Ovarian Cancer Awareness Month – What you need to know

Held each February to raise awareness of the signs and symptoms of ovarian cancer, as well as share stories of real women affected by the disease, the focus is to highlight the risk factors and educate Australians about ovarian cancer diagnosis and treatment.


What is ovarian cancer?

To those who have never heard of it before, it is when abnormal cells in the ovary begin to multiply rapidly and form a tumour. There are different types of ovarian cancer, each just as worse than the last.

Type of Ovarian Tumours and Cancers                                                           Description
Epithelial tumours


About 90 percent of ovarian cancers develop in the epithelium, the thin layer of tissue that covers the ovaries. This form of cancer generally occurs in postmenopausal women.


Germ cell carcinoma tumours


Making up about five percent of ovarian cancer cases, this type begins in the cells that form eggs. While this type of cancer can occur in women of any age, it tends to be found most often in women in their early 20s. Six main kinds of germ cell carcinoma exist, but the three most common types are: teratomas, dysgerminomas and endodermal sinus tumours.

Many tumours that arise in the germ cells are benign.


Stromal carcinoma tumours


This type of ovarian cancer accounts for about five percent of ovarian cancer cases. It develops in the connective tissue cells that hold the ovary together and those that produce the female hormones oestrogen and progesterone. The two most common types are granulosa cell tumours and sertoli-leydig cell tumours. Unlike epithelial ovarian carcinoma, 70 percent of stromal carcinoma cases are diagnosed in Stage I.


Small cell carcinoma of the ovary


Also known as SCCO, this cancer is a rare, highly malignant tumour that affects mainly young women, with the median age at diagnosis of 24 years old. The subtypes of SCCO include pulmonary, neuro-endocrine and hypercalcemic. SCCO counts for 0.1 percent of ovarian cancer cases. Approximately two-thirds of patients with SCCO have hypercalcemia.

The symptoms are the same as the other types of ovarian cancer.

Table 1: Types of Ovarian Cancer

Credit: ocrfa.org


Symptoms of ovarian cancer

So now that we know more about ovarian cancer and its different types, what should you look for in case you feel you or someone you love might have it?

Note: These are symptoms only, please check with your GP. These symptoms can occur with other conditions and it’s better to seek professional advice rather than worry yourself sick.

10 signs of ovarian cancer

Women who are diagnosed with ovarian cancer report four types of symptoms most frequently:

  • Abdominal or pelvic pain
  • Increased abdominal size or persistent abdominal bloating
  • Needing to urinate often or urgently
  • Feeling full after eating a small amount

There are also possible symptoms to be aware of:

  • Changes in bowel habits
  • Unexplained weight loss or gain
  • Bleeding in-between periods or after menopause
  • Indigestion or nausea
  • Excessive fatigue
  • Pain during intercourse

Understand the risks

Research has shown that certain risk factors increase the likelihood that a woman may develop ovarian cancer, while other factors may decrease the probability..

Having risk factors does not predict you will get ovarian cancer. Some women who develop ovarian cancer have no known risk factor, and most women with risk factors don’t. However, if you think you are at risk for ovarian cancer, discuss any concerns with your doctor.

Factors that may increase risk:

  • Age

Ovarian cancer is most common in women over 50, in women who have stopped menstruating, and the risk increases with age. However, ovarian cancer can affect women of all ages.

  • Genetics: BRCA1 and BRCA2

Approximately 10 to 40 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. The most significant genetic risk factor for ovarian cancer is an inherited genetic mutation in one of two genes: breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2).

These genes are linked to both breast and ovarian cancer.

Remember that regardless of heritability, the wonderful world of epigenetics offers hope. While you may have a gene, your lifestyle can help to turn its expression on or off. This is why lifestyle is so important.

  • Lifestyle factors

Such as smoking tobacco, being overweight or certain dietary choices. For example, in a study published in the Journal of the National Cancer Institute, it was noted that risk increased with:

“Significantly elevated frequency of consumption of meat (more than seven servings per week), specifically ham (more than four servings per week), and higher subjective scores of fat intake, particularly butter.”

  • Endometriosis

This painful condition is when the tissue lining the uterus (endometrium) is also found outside of the uterus. You can find out more at Jean Hailes here.

  • Child-bearing history

Women who have not had children, have never used oral contraceptives, have had children while over the age of 30, may be slightly more at risk. This is due to the ovaries not having a “rest” from the break and repair of the surface of the ovary when women ovulate each month.



Stages of Ovarian Cancer

There are a total of four stages in ovarian cancer, which is then divided into subgroups. Doctors use a simple 1 to 4 staging system for ovarian cancer. It’s called the FIGO system after its authors – the International Federation of Gynaecological Oncologists.

