About ovarian cancer

What is ovarian cancer?

Ovarian cancer starts when cells in one or both ovaries, the fallopian tubes or the peritoneum become abnormal, grow out of control and can form a lump called a tumour. Cancer of the fallopian tube was once thought to be rare, but research suggests that many ovarian cancers start in the fallopian tubes.

If ovarian cancer spreads from the ovaries, it is often to the organs in the abdomen and pelvis. It is common in some types of ovarian cancer for a large amount of fluid to build up in the abdomen (belly).

Sometimes an ovarian tumour is diagnosed as a borderline tumour (also known as a low malignant potential tumour). This tumour is not considered to be cancer but can still spread within the abdomen (see Types of ovarian cancer).

Guides to Best Cancer Care

Find an overview of what to expect at every stage of your ovarian cancer care. These are short guides about diagnosis, treatment and beyond for many types of cancer.

How common is it?

Each year, about 1930 women are diagnosed with ovarian cancer in Australia. This number includes cancers of the fallopian tube. More than 8 out of 10 women diagnosed are over the age of 50, but ovarian cancer can occur at any age. It is the 9th most common cancer in females in Australia.

Ovarian cancer affects anyone with ovaries. Transgender men and intersex people can also get ovarian cancer if they have ovaries. For information specific to you, speak to your doctor. 

The ovaries

The ovaries are part of the female reproductive system, which also includes the fallopian tubes, uterus (womb), cervix (the neck of the uterus), vagina (birth canal) and vulva (external genitals).

Ovaries are made up of:

• epithelial cells – found on the outside
• germ (germinal) cells – inside, these mature into eggs
• stromal cells – forming connective tissue and making hormones.

What the ovaries do – The ovaries produce eggs. They also make the hormones oestrogen and progesterone, which control the release of eggs (ovulation) and the timing of periods (menstruation).

Shape and position in the body – The ovaries are 2 small, walnut-shaped organs. They are found in the lower part of the abdomen (belly). There is one ovary on each side of the uterus, close to the end of each fallopian tube.

Ovulation and menstruation – During ovulation, from puberty through to menopause, one ovary – or occasionally both – releases an egg. The egg travels through the fallopian tube to the uterus. If a pregnancy does not occur, some of the lining of the uterus is shed and flows out of the body. This flow is called a period or menstruation.

Menopause – As you get older, the ovaries gradually make less oestrogen and progesterone. When levels of these hormones fall low enough, periods stop. This is known as menopause. After menopause, you can’t have a child naturally.

The female reproductive system

Organs and structures near the ovaries

Other organs and structures near the ovaries include the:

• bladder – stores urine (pee)
• bowel – helps the body break down food
• rectum – stores faeces (poo)
• peritoneum – lining of the abdomen
• omentum – a curtain of fatty tissue that hangs in front of the large bowel like an apron.

Types of ovarian cancer

There are many types of ovarian cancer. The 3 main types start in different cells found in the ovary.

Epithelial cell

• the most common type of ovarian cancer (about 9 out of 10 cases)
• starts on the surface layer (epithelium) of the ovary, fallopian tube or peritoneum
• the most common subtypes include serous, endometrioid, clear cell, mucinous
• serous is the most common subtype; it’s divided into high grade and low grade
• mostly occurs over the age of 60 stromal cell (or sex cord-stromal tumours)

Stromal cell (or sex cord-stromal tumours)

• rare cancer (about 1 in 10 cases)
• starts in the cells that form the connective tissue in the ovaries and make the hormones oestrogen and progesterone
• may produce extra hormones, such as oestrogen
• usually occurs between the ages of 40 and 60 germ cell

Germ cell

• rare type of ovarian cancer (less than 1 in 10 cases)
• starts in the egg-producing (germinal) cells found inside the ovary
• usually occurs under the age of 40

Non-cancerous ovarian tumour

Borderline tumour

• abnormal cells that form in the tissue covering the ovary
• doesn’t grow into the supportive tissue (stroma)
• grows slowly

Which health professionals will I see?

Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist called a gynaecological oncologist. The specialist will arrange further tests.

If ovarian cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you will likely see a range of health professionals.

Health professionals you may see

• gynaecological oncologist – diagnoses and performs surgery for cancers of the female reproductive system (ovarian, cervical, uterine, vulvar and vaginal cancers) and oversees your care
• medical oncologist – treats cancer with systemic drug therapies such as chemotherapy, targeted therapy and immunotherapy
• fertility specialist – diagnoses, treats and manages infertility; may be an obstetrician, gynaecologist or reproductive endocrinologist
• radiation oncologist – treats cancer by prescribing and overseeing a course of radiation therapy
• radiation therapist – plans and delivers radiation therapy
• radiologist – analyses and interprets diagnostic scans, such as x-rays and CT and PET–CT scans
• cancer care coordinator – coordinates your care, liaises with other members of the MDT and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
• nurse – administers drugs and provides care, information and support throughout treatment
• occupational therapist – assists in adapting your living and working environment to help you resume usual activities after treatment
• women’s health physiotherapist – assists with physical problems associated with gynaecological cancers, such as bladder and bowel issues, sexual issues and pelvic pain
• exercise physiologist – prescribes exercise to help people with medical conditions improve their overall health, fitness, strength and energy levels
• dietitian – helps with nutrition concerns and recommends changes to diet during treatment and recovery
• social worker – links you to support services and helps you with emotional, practical and financial issues
• psychologist, counsellor – help you manage your emotional response to diagnosis and treatment
• lymphoedema practitioner – educates people about lymphoedema prevention and management, and provides treatment if lymphoedema occurs; often a physiotherapist or occupational therapist
• cancer genetics specialist, genetic counsellor – provide advice about genetic causes of ovarian cancer; arrange genetic tests if required and interpret the results for you and your family