Ovarian Cancer

The symptoms of ovarian cancer can be vague and seem a bit like some other conditions.  There are a number of symptoms to look out for, including:

• bloating in the belly or increased size around your belly
• feeling full quickly or not feeling like eating
• pain in the belly or in the pelvis
• change in toilet habits, such as constipation or feeling like you need to wee more frequently
• feeling very tired
• putting on or losing weight for no reason.

If you have any of these problems, especially if they are unusual for you or persistent, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

There is no screening test for ovarian cancer.
 

You won’t know if you have ovarian cancer until your doctor has yarned with you, completed a physical examination and done some tests. 

The tests might include:

• an ultrasound, like you might have had when pregnant, except that the doctor puts a probe inside your vagina to do it
• blood tests 
• imaging tests like an ultrasound, a CT scan or MRI scan to see what your insides look like.
• a biopsy, where a tiny bit of the tumour is taken out, and they look at it with a microscope. 

Most women who have these tests find out they don’t have cancer, but it’s important to check.
 

Most ovarian cancers are epithelial ovarian cancer, which starts in the epithelial cells, the outer layer of the ovary. Many epithelial ovarian cancers start in the fallopian tubes, which connect the ovaries to the womb (uterus). 

Epithelial ovarian cancer is more common in women over 50 years of age. 

Other types of ovarian cancer include borderline ovarian cancer, which tends to affect younger women, and ovarian germ cell tumours and stromal tumours which are both very rare.

Advanced (metastatic) ovarian cancer means that cancer cells have spread in the bloodstream or lymphatic system to other areas of the pelvis, or to tissues and organs outside the pelvis.

With all types of ovarian cancer, there is plenty of treatment and support that can help you.

Read about types of ovarian cancer.
 

If you have ovarian cancer, you might be told it’s at a certain stage. This describes whether or not the cancer has spread to other parts of the body, and how far. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.

• Stage 1: The cancer is only in one or both ovaries and has not spread.
• Stage 2: The cancer is in one or both ovaries and has spread to nearby organs in the pelvis such as uterus (womb), fallopian tubes, bladder and bowel.
• Stage 3: The cancer has spread to outside the pelvis to other parts of the abdomen or nearby lymph nodes.
• Stage 4: The cancer has spread to other parts of the body beyond the pelvis and abdomen, such as the lungs or liver – this is also known as metastatic cancer. 

With all stages of ovarian cancer, there are options of treatment and support that can help you. 
 

There are a number of different ways to treat ovarian cancer. 

Your doctors will yarn with you about what treatments they recommend and what your options are best for you. 

Most women have surgery. Some have radiotherapy, chemotherapy or hormone therapy as well. You might need one of these, or a combination of them. 

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have.

Surgery

Surgery is a procedure done to remove the cancer and help to stop it from spreading to other parts of your body. Having surgery involves staying in hospital and having an anaesthetic (so that you are asleep during the operation) and an operation. 

Depending on how far the cancer has spread, the surgery may remove the ovary and nearby pelvic organs too such as fallopian tubes and womb. If the cancer has spread outside the pelvis, other tissues and organs may need to be removed as well, including lymph nodes. 

Sometimes the surgery is done through a cut in your belly. Sometimes it can be done as keyhole surgery. 

Surgery for ovarian cancer affects your ability to have children (fertility) and may lead to menopause. Yarn with your doctor or Aboriginal and/or Torres Strait Islander health worker. 

Read more about surgery.

Radiotherapy

Radiotherapy (or radiation therapy) uses X-rays to destroy cancer cells in one part of your body. It is not used commonly in ovarian cancer but can be used to relieve symptoms if the cancer has grown or is not able to be removed surgically.

Most people who have radiotherapy have it 5 days a week for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks you need radiotherapy and you don’t live near a radiotherapy site, assistance is available for travel and accommodation for you and your family.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker. 

Read more about radiotherapy.
 

Chemotherapy

Chemotherapy or ‘chemo’ involves you taking strong drugs to kill the cancer cells. 

Many people have chemo in cycles – such as one day every three weeks, or once a week. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.

Most chemo comes as injections into your arm or hand that drip in over a few hours and some need you to take home a small bottle home for two days then come back to take it off again. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Most women with ovarian cancer will have surgery and then chemotherapy after their operation to get rid of any cancer that might remain after surgery.

Chemo can make people feel sick for a while, but there are things they can do and take to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker. Mob who have had chemo say that traditional healing, bush medicines, Women’s Business, being on Country and cultural practices help with managing the side effects of chemo.

Read more about chemotherapy and side effects.

Targeted therapies

Targeted therapies are newer drugs that try to stop the cancer growing. They are usually in the form of tablets that you can take at home.  

Targeted therapy is usually used in combination with other treatments, such as radiation therapy, chemotherapy or surgery. 

If your doctor thinks they might help, here are some questions to ask.

Read more about targeted therapy.

Hormone therapy

Some types of ovarian cancer depend on the hormones in your body. If you have this type of cancer, then your doctor might suggest drugs to affect your body’s hormones. It can slow, and maybe stop, the growth of the cancer. 

Hormone therapy usually means that you take tablets every day for months or years. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker. 

Read about the types of hormone therapy and possible side effects.
 

Effect on fertility

If you haven’t had menopause, some of these treatments will affect your ability to have children. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker about this. 
 

It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or
• won’t cure you, but is meant to prolong your life, or make your feel better

Your doctors will talk to you and explain this. You can yarn with them and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or may not want to leave Country for treatment, or don’t want any treatment at all. It’s your choice. You can also talk to another doctor to help you decide.
 

It can take time to decide about treatment. There are usually some options to hear about and choices to make. Read more about treatment.

It can be helpful to write things down, and have someone else come to appointments to help remember information.

Talk to your doctor, specialist nurse or Aboriginal and/or Torres Strait Islander Health Worker.

Other mob who have had cancer say that yarning with trusted family, friends and Elders helps.

Read more about treatment. 
 

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some may not be. Ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time.

After treatment is finished, your doctors will keep in touch with you to check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.
 

It is not possible to say what causes ovarian cancer in a single person. We do know there are some features that are more common in women who develop ovarian cancer. These features are called ”risk factors”. 

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for ovarian cancer does not mean that a woman will develop this cancer. In fact, many women who have ovarian cancer have no obvious risk factors.

Risk factors for ovarian cancer include:

• getting older
• never having children
• having a family history of ovarian, breast or colon cancer
• inheriting a gene fault, such as BRCA1 or BRCA2, from either parent
• some medical conditions such as endometriosis
• use of hormone replacement therapy (HRT) 
• being overweight
• tobacco smoking.

If you have any of these risk factors or you’re worried about your risk for ovarian cancer, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.
 

Clinical trials might be an option for you. Yarn with your doctor to help you decide if taking part is a good option. Read more about clinical trials. 

Read more detail on ovarian cancer here.