Ovarian cancer refers to any cancerous growth that begins in the ovaries, the organs that produce eggs in females. There are often no symptoms in the early stages, but a person may notice pain or pressure in the lower abdomen and vaginal bleeding.

Ovarian cancer is now the fifth most common cause of cancer-related death among females in the United States. That said, deaths from ovarian cancer have been falling in the U.S. over the past two decades.

The American Cancer Society (ACS) estimates that in 2022, around 19,880 people in the U.S. may receive a diagnosis of ovarian cancer. Around 12,810 people are likely to die from this condition.

Furthermore, around 1.1% of females will receive an ovarian cancer diagnosis at some point in their lifetime.

This article explores how to recognize ovarian cancer symptoms and what to expect if a person receives a diagnosis.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Most ovarian cancers start in the ovary’s epithelium, or outer lining. In the early stages, there may be few or no symptoms.

If symptoms do occur, they can resemble those of other conditions, such as premenstrual syndrome, irritable bowel syndrome, or a temporary bladder problem. However, in ovarian cancer, the symptoms will persist and worsen.

Early symptoms may include:

  • pain or pressure in the pelvis
  • unexpected vaginal bleeding
  • pain in the back or abdomen
  • bloating
  • feeling full rapidly when eating
  • changes in urination patterns, such as more frequent urination
  • changes in bowel habits, such as constipation

If any of these symptoms last for 2 weeks or more, a person should see a doctor.

There may also be:

The symptoms can change if cancer spreads to other parts of the body.

Learn more here about the early symptoms of ovarian cancer.

Ovarian cancer develops when cells in this area of the body divide and multiply in an uncontrolled way.

The cause of ovarian cancer is not clear, but experts have identified some risk factors that may contribute, including:

  • having a family history of breast or ovarian cancer
  • being an older adult
  • having children later in life or never having children
  • having a history of breast cancer
  • undergoing hormone replacement therapy
  • being overweight

Here is a closer look at each risk factor:

Family history

Having a close relative with a history of ovarian or breast cancer increases a person’s chance of developing ovarian cancer themselves.

Undergoing genetic screening for mutations in the BRCA gene may help determine if someone has a higher risk of both ovarian and breast cancer.

Age

Ovarian cancer is more common in older adults. In fact, around half of ovarian cancer cases occur after the age of 63 years.

Reproductive history

Having had one or more full-term pregnancies has an association with a lower risk of ovarian cancer. The more pregnancies a person has, the lower the risk seems to be. Breastfeeding or chestfeeding may also lower the risk.

However, having children later in life (after age 35) or never having children have links with a higher risk.

People who use some types of fertility treatment may have a higher chance of developing borderline cells, but not all studies confirm this.

Learn more about carcinoma in situ, or abnormal cells that may become cancerous, here.

Females who use birth control pills or an injectable contraceptive hormone also appear to have a lower risk.

Breast cancer

People with a history of breast cancer seem to have a higher chance of ovarian cancer. This may be due to changes in the BRCA gene.

For this reason, some people with breast cancer who test positive for this gene mutation may opt to have an oophorectomy, or surgery to remove the ovaries, as preventive therapy.

Hormone therapy

Undergoing hormone replacement therapy (HRT) after menopause appears to increase the risk of ovarian cancer, particularly if the therapy uses synthetic progestins.

Obesity and overweight

Ovarian cancer is more common in people with a body mass index (BMI) of over 30.

Additionally, a person is 1.1 times more likely to develop ovarian cancer with each 5-unit increase in BMI.

Gynecologic surgery

Having surgery to remove the uterus — a hysterectomy — may reduce the risk of ovarian cancer by one-third.

HPV

Scientists have found links between the human papillomavirus (HPV) and various cancers, including tonsil and cervical cancer.

The authors of a 2021 meta-analysis reported finding a higher rate of HPV among people with ovarian cancer. However, more research is necessary to determine whether HPV causes or contributes to the development of cancer.

Learn more about HPV, including its effects and how to prevent it, here.

