Listening to your body and being aware of individual risks are especially important when it comes to ovarian cancer.
As a woman, you’re most likely aware of ovarian cancer, but you’re unlikely to think that 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 what is considered by medical experts to be the deadliest gynecological cancer for women.
To help create awareness and understanding, let’s discuss the myths versus the facts of ovarian cancer, important advances 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?
It was previously thought of as a silent disease because it is typically diagnosed in the late stages of disease when most symptoms appear. On the other hand, if detected early, most can be cured — but early disease is usually asymptomatic.
What are the symptoms of ovarian cancer?
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 due to other causes. However, if the symptoms persist over weeks, we recommend 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 a patient’s symptoms, and sometimes by examination of a large abdominal mass, but often it is diagnosed on imaging with a transvaginal ultrasound or CT scan after the patient develops symptoms. The diagnosis is confirmed by biopsy or surgical resection. To date, we do not have an effective method of screening.
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, but it should not be used in isolation as the protein can be elevated in women with noncancerous conditions, as well. More research is needed, and progress is being made: A recent study led by Dr. Arthur Fleischer at Vanderbilt University Medical Center was proof a principle that fallopian tubes can be imaged and characterized using ultrasound for screening purposes. And in the Department of Engineering, Dr. Todd Giorgio is developing nanoparticles that bind to proteins on the surface of cancers both to increase the ability to detect early cancers by ultrasound and to treat those cancers.
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 its risk. In contrast, infertility 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 predispose women to developing ovarian cancer.
There is something called hereditary breast and ovarian cancer syndrome, although there are some with a family history of just breast cancer or just ovarian cancer who are at higher risk. We’ve known for a very long time that women who were at higher risk for developing ovarian cancer include those who have the mutations in BRCA1 and BRCA2. Insurance does cover testing, but it’s important to seek specialty care for this.
Any provider can order these labs. Vanderbilt Health, however, offers multi-disciplinary teams that include highly trained genetics counselors who perform critical counseling to the patient that accompanies the testing. This important because genetic tests have implications for an entire family.
Why is the mortality rate so high?
It’s the leading cause of gynecologic cancer death in the U.S. The high mortality rate is due to the fact that it is typically diagnosed only once it has become widespread within the peritoneal cavity. If diagnosed early, at stage 1, most ovarian cancers can be cured.
Most symptoms that are usually associated with this type of cancer are 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 treatment therapies available now, either new or otherwise?
Treatment of ovarian cancer combines aggressive surgery to remove as much tumor as possible and chemotherapy. Depending on the extent of the cancer, sometimes the surgery is performed first followed by six cycles of chemotherapy. Other patients may receive chemotherapy first to shrink the cancer and make it more amenable to surgical resection, followed by additional chemotherapy to clean up any cancer that may be left behind. Another form of chemotherapy, for which Vanderbilt is involved in a national trial, administers heated chemotherapy into the peritoneal cavity at the time of surgery.
In recent years, new types of therapies have become available. Patients with BRCA1 and BRCA2 mutations may benefit from maintenance therapy with PARP inhibitors. An exciting area of research is antibody-drug conjugates (ADCs), which target a protein on the surface of the ovarian cancer cell. The ADC is taken into the cancer cell, where it releases its chemotherapy drug payload.
There are many types; one type, a low-grade serous carcinoma, typically responds poorly to conventional chemotherapy and medication. In May 2025, the FDA approved a two-drug combination — avutometinib and defactinib — specifically for patients with these carcinomas that have a mutation in the protein KRAS.
This is an important reason why all women with advanced-stage ovarian cancer should undergo both genetic and tumor testing to see if they might be among the women who might benefit most from these medications.
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, and has a large portfolio of clinical trials for people diagnosed with all types of cancer, including ovarian. Several clinical trials exist for primary therapies and for patients with recurrent ovarian cancer.
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 learn about individual risk, which includes understanding and awareness of her family history. Personal history of infertility and not bearing children are risk factors. Pregnancy and use of oral contraceptive pills decrease the risk.
It is important for women to listen to their bodies for symptoms, such as bloating, abdominal swelling and pain, difficulties eating or feeling full quickly. If the symptoms last for more than a few weeks it is important to seek evaluation by a gynecologist.
all women with advanced-stage ovarian cancer should undergo both genetic and tumor testing to see if they might be among the women who might benefit most from these medications.
Unfortunately, there is no effective screening test. More research is urgently needed. If a woman develops symptoms that persist and her gynecologist or other provider considers that ovarian cancer is a possibility, it is important to seek care from a gynecologic oncologist, a specialist in this area.
Expert care
- The Vanderbilt-Ingram Cancer Center is a national leader in patient care and research. Vanderbilt offers the region’s most complete range of oncology care, from advanced imaging to team-based treatment options to genetic cancer medicine and the latest in therapies being studied in clinical trials. Learn more here or call for an appointment: 615-936-8422 or toll-free 877-936-8422.
- Need to find a gynecologist or just have more women’s health questions? Visit the Vanderbilt Center for Women’s Health or call 615-343-5700 for more information.
