Women fear ovarian cancer, and rightly so. A diagnosis can seem like a certain death sentence. While nearly all women survive breast cancer if it’s caught early, survival rates for ovarian cancer aren’t as promising.

Compounding this fear is the fact that ovarian cancer death rates are virtually the same today as they were 30 years ago. This means that despite advances in technology and cancer research during the past 30 years, ovarian cancer survival rates haven’t improved. The one-year survival rate is currently 75% and the five-year survival rate is just 45%.

The picture is more hopeful if the cancer is found before it has spread outside the ovary (survival rate of 92%); once it has spread, the rate drops to 71%.


All women are at risk for ovarian cancer; it’s the second-most common gynecological cancer after endometrial cancer. Your risk for ovarian cancer increases as you age. Some 20,000 women are diagnosed with ovarian cancer each year. And 15,000-plus women will die of ovarian cancer this year. Most ovarian cancer is believed to occur by chance. Only about 1% of women carry the alterations in the BRCA-1 or -2 genes associated with breast cancer that also place them at higher risk for ovarian cancer.

Women with a BRCA-1 gene mutation have a 25% to 40% risk of developing ovarian cancer, while women with a BRCA-2 gene mutation have a 15% to 27% increased risk. So if you have more than one woman in your family who has had breast or ovarian cancer, discuss genetic testing with your healthcare provider.

You will also want to consider preventive surgery (removal of breasts and/or ovaries) and more frequent pelvic exams, mammograms and pelvic ultrasounds. Also request a CA- 125 blood test at least once a year.

Other factors that raise your risk for ovarian cancer over time are:

• aging (most cases occur in women age 50 or older)
• family history
• your personal risk of breast, uterine or colorectal cancer

White women are at higher risk, particularly if your background is Northern or Eastern European or Ashkenazi Jewish. If you’ve struggled with infertility, have not had children or have a history of endometriosis, you’re also at increased risk.

We can’t yet prevent ovarian cancer, but taking oral contraceptives, having a tubal ligation or hysterectomy or having your ovaries removed can reduce your risk.


Ovarian cancer causes symptoms, but sometimes they are so subtle and slow in their onset it’s easy to dismiss or ignore them:pelvic pain, back pain, fatigue, bloating, gas, urinary urgency, heartburn, upset stomach or abnormal vaginal discharge are all considered warning signs and warrant a visit to your healthcare provider. An increase in waist size may be a worrisome sign. Loss of appetite, feeling full even after a small meal and pain during intercourse are also red flags.

In one study more than 81% of women with ovarian cancer had one of these symptoms before diagnosis. Nausea, vomiting, constipation, diarrhea and other digestive disorders were associated with more advanced cancer, while abnormal bleeding and pelvic pain were found in less advanced cases.

This means that both you and your healthcare provider need to practice a high level of suspicion when unresolved gastrointestinal symptoms occur. Sadly, there are currently no simple and reliable ways to test for ovarian cancer, especially in women without signs or symptoms. This means you need to stay in touch with your body, particularly how you feel throughout the month, and report any changes to your healthcare provider, because early detection is crucial.

If you go through screening for ovarian cancer, you’ll need a rectovaginal pelvic exam, a transvaginal pelvic ultrasound and the CA-125 blood test. For a rectovaginal pelvic exam, your healthcare provider will insert one finger into your vagina and another one into the rectum to feel or palpate your pelvic organs, including your ovaries. Ultrasound uses sound waves to produce pictures of your pelvic organs and can show enlarged ovaries. CA-125 is a protein that is produced by some cancers, including ovarian cancer, but the problem with CA-125 screening is that you can have elevated levels without having cancer.

If cancer is suspected and found, staging is a process that will determine whether the cancer has spread beyond your ovaries. How the cancer will be treated depends on the stage of the tumor. Treatment usually involves removing as much of the cancer as possible, followed by chemotherapy, and may include other drugs that help prevent cancer recurrence.

Currently, new tumor markers are being studied and hold promise for future testing. But for now, the best key to early detection of this disease is for you and your healthcare provider to remain alert to the symptoms of ovarian cancer and not automatically chalk them up to menopause, aging, dietary changes, stress, depression or bowel problems.

About the Author: Kathleen Furniss, RNC, DMH, is coordinator of Women’s Imaging at Mountainside Hospital in Montclair, NJ.