Ovarian Cancer

Signs & symptoms

Ovarian cancer often does not have signs or symptoms until later in its development. Symptoms may include:

• Abdominal bloating or swelling
• Abdominal or pelvic pain
• Difficulty eating or feeling full quickly
• Frequent urination or feeling a need to urinate

If these symptoms are persistent and a change from the norm, you should see a gynecologist.

Others symptoms of ovarian cancer can include:

• Back pain
• Constipation
• Fatigue
• Menstrual changes
• Pain during sex
• Upset stomach

These symptoms, however, may be caused by other conditions and aren't necessarily signs of ovarian cancer.

Diagnosis

To help find the cause of your symptoms, your doctor will evaluate your medical history, perform a physical exam and recommend diagnostic tests. The exams and tests may include some of the following:

• Pelvic exam. A pelvic exam consists of feeling the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size. A Pap test, an effective test for cancer of the cervix, is often done along with the pelvic exam, but it is not a reliable way to find or diagnose ovarian cancer.
• Ultrasound. Ultrasound refers to the use of high-frequency sound waves that are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid-filled cysts and tumors look different on this picture.
• CA-125 assay. This is a blood test used to measure the level of CA-125, a tumor marker that is often found in higher-than-normal amounts in the blood of women with ovarian cancer.
• Lower GI series. Also called a barium enema, this is a series of X-rays of the colon and rectum. The pictures are taken after the patient is given an enema with a white, chalky solution containing barium, which outlines the colon and rectum on the X-ray, making tumors or other abnormal areas easier to see.
• Computed tomography (CT) scan. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to a X-ray machine.
• Biopsy. Biopsy is the removal of tissue for examination under a microscope. A pathologist studies the tissue to make a diagnosis. To obtain the tissue, the surgeon performs a laparotomy, an operation to open the abdomen. If cancer is suspected, the surgeon performs an oophorectomy, where the entire ovary is removed. This is important because if cancer is present, removing just a sample of tissue by cutting through the outer layer of the ovary could allow cancer cells to escape and cause the disease to spread.

Treatments

Health care professionals specializing in pelvic cancers at UCSF Medical Center will discuss all available therapies with you and make recommendations based on the stage of your disease, age and the overall condition of your health.

Surgery

Surgery to remove the cancerous growth is the primary method for diagnosing and treating ovarian cancer. In some cases, we can remove the cancer using robotic surgery, a minimally invasive technique that can reduce recovery time and the risk of surgical complications.

Radiation therapy

This treatment uses high-energy rays to damage cancer cells and stop them from growing. It is a localized treatment, which means that it works to attack cancer cells in one area. The radiation may come from a large machine, which is called external radiation, or from radioactive materials placed directly into the ovaries, called implant radiation. Some patients receive both types of radiation therapy.

Chemotherapy

Drugs to kill cancer cells are most often used when ovarian cancer has spread to other parts of the body. A patient may receive just one drug or a combination of drugs in cycles. Chemotherapy may be given by injection into a vein or orally. It is a systematic treatment, meaning that the drugs flow through the body in the bloodstream.