Listening to your body and being aware of your risk are especially important.
As a woman, you’ve probably heard of ovarian cancer, but haven’t thought much about it. It’s easy not to — we’ve been taught that it’s the “silent killer,” rarely diagnosed until it’s too late for effective treatment. The most we can do is hope we don’t get it, right? How common is it, anyway?
More common than you might think. An estimated one out of every 91 women will be diagnosed with ovarian cancer in her lifetime, according to the American Cancer Society. Yet there seems to be so much mystery surrounding this cancer — thought medical experts consider it the most deadly gynecological cancer.
To help with awareness and understanding, let’s discuss the myths versus facts of ovarian cancer; improvements in treatments; and how much further researchers have to go to find a cure.
Ovarian cancer is often called “silent.” Why do people think there are no symptoms?
This type of caner used to be thought of a a “silent” disease because typically it is diagnosed in its late stages, which is when most symptoms start to happen. If it is detected early, it can usually be cured — but early ovarian cancer usually doesn’t cause any symptoms.
What are the symptoms?
We now know that it’s not silent. Many women complain of symptoms such as persistent abdominal bloating and swelling, loss of appetite and feeling full easily, changes in bowel and bladder habits and irregular vaginal bleeding. The symptoms are common, and could be happening because of other things. However, if the symptoms persist over weeks, it’s wise to get a gynecologic evaluation.
What are the most effective ways to diagnose ovarian cancer?
Current methods of diagnosing ovarian cancer early are not very effective. It is typically diagnosed by its symptoms, and sometimes by examination of a large abdominal mass. However, ovarian cancer is often diagnosed by imaging, with a transvaginal ultrasound or computerized tomography (CT) scan after the patient develops symptoms. The diagnosis is confirmed with a biopsy or surgery. So far there is no effective method of screening, or routine checks to catch ovarian cancer early.
Are there ways to screen for ovarian cancer?
CA-125 is a blood test that measures a protein that is often elevated in ovarian cancer. However, diagnosing ovarian cancer should not be done with this test alone, because this protein can also be elevated in women with other, noncancerous, conditions. More research is needed, but there has been progress toward screening methods. For example, a recent study led by Dr. Arthur Fleischer at Vanderbilt University Medical Center showed that fallopian tubes can be imaged using ultrasound to check for ovarian cancer.
Are there certain risk factors or demographics more prone to ovarian cancer?
Ovarian cancer occurs most often after menopause. Some reproductive factors, such as breastfeeding and birth control pills, reduce a woman’s chances of getting ovarian cancer. Infertility, though, is associated with an increased risk. One of the risk factors is a strong family history of ovarian and breast cancer. Inherited mutations in genes such as BRCA1 and BRCA2 make women more likely to develop ovarian cancer.
There is something called hereditary breast and ovarian cancer syndrome, although some women have a family history of just breast cancer or just ovarian cancer who are at higher risk. Women at high risk for having ovarian cancer include those who have the mutations in the BRCA1 and BRCA2 genes. Insurance usually covers testing for these mutations, but it’s important to seek specialty care for this.
Any provider can order these lab tests. Vanderbilt Health offers multi-disciplinary teams that include highly trained genetics counselors who offer counseling to the patient along with the genetic testing. This important because genetic tests have implications for an entire family.
Why is the mortality rate so high?
Ovarian cancer is the leading cause of gynecologic cancer death in the U.S. The high mortality rate (death rate) is due to the fact that this cancer is typically diagnosed only after it has spread. If diagnosed early, at stage 1, most ovarian cancers can be cured.
Most symptoms usually associated with this type of cancer start when the disease is already at a stage 3 or 4. Nevertheless, women need to be aware of what those symptoms are and to seek help as early as possible.
What are some of the most effective treatments?
Treating ovarian cancer combines aggressive surgery to remove as much tumor as possible, plus chemotherapy. Depending on the extent of the cancer, sometimes the surgery is performed first, followed by chemotherapy. Sometimes chemotherapy is done first to shrink the cancer and make it easier to remove by surgery, then additional chemotherapy to address any cancer that may be left behind.
Another type of chemotherapy, administers heated chemotherapy into the peritoneal cavity at the time of surgery. Vanderbilt is involved in a national clinical trial to study this technique.
In recent years, new medications have become available. For example:
Patients with BRCA1 and BRCA2 mutations may benefit from maintenance therapy with PARP inhibitors.
Antibody-drug conjugates (ADCs) target a protein on the surface of the ovarian cancer cell. The cancer cell pulls in the drug, which releases chemotherapy into the cancer.
Different types of ovarian cancer respond differently to different medications. One type (low-grade serous carcinoma), typically does not respond well to conventional chemotherapy and medication. In May 2025, the FDA approved a two-drug combination — avutometinib and defactinib — for patients with these carcinomas that have a mutation in the protein called KRAS.
It’s important for women with advanced-stage ovarian cancer to get both genetic and tumor testing, to see which treatment is most likely to help with their type of cancer.
Does Vanderbilt have any clinical trials for patients?
Vanderbilt is a National Cancer Institute-designated Comprehensive Cancer Center, one of only a few in the country. Vanderbilt patients participate in many clinical trials for people diagnosed with all types of cancer, including ovarian.
Is there anything you can do to reduce your risk or prevent ovarian cancer?
According to the Foundation for Women’s Cancer, it is important for a woman to understand her individual risk for ovarian cancer. This includes awareness of her family history.
It is important for women to pay attention to their bodies and symptoms, such as bloating, abdominal swelling and pain, difficulties with eating or feeling full quickly. If the symptoms last for more than a few weeks, it is important to be evaluated by a gynecologist. If that doctors suspects ovarian cancer, it is important for the patient to seek care from a gynecologic oncologist, a specialist in cancers of the female reproductive system.
Expert care
The Vanderbilt Gynecologic Oncology team provides specialized care for cancers and precancers of the female reproductive system.
If you’ve been diagnosed with cancer of the uterus, cervix, fallopian tubes, ovaries, vulva or vagina, we can offer you sophisticated, compassionate care. We deliver the latest treatments, perform the most advanced procedures and care for women with even very complicated cancer diagnoses.
