Ovarian cancer starts in the cells of the ovaries
Ovarian cancer begins when cells in one or both ovaries grow in an abnormal way and multiply without control. The ovaries are two small organs on either side of the uterus that produce eggs and hormones. When normal cells start dividing faster than they should and don't die off as they normally would, a tumor forms. This tumor can stay in the ovary, spread to nearby organs, or travel through the bloodstream and lymph system to distant parts of the body.
Most ovarian cancers are epithelial tumors, meaning they start in the thin layer of tissue covering the ovary. Other types include germ cell tumors (which develop from the cells that make eggs) and stromal tumors (which form in the tissue that holds the ovary together). The type matters because it affects how the cancer behaves and how it is treated.
Ovarian cancer is often called a "silent" cancer because early stages may cause no symptoms at all, or symptoms so mild they are mistaken for other conditions. By the time many people are diagnosed, the cancer has already spread beyond the ovary. This is why understanding the signs and risk factors matters—it can help you recognize when something warrants a medical evaluation.
Key Takeaways
- Ovarian cancer develops when cells in the ovary multiply abnormally and form a tumor that can spread to other parts of the body.
- Epithelial tumors are the most common type, but germ cell and stromal tumors also occur and behave differently.
- Early ovarian cancer often has no symptoms, which is why awareness of risk factors and subtle changes is important.
- Symptoms that last more than a few weeks—such as bloating, pelvic pain, or changes in appetite—warrant a conversation with a doctor.
- Family history of ovarian or breast cancer, age over 50, and certain genetic mutations increase the risk.
How ovarian cancer spreads
Ovarian cancer spreads in stages. Stage 1 means the cancer is confined to one or both ovaries. Stage 2 means it has spread to nearby organs like the uterus or fallopian tubes. Stage 3 indicates spread to the lining of the abdomen or lymph nodes in the abdomen. Stage 4 means it has reached distant organs such as the liver, lungs, or brain.
The cancer can spread in three ways: directly into surrounding tissue, through the lymph system (which drains fluid from organs), or through the bloodstream. In ovarian cancer, cells often shed into the fluid that fills the abdomen, allowing them to implant on the peritoneum (the lining of the abdominal cavity) or on other organs. This pattern of spread is one reason why ovarian cancer is frequently diagnosed at a later stage.
Symptoms that may appear
Early ovarian cancer may cause no symptoms, or symptoms so vague they are easy to overlook. As the cancer grows, symptoms may include persistent bloating, pelvic or abdominal pain, feeling full quickly when eating, urinary urgency or frequency, and changes in bowel habits. Some people experience fatigue, back pain, or pain during intercourse.
The key word is persistent. Bloating and digestive changes happen to everyone occasionally. But if these symptoms last more than two or three weeks, occur most days, or are new and different from your normal pattern, they warrant a conversation with your doctor. Bring a list of what you have noticed, when it started, and how often it happens. This information helps your doctor decide whether further evaluation is needed.
Risk factors that increase your chances
Age is a significant risk factor—ovarian cancer is more common after age 50, though it can occur at any age. Family history matters: if a close relative (mother, sister, or daughter) had ovarian cancer, breast cancer, or colon cancer, your risk is higher. Certain genetic mutations, particularly in the BRCA1 and BRCA2 genes, substantially increase the risk of ovarian cancer.
Other factors include never having been pregnant, endometriosis, obesity, and long-term use of hormone replacement therapy. Having a personal history of breast cancer also raises the risk. If you have multiple risk factors or a family history of cancer, your doctor may recommend genetic testing or more frequent screening, though routine screening for ovarian cancer is not standard for people without symptoms.
How ovarian cancer is found
Ovarian cancer is usually found through a combination of a pelvic exam, imaging, and blood tests. During a pelvic exam, your doctor feels the ovaries and surrounding organs for lumps or abnormalities. If something seems unusual, an ultrasound (usually transvaginal, meaning the probe is inserted into the vagina) creates detailed images of the ovaries.
A blood test may measure a protein called CA-125, which is often elevated in ovarian cancer, though it can also be high in benign conditions. If imaging and blood work suggest cancer, a biopsy—removing a small sample of tissue to examine under a microscope—confirms the diagnosis. Sometimes the diagnosis is made during surgery when a doctor is investigating an abnormal mass.
What happens after diagnosis
Once ovarian cancer is diagnosed, staging tests determine how far it has spread. These may include a CT scan of the abdomen and pelvis, chest X-ray, or other imaging. Staging guides treatment decisions and helps predict outcomes. Most people with ovarian cancer receive surgery to remove the tumor and affected tissue, often followed by chemotherapy to kill remaining cancer cells.
Treatment plans are individualized based on the stage, type, and grade of the cancer, as well as your overall health and preferences. Your doctor will explain the goals of treatment—whether it is to cure the cancer, slow its growth, or manage symptoms—and discuss what to expect from each step. Support from oncologists, nurses, social workers, and support groups becomes part of your care journey.
The difference between ovarian cancer and other pelvic cancers
Ovarian cancer is distinct from uterine cancer (which starts in the lining of the uterus) and cervical cancer (which starts in the cervix). Each arises from different tissue, behaves differently, and is treated differently. Ovarian cancer is also different from metastatic cancer that has spread to the ovary from somewhere else—for example, colon cancer that has spread to the ovary is treated as colon cancer, not ovarian cancer.
Understanding which type of cancer you or a loved one has is important because it determines the specific treatment approach. Your pathology report will specify the exact type and origin of the cancer, which your doctor will use to plan care.
Frequently Asked Questions
Can you feel ovarian cancer yourself?
In early stages, no—the ovaries are deep inside the abdomen and small tumors cannot be felt from outside. As cancer grows, you might notice abdominal swelling or feel a mass during a pelvic exam by a doctor, but self-detection is not reliable. This is why persistent symptoms warrant medical evaluation rather than waiting to feel something yourself.
Is ovarian cancer hereditary?
Some ovarian cancers run in families, particularly those linked to BRCA1 and BRCA2 mutations. However, most ovarian cancers are not hereditary. If you have a family history of ovarian or breast cancer, genetic counseling can help you understand your personal risk and whether testing makes sense for you.
What is the difference between a cyst and ovarian cancer?
Ovarian cysts are fluid-filled sacs that are very common and usually harmless. They often go away on their own. Ovarian cancer is a solid tumor of abnormal cells. Imaging tests can usually distinguish between them, but sometimes a doctor needs to monitor a cyst over time or perform a biopsy to be certain.
Can ovarian cancer be prevented?
There is no may provide way to prevent ovarian cancer. However, certain factors lower risk: pregnancy and breastfeeding, use of birth control pills, and removal of the ovaries and fallopian tubes in people at very high genetic risk. Maintaining a healthy weight and regular exercise may also help, though they do not eliminate risk entirely.
What should I do if I have symptoms?
Schedule an appointment with your primary care doctor or gynecologist. Describe your symptoms in detail, including when they started and how often they occur. Your doctor will perform an exam and decide whether further testing is needed. Most persistent abdominal symptoms are not cancer, but they deserve evaluation to find out what is causing them.