If You Have Ovarian Cancer

What is ovarian cancer?

Cancer can start any place in the body. Cancer that starts in the ovary is called ovarian cancer. It starts when cells in the ovary grow out of control. Some ovarian cancers can also start in the fallopian tubes - tubes that connect the ovary to the uterus.

Women have 2 ovaries. They are where eggs are made, and also where most of women’s hormones are made.

Cancer cells can spread to other parts of the body. Cancer cells in the ovary can sometimes travel to the liver and grow there. When cancer cells do this, it’s called metastasis. To doctors, the cancer cells in the new place look just like the ones from the ovary.

Cancer is always named for the place where it starts. So when ovarian cancer spreads to the liver (or any other place), it’s still called ovarian cancer. It’s not called liver cancer.

Ask your doctor to use this picture to show you where the cancer is.

Are there different kinds of ovarian cancer?

There are many types of ovarian cancer. Your doctor can tell you more about the type you have. Below are the medical names for the most common types of ovarian cancer.

Epithelial cancers

These cancers start from the cells that cover the outside of the ovary.

Germ cell cancers

These start from the ovarian cells that make the eggs.

Stromal cancers

These start from cells that hold the ovary together and make female hormones.

Questions to ask the doctor

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of ovarian cancer you think I might have?
• What will happen next?

How does the doctor know I have ovarian cancer?

Early ovarian cancer often causes no symptoms. Some signs of ovarian cancer are bloating, feeling full soon, belly pain, and needing to pee more often or feeling like you have to pee right away.

Tests that may be done

Your doctor will ask you questions about your health and do a physical exam. If signs are pointing to ovarian cancer, more tests will be done. Here are some of the tests you may need:

• Ultrasound: For this test a small probe is put into the vagina or on the skin over the belly (abdomen). It gives off sound waves and picks up the echoes as they bounce off tissues. The sound waves make a picture of the ovaries on a video screen.
• CT (computed tomography) scans: This is also called a “CAT scan.” It’s a kind of x-ray that takes clear pictures of the ovaries and other body parts to see if the cancer has spread.
• Chest x-rays: X-rays of your chest may be done to see if your cancer has spread to your lungs.
• Laparoscopy: This is a type of surgery that uses a thin, lighted tube so that a doctor can look at the ovaries and other body parts in the area. This helps the doctor tell if the tumor has spread and plan surgery or other treatments
• Blood tests: The doctor may check your blood to see if it has high levels of some proteins. Levels of these proteins can go up if certain cancers are there.

Ovarian biopsy

In a biopsy, the doctor takes out a little bit of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have cancer. For ovarian cancer, the biopsy is most often done when you have surgery to take out the cancer.

Questions to ask the doctor

• What tests will I need to have?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have ovarian cancer, the doctor will want to find out how far it has spread. This is called staging. You may have heard other people say that their cancer was “stage 1” or “stage 2.” Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage describes the growth or spread of the cancer through the ovaries. It also tells if the cancer has spread to other places in your body that are close by or farther away.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a worse cancer that has spread to areas of the body farther from the ovary. Ask the doctor about the cancer stage and what it means for you.

Questions to ask the doctor

• Do you know the stage of the cancer?
• If not, how and when will you find out the stage of the cancer?
• Will you explain to me what the stage means in my case?
• Based on the stage of the cancer, how long do you think I’ll live?
• What will happen next?

What kind of treatment will I need?

There are several types of treatment that are used to treat ovarian cancer. The treatment plan that’s best for you will depend on:

• The type of ovarian cancer you have
• The stage of the cancer
• Your overall health
• Your feelings about the treatment and the side effects that may come with it

Surgery

Surgery is the main treatment for most ovarian cancers. The goals of surgery are to see how far the ovarian cancer has spread and to take out as much of the cancer as the doctor can. How much and what type of surgery you have depends on how far the cancer has spread, your health (other than the cancer), and if you still hope to have children. Since ovarian cancer often spreads to nearby areas, the doctor may also need to take out other parts of the body affected by the cancer. Ask your doctor what kind of surgery you will have and what to expect.

Chemotherapy

Chemo is the short word for chemotherapy – the use of drugs to fight cancer. Chemo is the use of drugs to kill cancer cells or shrink tumors. Most cancer doctors believe that using more than one drug works better in treating ovarian cancer than using one drug alone.

Targeted therapy

Targeted therapy is a newer type of cancer treatment that uses drugs to find and attack cancer cells while doing little harm to normal cells. Not all types of targeted therapy work the same, but they all change the way a cancer cell grows, divides, heals itself, or acts.

Hormone therapy

Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. It is used more often to treat ovarian stromal cancers. There are many kinds of hormone therapy. Ask your doctor which one you will get and what to expect.

Radiation therapy

Radiation uses high-energy rays (like x-rays) to kill cancer cells or shrink tumors. Radiation is rarely, if ever, used as the main treatment for ovarian cancer. It is sometimes used to treat areas where cancer has spread.

Clinical trials

Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better.

Clinical trials are one way to get the newest cancer treatment. They are the best way for doctors to find better ways to treat cancer. If your doctor can find one that’s studying the kind of ovarian cancer you have, it’s up to you whether to take part. And, if you do sign up for a clinical trial, you can always stop at any time.

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials. See Clinical Trials to learn more.

What about other treatments that I hear about?

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment too?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• How soon do I need to start treatment?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What’s the next step?

What will happen after treatment?

You’ll be glad when treatment is over. But it’s hard not to worry about cancer coming back. And for some people with ovarian cancer, treatments may not cure your cancer. You may need ongoing treatment and care. At times some tests will be done to see how your treatment is working, and at other times tests will be done to see if your cancer has come back. Ask your doctor what to expect.

No matter what, your doctors will still want to watch you closely. Be sure to go to all of these follow-up visits. During these visits, your doctors will ask about symptoms, do physical exams, and may order blood tests or imaging tests such as CT scans.

At first, your visits may be every 2-4 months. Then, the longer you are cancer-free, the less often the visits are needed. After 5 years, they may be done once a year.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.