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Formerly known as California Oncology of the Central Valley Request an Appointment
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Formerly known as California Oncology of the Central Valley Request an Appointment

Ovarian Cancer

What is Ovarian Cancer?

Located in the pelvis on either side of the uterus, the ovaries are an important part of the female reproductive system—they produce both female hormones, namely estrogen and progesterone, and eggs. When a woman reaches menopause, her ovaries stop releasing eggs and producing certain hormones. When cells in the ovaries begin to grow out of control, they develop into ovarian cancer, which has the potential to spread to nearby tissues or throughout the body.

Female reproductive system

However, some ovarian cancers become benign tumors, which will not spread and are not life-threatening. Ovarian epithelial cancer is closely related to fallopian tube cancer and primary peritoneal cancer because they form in the same types of epithelial tissue, resulting in similar symptoms and treatments.

Types of Ovarian Cancer

There are three main types of this cancer. Epithelial, germ cell, and stromal ovarian cancer each contain several subtypes differentiated by how the cells look under a microscope. Ovarian cysts are usually not cancerous but can have some similar symptoms.

Ovarian Epithelial Tumors

Ovarian epithelial cancer can be benign, borderline, or malignant. The tumors develop in the cells on one or both of the ovaries’ outer surface. In addition to staging and grading this type of cancer, the care team sometimes assigns a type. Type I tumors grow slowly and cause fewer symptoms. Type II tumors grow faster and spread sooner but respond much better to chemotherapy than Type I tumors.

Ovarian Germ Cell Tumors

This type of ovarian cancer develops from the egg-producing cells in the ovaries and is more likely to affect younger women. It is much rarer than ovarian epithelial carcinoma, comprising less than 2% of ovarian cancer diagnoses.

Ovarian Stromal Tumors

Stromal tissue holds the ovary together and produces hormones. Tumors that develop in this tissue can result in an overproduction of female hormones, a notable symptom. 

Ovarian Cysts

Ovarian cysts are not a type of ovarian cancer, but these collections of fluid can form on the ovaries and become painful as they grow. In rare cases, ovarian cysts can be malignant, but ovarian cysts are usually benign and often go unnoticed. If there are symptoms, they can feel similar to those of ovarian cancer, but cysts are not an indication that a person will develop ovarian cancer—there is no known correlation.

Ovarian Cancer Diagnosis

Typically, providers begin to suspect ovarian cancer after feeling a mass during a pelvic examination. There are several risk factors for ovarian cancer, including age, family history, having children later in life or not having children, using fertility treatments, postmenopausal hormone therapy, smoking, and using alcohol. Still, no one knows why one woman gets this cancer and another does not. Specific genetic mutations indicate an increased risk, and are tested for if the family history warrants it. One well-known gene mutation is either on the BRCA1 or BRCA2 gene, known as breast and ovarian cancer syndrome.


  • Bloating, cramping, or swelling
  • Pelvic or abdominal pain
  • Backache
  • Difficulty eating, feeling full quickly
  • Indigestion, heartburn, nausea, or gas
  • Unintentional weight loss or gain
  • Urgent or frequent urination
  • Diarrhea or constipation
  • Vaginal bleeding
  • Pain during intercourse

Tests & Exams

Some tests are performed by primary care providers or OB/GYNs as part of routine screenings, while others are done after receiving abnormal results to learn more.

  • Pap test
  • Pelvic exam
  • CA-125 blood test
  • BRCA test
  • Transvaginal ultrasound
  • CT scan
  • Biopsy


Staging is a measurement system based on the size of the tumor and how far it has spread in the body. Using the TNM system, all of the information from tests and examinations is then combined and assessed to determine the stage, from I (one) to IV (four). Generally, the higher the stage, the more serious the cancer.

TNM System

(Tumor – node – metastasis system)

  • T: shows how far the main tumor has spread into nearby tissue
  • N: shows whether or not the nearby lymph nodes have cancer in them
  • M: shows if the cancer has spread (or metastasized) to distant organs in the body
Stage 0
Stage I
Stage II
Stage III
Stage IV

Stage 0

If left untreated, these cells will likely become invasive ovarian cancer. This stage is also called carcinoma in situ.

Stage 0 Ovarian Cancer

Stage I

Cancer cells have formed and can be found in one or both of the ovaries or fallopian tubes.

Stage I Ovarian Cancer

Stage II

Cancer cells have spread from the ovaries to the uterus and/or other pelvic organs.

Stage II Ovarian Cancer

Stage III

Cancer has spread to the peritoneum (lining of the abdomen and organs within) and/or nearby lymph nodes.

Stage III Ovarian Cancer

Stage IV

Cancer has spread to the liver, spleen, intestines, or other organs or lymph nodes in the body.

Stage IV Ovarian Cancer


The grade of an illness refers to how the cancer cells look when compared to normal cells. The lower the number, the more cancer cells look like the normal cells. This means the cancer is less likely to spread and may be easier to treat. Grade 3 looks very different from normal cells and is likely to grow and spread faster.

Comparison of the grades of cancer

Ovarian Cancer Treatment

Treatment usually involves surgery to remove cancerous cells. Surgery can also help the care team determine the severity and spread of the cancer.

In-Office Therapies

Other Courses of Treatment

Radiation Therapy

This type of treatment uses radiation to kill cancer cells or stop them from growing. The method and dosage of radiation therapy are dependent on the extent of the cancer.


Typically, the uterus, ovaries, and fallopian tubes are removed in surgical treatment for ovarian cancer (called a hysterectomy and bilateral salpingo-oophorectomy) because there is a risk of microscopic disease in both the ovaries and uterus. However, if a woman still wishes to have children and has very early-stage ovarian cancer, the surgeon may choose to remove only the cancerous ovary and fallopian tube, removing the remaining ovary, fallopian tube, and uterus after children.

In early stages, surgery can often remove most or all of the cancerous cells. During later stages, this can become more difficult. Debulking surgeries remove as much of the cancerous tissue as possible to improve the long-term outcome, but there is a higher chance of recurrence.