If you are reading this, chances are you, or someone close to you, has felt that nagging worry. A bloated stomach that won't settle. A strange ache in the pelvis. A doctor's appointment that did not bring the answers you hoped for. Ovarian cancer is one of those conditions that quietly hides behind everyday symptoms, which is exactly why it deserves your attention.
In India, around 47,000 new cases of ovarian cancer are reported each year, making it the third most common cancer affecting Indian women after breast and cervical cancer. The good news? When picked up early, it is highly treatable. Let us sit down and talk through it the way we would in a clinic, simply, clearly, and without scaring you.
What Is Ovarian Cancer?
Ovarian cancer is a disease where the cells in your ovaries, the two small almond-shaped organs that produce eggs and hormones, start growing in an uncontrolled way. These rogue cells eventually form a tumour. An ovarian cancer tumour can stay confined to the ovary, or it can spread to nearby organs like the uterus, fallopian tubes, or even further.
Many women confuse it with uterus cancer. Both affect the female reproductive system, but they begin in different places. Uterus cancer (also called endometrial cancer) starts in the lining of the uterus, while ovarian cancer begins in the ovaries themselves.
What Are the Different Types of Ovarian Cancer?
Not all ovarian cancers behave the same way. Doctors classify them based on the type of cell where the cancer begins. Knowing the type matters because each one responds differently to treatment.
Among the types of ovarian cancer, epithelial ovarian cancer is by far the most common, especially in women over 50.
What Are the Symptoms and Signs of Ovarian Cancer?
Here is the tricky part. The symptoms and signs of ovarian cancer often feel like everyday tummy troubles. That is why it is sometimes called the "silent killer". But it is not really silent, it just whispers, and we are often too busy to listen.
If you notice any of the following on most days for more than two to three weeks, please do not brush them off:
A persistent feeling of bloating or a swollen tummy that does not go down. Pain in the lower belly or pelvis. Feeling full very quickly even after a small meal. Frequent urge to urinate. Unexplained tiredness. Changes in your bowel habits, like constipation. Unintended weight loss or weight gain around the abdomen. Pain during intercourse. Irregular periods or bleeding after menopause.
Many women in our country dismiss these as gas, indigestion, or "stress". I have had patients tell me, "Doctor, I just thought I was eating too much rajma." If a symptom does not settle within a couple of weeks, it deserves a check-up.
The ovarian cancer symptoms in advanced stages can include severe abdominal swelling due to fluid buildup (called ascites), back pain, and shortness of breath. The earlier you catch it, the better.
What Causes Ovarian Cancer?
Honestly, we still do not fully understand the exact causes of ovarian cancer. What we do know is that something triggers normal ovarian cells to mutate and multiply uncontrollably. Several factors raise your risk.
Family history plays a big role. If your mother, sister, or daughter has had ovarian, breast, or colon cancer, your risk goes up. Inherited gene mutations like BRCA1 and BRCA2 are well-known culprits. Around 10 to 15% of ovarian cancers are linked to these gene changes. Women with a strong family history may benefit from a Comprehensive Hereditary Cancer Panel, which screens for multiple cancer-linked gene mutations in a single test.
Age is another factor. Most ovarian cancers are diagnosed in women between 55 and 64 years. Hormonal factors matter too, women who started periods early, reached menopause late, never had children, or used hormone replacement therapy for a long time, carry a slightly higher risk.
Other contributors include obesity, endometriosis, and a personal history of breast cancer. Smoking and exposure to certain chemicals like talc (in some cases) have also been studied as possible triggers.
Who Is at Higher Risk of Developing Ovarian Cancer?
You may be at greater risk if you tick any of the boxes below. This does not mean you will definitely get cancer. It just means you should be more vigilant.
Women over 50, especially those past menopause. Women with a family history of ovarian, breast, or colorectal cancer. Carriers of BRCA1, BRCA2, or Lynch syndrome gene mutations. Women who have never been pregnant. Women undergoing prolonged hormone replacement therapy. Women with conditions like endometriosis or polycystic ovary syndrome.
If two or more of these apply to you, please speak to your doctor about regular screening.
How Is Ovarian Cancer Diagnosed?
There is no single test that confirms ovarian cancer in one go. The ovarian cancer diagnosis is usually a step-by-step process where your doctor pieces together clues from different tests. In cases where ascites (abdominal fluid build-up) is present, doctors often recommend a CA-125 Fluid test to detect tumour markers directly in the fluid sample for added diagnostic clarity.