Other possible risk factors

Other factors that may increase the risk of some types of ovarian cancer include:

  • having high levels of androgens, or male hormones
  • dietary factors
  • using talcum powder

However, researchers have not yet proven a link between these factors and ovarian cancer.

Risk for transgender people

Some studies suggest that having high levels of androgens may increase the risk of ovarian cancer. This can be a concern for transgender men who use hormone treatment in their transition.

A study from 2017 notes that removing the ovaries may lower the risk, but the authors urge people to be aware that ovarian cancer remains a possibility.

The National LGBT Cancer Network points out that transgender people may have difficulty seeking regular medical help due to concerns about revealing their gender identity.

It encourages people to ask friends, their local hospital, and their insurance company to find a suitable doctor who can help them take care of their health and their body.

If a healthcare professional diagnoses ovarian cancer, they will need to determine the stage and grade to decide on a treatment plan.

The stage refers to how far cancer has spread. For example:

  • Localized: Cancer cells affect only the ovaries or fallopian tubes and have not spread elsewhere.
  • Regional: Cancer has spread to nearby organs, such as the uterus.
  • Distant: Cancer is present elsewhere in the body. It now affects other organs, such as the lungs or liver.

The grade, meanwhile, refers to how abnormal the cancer cells appear.

Getting an early diagnosis usually means that treatment can be more effective. However, other factors can affect this.

These factors include the person’s age and overall health and the type or grade of the cancer cell, as some types are more aggressive than others.

Healthcare professionals categorize the types of ovarian cancer based on the type of cell in which they form.

There are three common cell types:

  • epithelial cells, which occur in the lining of the surface of the ovary
  • germ cells, which will become eggs for reproduction
  • stromal cells, which release hormones and link up the structures of the ovaries

Epithelial tumors are the most common and the most invasive. They occur in around 85–90% of people with ovarian cancer.

Germ cell tumors are often benign. In 90% of cases that become cancerous, treatment is effective.

Though there is no known way to prevent ovarian cancer altogether, certain factors have an association with reduced risk, including:

  • taking birth control pills for 5 years or more
  • having given birth
  • breastfeeding or chestfeeding for at least a year
  • undergoing certain surgical procedures, such as an oophorectomy, tubal ligation, or hysterectomy

The ACS also recommends following a healthy, well-rounded diet, maintaining a moderate weight, and quitting smoking, if applicable, to reduce the risk.

Additionally, regular exams and discussing any symptoms with a doctor can help detect ovarian cancer early, improving a person’s outlook.

If a routine screening or symptoms suggest that a person may have ovarian cancer, a doctor will typically:

  • ask the person about their personal and family medical history
  • carry out a pelvic examination

They may also recommend:

  • Blood tests: These tests will check for high levels of a marker called CA-125.
  • Imaging tests: Examples include transvaginal ultrasound, an MRI scan, or a CT scan.
  • Laparoscopy: A healthcare professional will insert a thin tube with a camera attached through a small hole in the abdomen to see the ovaries and perhaps take a tissue sample for a biopsy.
  • Biopsy: This involves the microscopic examination of a tissue sample.

Only a biopsy can confirm that a person has cancer. A healthcare professional may do this as part of the initial assessment or following surgery to remove a tumor.

When detected early, approximately 94% of people live longer than 5 years after diagnosis.

What does a biopsy involve? Learn more here.

