Ovarian Cancer: Symptoms, Risk Factors, and Fertility Considerations
Learn the early signs, risk factors, diagnosis, and treatment options for ovarian cancer, plus fertility preservation advice.
In short: Ovarian cancer is often found late because its early symptoms are vague: bloating, feeling full quickly, frequent urination, a change in bowel habit, and loss of weight and appetite. Risk factors include older age, no children, gene mutations and endometriosis. It is diagnosed by ultrasound, MRI, blood tests and biopsy, and treated by surgery and chemotherapy, with discussion of options to preserve fertility.
Ovarian cancer is considered one of the most serious gynecological cancers because it is usually discovered at a later stage. This is largely because its early symptoms are often subtle and easy to overlook.
The symptoms are very vague, which is why the disease is usually discovered late, once it has reached more advanced stages. Being aware of these signs and discussing any concerns with your gynecologist can help support earlier evaluation.
Symptoms:
- Bloating
- Abdominal distention
- Pain
- Early satiety
- Urinary frequency
- Change in bowel habits
- Weight loss
- Loss of appetite
Risk factors:
- Nulliparity (never having given birth)
- Advanced age
- Inherited gene mutations, mainly BRCA1 and BRCA2, and Lynch syndrome (a strong family history of ovarian, breast, bowel or endometrial cancer)
- Endometriosis
- Using hormone replacement therapy
How is it diagnosed?
- History taking
- Physical examination that involves pelvic examination
- Ultrasound scan
- Complementary MRI or CT scan
- Blood tests like tumor markers
- Definitive diagnosis with histopathology after surgical resection or biopsy
How is it treated?
- Surgical resection
- Chemotherapy
- Maintenance targeted therapy after chemotherapy, such as PARP inhibitor tablets (olaparib, niraparib), especially for BRCA carriers, and bevacizumab; hormonal therapy is used only in selected tumour types
What about the prognosis?
Prognosis is usually poor because the disease tends to be diagnosed late, once it has progressed. This is why paying attention to symptoms and attending regular gynecological check-ups matters.
Does using ovulation induction medications increase the risk of ovarian cancer?
Evidence is mixed and overall reassuring. If you have concerns about fertility treatment and long-term health, it’s worth discussing your personal risk factors with your fertility specialist.
If it was caused by gene mutations, what other types of cancers might accompany it?
With BRCA mutations: breast cancer (also in men), pancreatic cancer, and prostate cancer in male relatives. With Lynch syndrome: bowel (colorectal) and endometrial cancer. Relatives may benefit from genetic counselling and testing.
Is pregnancy protective from ovarian cancer?
Yes, breastfeeding is also protective, as both inhibit monthly ovulation, preventing repeated trauma to the ovarian cortex.
Using the combined contraceptive pill for several years also lowers the risk significantly. Because many ovarian cancers actually begin in the fallopian tubes, women having a hysterectomy or sterilisation may be offered removal of the tubes to reduce their risk.
Can fertility be preserved when treating ovarian cancer?
Yes, in selected cases. If the cancer is at an early stage and of a favourable type, surgeons can remove only the affected ovary and tube while keeping the uterus and the other ovary. Freezing eggs, embryos or ovarian tissue before chemotherapy may also be possible. Fertility preservation options should be discussed as early as possible with your care team.
How this fertility-preservation option works is explained in our guide to egg freezing.
Can we screen for the disease?
Unfortunately, no
Women known to carry a BRCA gene mutation or Lynch syndrome should see a specialist, because removing the tubes and ovaries after completing their family (usually around age 35-45) greatly reduces their risk. — there is currently no reliable screening test, so the disease cannot be prevented through routine screening alone. This makes awareness of symptoms and regular gynecological care especially important.
If you have questions about your gynecological health, symptoms, or fertility preservation options, Dr. Najeeb Layyous and his clinic team are available to guide you through evaluation and care.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
We’re grateful for dealing with such a physician — he’s very caring and deals with each case separately. We would’ve loved to spend more time with him, however he was never in a hurry during our given time.