An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer). Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.

Ovarian cancer can invade, shed, or spread to other organs.

  • Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.
  • Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.
  • Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.

Early ovarian cancer may not cause obvious symptoms. But, as the cancer grows, symptoms may include:

  • pressure or pain in the abdomen, pelvis, back, or legs
  • a swollen or bloated abdomen
  • nausea, indigestion, gas, constipation, or diarrhea
  • feeling very tired all the time

Less common symptoms include:

  • shortness of breath
  • feeling the need to urinate often
  • unusual vaginal bleeding (heavy periods, or bleeding after menopause)

Most often these symptoms are not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.

You may have one or more of the following tests. Your doctor can explain more about each test.

  • Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
  • Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
  • Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman's response to ovarian cancer treatment and for detecting its return after treatment.
  • Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
  • Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the "Treatment" section.

Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

Your doctor can describe your treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, radiation therapy is used.

Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body.

  • Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
  • Intraperitoneal chemotherapy: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.
  • Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.


The surgeon makes a long cut in the wall of the abdomen. This type of surgery is called a laparotomy. If ovarian cancer is found, the surgeon removes:

  • both ovaries and fallopian tubes (salpingo-oophorectomy)
  • the uterus (hysterectomy)
  • the omentum (the thin, fatty pad of tissue that covers the intestines)
  • nearby lymph nodes
  • samples of tissue from the pelvis and abdomen

If the cancer has spread, the surgeon removes as much cancer as possible. This is called "debulking" surgery.


Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some women have chemotherapy before surgery.

Usually, more than one drug is given, and can be given in different ways.

  • By vein (IV): The drugs can be given through a thin tube inserted into a vein.
  • By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
  • By mouth: Some drugs for ovarian cancer can be given by mouth.

Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.

Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.

Doctors cannot always explain why one woman develops ovarian cancer and another does not. However, we do know that women with certain risk factors may be more likely than others to develop ovarian cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for ovarian cancer:

  • family history of cancer. Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer.
    • If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.
  • personal history of cancer. Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
  • age over 55. Most women are over age 55 when diagnosed with ovarian cancer.
  • never pregnant. Older women who have never been pregnant have an increased risk of ovarian cancer.
  • menopausal hormone therapy. Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.

Scientists have also studied whether taking certain fertility drugs, using talcum powder, or being obese are risk factors. It is not clear whether these are risk factors, but if they are, they are not strong risk factors.

Having a risk factor does not mean that a woman will get ovarian cancer. Most women who have risk factors do not get ovarian cancer. On the other hand, women who do get the disease often have no known risk factors, except for growing older. Women who think they may be at risk of ovarian cancer should talk with their doctor.

Every cancer diagnosis is different, just as every person who is diagnosed with cancer is different. Cancer knows no barriers to race, age, or social group. However there is one thing that each and every person who is diagnosed with cancer will have in common: help with fighting and beating the disease.

Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain: no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.

Clinical Trials

The search for a cure for cancer is an ongoing, constant battle. Clinical trials are the basis upon which new treatments and medications are proven to help the fight against cancer, or if researchers should pursue another tactic. The advancement of medicine depends on willing and able cancer patients to volunteer for experimental treatments so that future generations will have proven and effective cures. Not every patient with cancer will be eligible for a clinical trial, as the scientific method needs specific patients with specific types of cancers. However, patients who are selected for trials may benefit from being at the cutting edge of new research, and gain time they otherwise might not have had.

The National Cancer Institute at the National Institutes of Health has a comprehensive database of over 10,000 ongoing clinical trials that both help advance medicine and help patients.

Financial Help

Unfortunately, cancer treatment can be costly, even if a patient has very comprehensive health insurance. For patients who do not have health insurance, the cost of treatment may seem insurmountable. Fortunately many pharmaceutical companies offer cost assistance to help make treatment more affordable. The National Comprehensive Cancer Network has compiled a Virtual Reimbursement Room where patients can find information for accessing financial help with their treatment costs.

Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). They are studying new and better ways to prevent, detect, and treat ovarian cancer.

Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to advances, and researchers continue to search for more effective methods.

Women who join clinical trials may be among the first to benefit if a new approach is effective. And even if the women in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about ovarian cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.

Researchers are conducting studies with women across the country.

  • Prevention studies: For women who have a family history of ovarian cancer, the risk of developing the disease may be reduced by removing the ovaries before cancer is detected. This surgery is called prophylactic oophorectomy. Women who are at high risk of ovarian cancer are taking part in trials to study the benefits and harms of this surgery. Other doctors are studying whether certain drugs can help prevent ovarian cancer in women at high risk.
  • Screening studies: Researchers are studying ways to find ovarian cancer in women who do not have symptoms.
  • Treatment studies: Doctors are testing novel drugs and new combinations. They are studying biological therapies, such as monoclonal antibodies. Monoclonal antibodies can bind to cancer cells. They interfere with cancer cell growth and the spread of cancer.

Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain: no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.

Your experience with cancer will depend on the type of cancer you have, your choices of treatment and the lifestyle you lead. Be sure to speak with your doctor about the side effects of your disease and the treatments you choose. Your doctor will be able to consult with you on realistic lifestyle expectations. 

Review Date: 
March 27, 2012