Ascites is a buildup of fluid in the abdomen. It can happen in the advanced stages of ovarian cancer. Draining excess fluid from the abdomen can help relieve symptoms of ascites.

If cancer cells spread to the abdomen, they can irritate the lining and cause excess fluid to build up. Cancer cells may also affect the lymphatic system, which can prevent fluid from draining properly from the abdomen.

This article looks at when ascites might occur, its symptoms, diagnosis, treatment options, and outlook.

A surgeon preparing to perform surgery on someone with ascites related to ovarian cancer.Share on Pinterest
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Ascites is a buildup of fluid in the abdomen. The abdomen has a lining called the peritoneum. The peritoneum consists of two layers — one to protect the inner organs, such as the pancreas and liver, and one to line the abdominal wall.

The layers of the peritoneum excrete a small amount of fluid to allow the organs to move smoothly within the abdomen. If a condition causes an increase in fluid in the abdomen, fluid can build up between the two layers of the peritoneum.

This buildup of fluid can put pressure on surrounding organs and cause the abdomen to swell. People may experience discomfort or a feeling of tightness or fullness in the abdomen as a result.

Ascites can occur in the advanced stages of ovarian cancer. According to older research from 2013, ascites was present in 90.1% of study participants with stage 3 ovarian cancer and 100% of those with stage 4 ovarian cancer.

The type of ovarian cancer can also depend on who may develop ovarian ascites. For example, a 2019 retrospective analysis found that ascites is most likely to occur in high-grade serous papillary ovarian cancer.

Symptoms of ascites may develop within a few days to over the course of a few weeks and may include:

According to Cancer Research UK, a charity based in the United Kingdom, ascites in ovarian cancer may form when cancer cells spread to the peritoneum, which is the lining of the abdomen. The cancer cells can irritate the lining, causing fluid to build up.

Cancer can also block lymph nodes, which are part of the lymphatic system, in the abdomen. This prevents fluid draining away from the abdomen properly.

If cancer has spread to the liver, it can increase the pressure in surrounding blood vessels, forcing fluid out.

According to 2016 research, the primary treatment for ovarian ascites is treating the underlying cause, which is the cancer.

Chemotherapy or hormone therapy can help to shrink cancer cells or prevent them from spreading. In some people, this might help to treat ascites.

Additionally, doctors may use a procedure called paracentesis, which uses a tube to drain the fluid. This can provide temporary relief that can last for a few days or weeks. The fluid often returns, so a person may need ongoing treatment.

People usually undergo paracentesis as an outpatient treatment.

A doctor will apply a local anesthetic to the abdomen before making a small cut. They will then insert a small tube into the abdomen to drain excess fluid into a drainage bag.

A doctor may use an ultrasound to direct the tube to the right area.

If people experience any pain or discomfort during the procedure, a doctor can provide them with pain relief medication.

People may also require a long-term drain, which is a tube, or catheter, that a doctor inserts into the abdomen. The catheter stays in place after fluid has drained away, and a dressing covers it when not in use.

When people need to drain fluid again, a drainage bag attaches to the catheter to drain any fluid buildup. A healthcare professional will provide instructions on how to properly use and care for a catheter.

Medication

Ascites can continue to develop despite treatment with chemotherapy and paracentesis. In these cases, a doctor may prescribe additional treatments to alleviate the ascites and its symptoms.

These include:

  • Diuretics: These are medicines that can help people urinate more frequently, which can help prevent excess fluid from building up.
  • Angiogenesis inhibitors: These are medications to stop the growth of new blood vessels, which is essential for the development of a tumor.
  • Immunologic agents: These are medications to modify a person’s immune response.

Other management tips

To help manage ascites, Johns Hopkins notes that people may need to:

  • reduce the number of fluids they drink
  • reduce salt intake by following a low-sodium diet
  • avoid excess potassium, as people may be taking medication for ascites that can increase potassium levels
  • avoid drinking alcohol
  • avoid smoking
  • maintain a moderate weight

Although there is currently no cure for ascites, treating and managing the condition can help to prevent complications.

Draining excess fluid from the abdomen effectively relieves symptoms in 90% of cases.

However, research from 2020 suggests that a higher frequency and volume of ascites may:

  • increase the risk of cancer cells spreading
  • increase resistance to chemotherapy
  • decrease how effectively surgeons can remove tumors

To diagnose ascites, a doctor will assess symptoms and carry out a physical exam.

They may also carry out the following tests:

  • Fluid sample: A doctor will use a needle to take a sample of fluid from the abdomen, which they can check for any signs of cancer or infection.
  • Imaging tests: A doctor may use ultrasound, MRI, or CT scans to get images of the inside of the abdomen.
  • Blood tests: A doctor may use blood tests to check the function of the liver and kidneys and to assess overall health.

Various organizations and programs offer support for people with ovarian cancer, such as:

Financial help

People might be able to access financial help through the following resources:

Research and understanding of ascites in ovarian cancer is continually advancing, and people may want to discuss participating in current clinical trials with their healthcare team.

Ascites is a buildup of fluid in the abdomen and can occur in advanced stages of ovarian cancer.

People may experience discomfort, swelling, or fullness in the abdomen, as well as other symptoms such as nausea, shortness of breath, or frequent urination.

Draining excess fluid from the abdomen with a tube, diuretics, and chemotherapy may all help to treat and manage ascites.