a protein that is often elevated in ovarian cancer but alone is not sufficient a diagnosis.

  • Genetic testing: Blood tests may be offered to check for inherited gene mutations (such as BRCA1 or BRCA2) that increase ovarian cancer risk.

Surgery and Biopsy

Sometimes surgery is needed to remove an ovary or suspicious tissue, which is then examined under a microscope to confirm the presence and type of cancer cells. Biopsy provides the definitive diagnosis.

Additional Sources of Information

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Stat Pearls Epithelial Ovarian Cancer: https://www.ncbi.nlm.nih.gov/books/NBK567760/

Cancer Research UK: What is ovarian cancer? https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/what-is-ovarian-cancer

Cancer Research UK: Diagnosis. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/getting-diagnosed/tests-ovarian-cancer

American Cancer Society: Ovarian Cancer Early Detection, Diagnosis https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging.html

Mayo Clinic: Ovarian Cancer Symptoms https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941

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