It typically starts with a detailed history and a pelvic examination. Your doctor will gently press on your abdomen and check for any lumps. From there, the journey usually moves through these stages.
Diagnostic Test & What It Does
Transvaginal ultrasound (TVS):
Uses sound waves to look at the ovaries and pelvis
CA-125 blood test
Measures a protein often raised in ovarian cancer
HE4 blood test
A newer marker, used along with CA-125
CT or MRI scan
Shows the size, spread, and location of the tumour
PET scan
Checks if cancer has spread to other organs
Biopsy
The only way to confirm cancer, by examining tissue under a microscope
At Unipath, our diagnostic team often combines imaging with tumour marker tests such as the HE4 (ROMA Index) test along with CA-125 to give your doctor a complete picture. HE4 is particularly useful in distinguishing benign pelvic masses from malignant ones, which adds an important layer of accuracy to the diagnosis. A reliable lab makes a real difference at this stage.
What Are the Stages of Ovarian Cancer?
Once cancer is confirmed, doctors "stage" it. This simply means figuring out how far it has spread. Staging helps decide the right treatment plan.
Stage & What It Means
Stage 1:
Cancer is limited to one or both ovaries
Stage 2:
Cancer has spread to the uterus, fallopian tubes, or other pelvic organs
Stage 3:
Cancer has reached the abdominal lining or lymph nodes
Stage 4:
Cancer has spread to distant organs like the liver or lungs
Early stages have a much higher survival rate. According to the American Cancer Society, the 5-year survival rate for Stage 1 ovarian cancer is around 93%, while Stage 4 drops to roughly 31%.
How Is Ovarian Cancer Treated?
Ovarian cancer treatment depends on the type, stage, your overall health, and whether you wish to preserve fertility. Most treatment plans combine two or more approaches.
Surgery is usually the first step. The surgeon may remove one ovary (in early-stage younger patients), both ovaries, the uterus, fallopian tubes, and nearby lymph nodes if needed. Chemotherapy is then often given to kill any remaining cancer cells. Drugs like carboplatin and paclitaxel are commonly used in India.
Newer therapies have changed the landscape. Targeted therapy uses drugs like PARP inhibitors that specifically attack cancer cells with BRCA mutations. Immunotherapy boosts your own immune system to fight cancer. Hormone therapy is sometimes used in stromal tumours.
Radiation therapy is less common but may be used in specific cases. Most importantly, every treatment plan should be tailored to you. There is no one-size-fits-all approach.
How Can You Lower Your Risk of Ovarian Cancer?
There is no foolproof way to prevent ovarian cancer, but you can certainly reduce your risk. Small lifestyle changes go a long way.
Eat a balanced diet rich in fruits, vegetables, and whole grains. Keep your weight in a healthy range. Stay physically active for at least 30 minutes most days. If you have a family history, consider genetic counselling. Discuss the long-term use of oral contraceptives with your doctor, studies show they may lower ovarian cancer risk by up to 50% with five years of use. Breastfeeding has also shown protective benefits.
If your risk is very high, your doctor may discuss preventive surgery (called risk-reducing salpingo-oophorectomy) where the ovaries and fallopian tubes are removed.
Also Read: What Is Cervical Cancer? Know the Causes and Early Signs
When Should You See a Doctor?
If you have any of the symptoms we spoke about, lasting more than two to three weeks, please do not wait. Especially if you are over 40, post-menopausal, or have a family history of cancer, an early consultation could be life-saving.
Annual pelvic check-ups, ultrasound, and CA-125 testing for high-risk women can catch the disease at its most curable stage.
A Final Word from Us
Ovarian cancer can feel terrifying when you first hear the diagnosis. But please remember, you are not alone, and you are not without options. Early detection saves lives. Listen to your body, trust your instincts, and never feel shy about asking your doctor questions, even the silly ones.
At Unipath, we believe accurate diagnosis is the first step towards better outcomes. If something feels off, get it checked. Your peace of mind is worth it.
Unipath Diagnostic Services: Serviceable Cities
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References & Citations
Cleveland Clinic. Ovarian Cancer: Symptoms, Diagnosis & Treatments
Mayo Clinic. Ovarian cancer - Symptoms and causes
American Cancer Society. Survival Rates for Ovarian Cancer
National Cancer Institute. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ).
Maheshwari A, et al. Gynecological cancers: A summary of published Indian data. South Asian Journal of Cancer. 2016
World Health Organization. Cancer Country Profile - India
Indian Council of Medical Research (ICMR). National Cancer Registry Programme Report