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Ovarian cancer is also called the silent killer and it affects women of all ages.

About Ovarian Cancer

Ovarian cancer is also called the silent killer and it affects women of all ages. It is one of the most lethal female cancers. Majority of women are diagnosed with ovarian cancer when the cancer has already spread, which is the advanced stage and it is more difficult to treat. There is no early detection test for ovarian cancer. Most of the time, patients do not experience any symptoms or the symptoms could be often confused with other illnesses.1

Types of Ovarian Cancer

There are several types of ovarian cancer tumours. These tumours are named after the type of cell they come from, they are:1,2

Stages of Ovarian Cancer

Staging is a process which describes how much cancer is in the body and how far the cancer has spread. Doctors can get information on how serious the cancer is and what best treatment he should consider to treat it. There are a total of 4 stages of ovarian cancer.3,4

Stage I

Cancer is confined to one or both ovaries.

Stage II

Cancer has spread within the pelvic region.

Stage III

Cancer has spread to other organs in the abdomen.

Stage IV

Cancer has spread beyond the abdomen to other parts of the body.

Signs and Symptoms

Ovarian cancer is easier to treat if it is detected early. There are some symptoms which are commonly associated with ovarian cancer.5,6

The common symptoms are:

Increased abdominal size / bloating

Difficulty eating / feeling full easily5

Pelvic / abdominal pain

Urinary urgency / frequency (always feel like going to the toilet)

Others symptoms of ovarian cancer can include:

  • Fatigue (extreme tiredness)
  • Upset stomach
  • Back pain
  • Pain during sex
  • Constipation
  • Changes in a woman’s period (heavier/irregular bleeding)
  • Abdominal (belly) swelling with weight loss

These symptoms are often confused with symptoms of other illnesses. If they are caused by ovarian cancer, they tend to stay for a long time and are more severe. If you have experienced these symptoms more than 12 times a month, please consult your doctor so cause can be found and treated if necessary.6

Risk Factors

Risk factors are anything that can increase your chances of getting certain diseases like cancer. But it does not mean that if you have a risk factor, you will definitely get the disease.

Researchers have found several risk factors that increases the chance of a woman developing ovarian cancer.7

Getting older

The risk of getting ovarian cancer increases with age. Most ovarian cancers develop after menopause.

Being overweight or obese

Obese women (body mass index [BMI] of at least 30) might have a higher risk of developing ovarian cancer. It is also associated with poorer ovarian cancer survival rate.

Having children later or never having a full-term pregnancy
Undertaking hormone therapy after menopause
Having a family history of ovarian cancer and other cancer

The risk of developing ovarian cancer is high if your first degree relatives (mother, sister or daughter) have ovarian cancer. The risk will also increase if there are more relatives in your family who have other cancers such as breast, prostate, colorectal or uterine cancers.

Having a BRCA mutation

Women with germline mutations in BRCA1 have a 25 – 50% chance of developing ovarian cancer. A mutation in the BRCA2 gene can also increase the chance of getting ovarian cancer of up to 20%.6

There are also a couple of factors that can lower the risk of developing ovarian cancer.

Pregnancy and breastfeeding
Birth control

BRCA mutation in Ovarian Cancer

The BRCA gene is an important gene that helps to control cell growth in our body. When a mutation happens in this gene, it will lead to an increased risk of cancer. The two most common cancers in women that are due to BRCA mutations are breast and ovarian cancers.

Learn more about Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer

In all women with ovarian cancer, up to 15% of the patients will have a germline BRCA1/2 mutation9 and up to 7% of the patients will have a somatic BRCA1/2 mutation.10

Treatment for Ovarian Cancer


Surgery is the main treatment option for most ovarian cancer cases. Operations will be carried out by specialists called gynaecologic oncologists.

Debulking surgery is the procedure to remove as much tumour as possible from the body. The more thorough the surgery is, the higher chance the patient will be able to do well.8,9

If your cancer is in the advanced stage, your doctor may recommend chemotherapy followed by surgery to remove as much of the cancer as possible. This procedure is called interval debulking.11


Chemotherapy is a drug treatment that uses chemicals to kill fast-growing cells in the body, including the small portion of remaining cancer cells from the surgery, or those cancer cells that have spread to other parts of the body. Chemotherapy drugs can be injected into a blood vein or taken by mouth. It will enter the bloodstream and reach almost all parts of the body.12,13

Targeted therapy

Targeted therapy uses medications that specifically target the certain defects or mutations which are present in the cancer cells. Your doctor may test your cancer cells (for instance: BRCA test — read more from Testing for BRCA) to determine which targeted therapy is most likely to have an effect on your cancer. Targeted therapies are often designed as a maintenance treatment after the completion of chemotherapy. Due to its ability to selectively kill cancer cells, it usually has less side effects compared to chemotherapy.12

Supportive (palliative) care

Palliative care is specialized medical care that supports and complements the cancer treatment like the relief from pain and other symptoms of a serious illness. It helps people with cancer feel better and live longer.12

  1. Everhobbes. “What Is Ovarian Cancer?” Accessed May 6, 2020.
  2. “What Is Ovarian Cancer: Ovarian Tumors and Cysts.” Accessed May 6, 2020.
  3. “Ovarian Cancer Stages: Staging for Ovarian Cancer.” American Cancer Society. Accessed May 6, 2020.
  4. Prat, Jaime. “Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum.” International Journal of Gynecology & Obstetrics 124, no. 1 (2013): 1–5.
  5. 5. Goff, Barbara A., Lynn S. Mandel, Charles W. Drescher, Nicole Urban, Shirley Gough, Kristi M. Schurman, Joshua Patras, Barry S. Mahony, and M. Robyn Andersen. “Development of an Ovarian Cancer Symptom Index.” Cancer 109, no. 2 (2007): 221–27.
  6. Morgan M, Boyd J, Drapkin R, Seiden MV. Ch 89 – Cancers Arising in the Ovary. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE, Kastan MB, McKenna WG, eds. Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier; 2014: 1592.
  7. “Ovarian Cancer Risk Factors.” American Cancer Society. Accessed May 6, 2020.
  8. “Ovarian Cancer Surgery: Debulking Surgery: Omentum Removal.” American Cancer Society. Accessed May 6, 2020.
  9. Burgess, Melissa, and Shannon Puhalla. “BRCA 1/2-Mutation Related and Sporadic Breast and Ovarian Cancers: More Alike than Different.” Frontiers in Oncology 4 (2014).
  10. Pennington, Kathryn P., and Elizabeth M. Swisher. “Hereditary Ovarian Cancer: Beyond the Usual Suspects.” Gynecologic Oncology 124, no. 2 (2012): 347–53.
  11. Schorge, John O., Christopher McCann, and Marcela G. Del Carmen. “Surgical debulking of ovarian cancer: what difference does it make?.” Reviews in obstetrics and gynecology 3, no. 3 (2010): 111.
  12. “Ovarian Cancer.” Mayo Clinic. Mayo Foundation for Medical Education and Research, July 25, 2019.
  13. “Chemotherapy for Ovarian Cancer: Intraperitoneal Chemotherapy.” American Cancer Society. Accessed May 6, 2020.
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