Ovarian cancer, together with cancers of the fallopian tubes and primary peritoneum, is the fifth leading cause of cancer-related death in women in the U.S. These cancers are often not diagnosed until they are advanced, due to the fact that symptoms typically do not present until the disease has progressed.
Ovarian epithelial cancer, the most common type of ovarian cancer, begins in the tissue that covers the ovaries. Less common — accounting for less than 2 percent of all ovarian cancers — are ovarian germ cell tumors that originate in the germ cells in the ovary. You may have also heard of ovarian low malignant potential tumors (OLMPT or LMP), a type of ovarian disease, yet they rarely become cancer.
Signs and Symptoms of Ovarian Cancer
In its early stage, ovarian cancer may not cause any discomfort or present any other symptoms. In most cases, it’s not until the cancer is advanced that symptoms appear. These include:
- pain, swelling or feeling of pressure in the abdomen
- heavy or irregular vaginal bleeding, especially after menopause
- clear, white or bloody-colored vaginal discharge
- a lump in the pelvic area
- gas, bloating, constipation or other gastrointestinal issues
While these can also be indications of other, non-cancer-related issues, symptoms that do not go away on their own or get worse should be evaluated by a healthcare professional.
Risk factors for ovarian cancer include:
- age, with most developing ovarian cancer post-menopause
- obesity — a body mass index of at least 30
- having the first full-term pregnancy after age 35 or never carrying a pregnancy to term
- use of the fertility drug clomiphene citrate (Clomid®) for longer than one year
- use of androgen or use of estrogens after menopause
- a family history of ovarian cancer (mother, sister, daughter or multiple family members on either the mother’s or father’s side)
- a family history of other types of cancer such as colorectal and breast cancer
- the presence of certain genetic mutations, such as mutations in BRCA1 and BRCA2 or genes linked to hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome)
- use of talcum powder (not cornstarch powder) in genital area
Screening for Ovarian Cancer
Screening tests for ovarian cancer include pelvic exam, transvaginal ultrasound (TVU) and CA-125 assay.
The TVU and CA-125 are recommended screenings for high-risk women, although research has shown that these screenings do not necessarily reduce the number of deaths from the disease. Clinical trials of screenings to identify ovarian cancer at an earlier stage continue to be conducted.