Treatment will depend on many factors, including:

  • the type, stage, and grade of the cancer
  • the individual’s age and overall health
  • their personal preferences
  • accessibility and affordability of treatment

Options tend to include:

  • Surgery: The choice will depend on the type of cancer and how far it has spread. Surgical options include a hysterectomy, removing one or both ovaries, and removing affected lymph nodes. A doctor will discuss suitable options with the person.
  • Chemotherapy: These drugs aim to kill cancer cells. If a person takes chemotherapy drugs by mouth or as an injection or infusion, they will affect the whole body. Another option is intraperitoneal chemotherapy. In this case, a tube delivers the drug directly to the body area affected by cancer. Chemotherapy can have widespread adverse effects, especially if it affects the whole body. Learn more about chemotherapy, including its adverse effects, here.
  • Targeted therapy: Some treatments target specific cells that help promote cancer growth. Examples include monoclonal antibody therapy and angiogenesis inhibitors. Targeted therapy aims to limit the adverse effects by targeting specific functions.
  • Radiation therapy: This technique uses X-rays to kill cancer cells. One way to do this is by introducing a radioactive liquid into the peritoneum. This may help people with advanced ovarian cancer.
  • Immunotherapy (biotherapy): This aims to boost the immune system’s ability to defend the body against cancer. Vaccine therapy involves injecting substances that will find and kill a tumor. It may help people with advanced ovarian cancer.

Some of these are relatively new types of treatment. Some people may opt to join a clinical trial, which can give access to some of the newest approaches.

According to the National Cancer Institute, the mortality rate for ovarian cancer is around 6.3 per 100,000 people each year.

This rate is slightly lower for certain groups, including Hispanic, Black, Asian American, or Pacific Islander people.

The current 5-year survival rates for ovarian cancer reflect the percentage of people who lived 5 or more years after receiving a diagnosis in 2011–2017.

The outlook depends on the stage and type of cancer. Individual factors such as age, overall health, and treatment access also affect survival rates.

The ACS provides survival rates for three types of ovarian cancer:

StageInvasive epithelial ovarian cancerOvarian stromal tumorsGerm cell tumors of the ovary
Localized93%97%98%
Regional75%90%94%
Distant31%70%74%

Below are a few common questions about ovarian cancer.

How does ovarian cancer begin?

Some research suggests that ovarian cancer actually begins forming in the cells at the tail end of the fallopian tubes, which are the tubes that connect the ovaries to the uterus.

Inherited or acquired genetic mutations, which cause healthy cells to become cancerous, can also be contributing factors.

What are the early warning signs of ovarian cancer?

Some early symptoms of ovarian cancer may include:

  • bloating or swelling of the stomach
  • decreased appetite
  • feeling the urge to urinate more frequently
  • pain or tenderness in the stomach
  • fatigue
  • indigestion
  • unintentional weight loss

If a person experiences any of these symptoms, it is best to talk with a healthcare professional.

Can doctors cure ovarian cancer?

Doctors can treat many types of ovarian cancer successfully. In fact, 5-year survival rates can range from 31%–98%, depending on the specific type and stage of ovarian cancer.

However, several factors can impact treatment outcomes, including a person’s age, overall health, and response to treatment.

What is the life expectancy of a female with ovarian cancer?

According to data from 2012–2018, about 49.7% of people survive for at least 5 years after receiving an ovarian cancer diagnosis. This may vary depending on the type and stage of cancer and how well a person responds to treatment.

Early detection can significantly improve a person’s outlook. About 94% of people live 5 years or longer after receiving an early diagnosis of ovarian cancer.

Should a person have ovarian cancer screening?

According to epidemiologist Yamini Ranchod, PhD, MS: “There is no recommendation for routine screening for those with an average risk of ovarian cancer.”

“For those at high risk — such as people with an inherited syndrome, genetic mutation, or strong family history — a doctor may recommend a transvaginal ultrasound or a blood test for the CA-125 marker. However, whether or not a doctor would recommend screening and how often depends on individual factors.”

“Many of the symptoms of ovarian cancer are similar to those of conditions that are not serious. However, if a person experiences the symptoms of ovarian cancer regularly for more than a few weeks, they should consult their doctor.”

All types of ovarian cancer may be treatable if a person receives a diagnosis in the early stages. Some types are also highly treatable in the later stages.

When considering survival statistics for ovarian cancer, it is worth noting that medical advances have been improving the outlook over the past 20 years.

Nevertheless, seeking help if any symptoms appear can often lead to an early diagnosis, and this will increase the chance of receiving effective treatment.