  • Stage 1

Stage 1 ovarian cancer means the cancer is only in the ovaries. This is divided into three groups:

Stage 1a The cancer is completely in one ovary
Stage 1b The cancer is completely in both ovaries
Stage 1c As well as cancer in one or both ovaries, there is some cancer on the surface of an ovary, there are cancer cells in fluid taken from inside your abdomen during surgery, or the ovary ruptures (bursts) before or during surgery

Table 2: Stage 1 Ovarian Cancer

Credit: cancerresearchuk.org

  • Stage 2

Stage 2 ovarian cancer means the cancer has grown outside the ovary or ovaries, and is growing within the pelvis. There may be cancer cells in the abdomen. It is divided into three groups:

Stage 2a The cancer has grown into the fallopian tubes or the womb
Stage 2b The cancer has grown into other tissues in the pelvis, for example the bladder or rectum
Stage 2c The cancer has grown into other tissues in the pelvis and there are cancer cells in fluid taken from inside your abdomen

Table 3: Stage 2 Ovarian Cancer

Credit: cancerresearchuk.org

  • Stage 3

Stage 3 ovarian cancer means the cancer has spread outside the pelvis into the abdominal cavity. The cancer is also stage 3 if cancer is found in the lymph nodes in your upper abdomen, groin or behind the womb. It is divided to three groups:

Stage 3a Cancer growths are found in tissue samples taken from the lining of the abdomen
Stage 3b There are cancer growths that are 2cm or smaller in size on the lining of the abdomen
Stage 3c Cancer growths larger than 2cm are found on the lining of the abdomen, OR cancer is found in lymph nodes in the upper abdomen, groin and/or behind the womb

                             Table 4: Stage 1 Ovarian Cancer

Credit: cancerresearchuk.org

  • Stage 4

Stage 4 ovarian cancer means the cancer has spread to other body organs some distance away from the ovaries, such as the liver or lungs. This is divided into two groups:

Stage 4a The cancer has caused a build-up of fluid in the lining of the lungs (called the pleura). This is called a pleural effusion.
Stage 4b The cancer has spread to the inside of the liver or spleen, to the lymph nodes in the groin or outside the abdomen and/or to other organs such as the lungs.

Table 5: Stage 1 Ovarian Cancer

Credit: cancerresearchuk.org


Treatment for ovarian cancer traditionally involves a combination of surgery and chemotherapy. Less often, treatment may include radiotherapy. The type of treatment given depends on the type and stage of their ovarian cancer and the sufferers’ general health.

The goal of mainstream treatment for ovarian cancer is often to surgically remove as much of the cancer as possible.

  • Surgery

During surgery, doctors attempt to remove all visible tumours. Women whose surgery is performed by gynaecologic oncologist may have better outcomes than patients whose surgeons are not oncologists, including improved survival and longer disease-free intervals.

  • Chemotherapy

The purpose of chemotherapy is to attack remaining cancer cells and slow down or halt their growth. Because chemotherapy can also damage healthy cells, it can cause a range of side effects

  • Radiotherapy

Radiotherapy may also be used as a treatment option for ovarian cancer. Radiotherapy may be used where cancer is confined to the pelvic cavity. It may also be used in advanced ovarian cancer to reduce the size of the cancer and help to relieve symptoms.

Radiotherapy is a treatment where special x-rays are aimed at the specific cancer site. The x-rays damage the DNA or genetic code in the cancer cells and to kill the cancer cells and stop multiplication. Treatment can be external or internal and is given daily over a number of weeks.

  • Other drugs

Other drugs, including angiogenesis inhibitors and targeted therapies, may be recommended either in conjunction with chemotherapy or as single agents. These drugs may have very different side effects than chemotherapies and may be useful only for specific populations.

There are also important natural health adjuncts or alternatives to cancer treatment. To find a health professional who specialises in this field, visit ACNEM.org I have studied with this incredible organisation and highly recommend anyone with health challenges to consider alternative support. You can locate a practitioner who specialises in cancer support on the ‘find a practitioner’ page here.


Ovarian cancer, unfortunately, is still one of the deadliest of women’s cancer, and this hasn’t changed in the past 30 years.

This 2018, Ovarian Cancer Awareness Month is about taking action.

“But what can I do to help?” you may ask. There are a handful of ways to take action during the month, and even beyond:

  • Learn the about the symptoms
  • Create a fundraising event for everyone to join in and learn more
  • Donate to well-established organisations
  • Volunteer at centres geared towards ovarian cancer support

These are just some of the things we can do to slow, down and in the longer term, hopefully eradicate ovarian cancer once and for all!

Dr. Rebecca Harwin
Chiropractor & Multi-book Author

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