Ovarian Cancer Q&A

Ask the Consultant

Three of our leading ovarian cancer specialists answer common questions on ovarian cancer including signs and symptoms, early diagnosis and effective treatments.

Prof. Gordon Rustin
Cancers that arise from the ovary, fallopian tube or lining surface of the abdomen called peritoneum. Patients frequently present with advanced disease after the cancer has spread throughout the abdomen. Only a quarter of these cancers are caught early and removed before they have spread.


Dr Anji Anand
Ovarian cancer is any cancerous growth that arises from the different parts of the ovaries. Majority of the ovarian cancers arise from the outer lining (called epithelium) of the ovary and hence are called epithelial ovarian cancers. In the UK, ovarian cancer is the 5th most common cancer among women, after breast cancer, bowel cancer, lung cancer and uterine (womb) cancer.


Mr Jafaru Abu
Ovarian cancer is the fifth most common cancer in women in the UK, affecting over 7000 women every year. It is a disease that affects the ovaries. There are usually 2 ovaries, one on either side of the womb inside the pelvis. It is a major source of the main female hormone called oestrogen. It also produces eggs which can be fertilised by sperm and then develop into a fetus. There is also a variant of ovarian cancer that behaves like ovarian cancer and the treatment for both is similar. This variant of ovarian cancer affects the lining of the inside of the abdomen and pelvis (peritoneum). It is called primary peritoneal cancer.

Prof. Gordon Rustin
Ovarian cancer is often called the silent cancer as patients do not develop symptoms until the cancer has spread. The symptoms are similar to those of irritable bowel syndrome. However a patient who develops new symptoms of bloating, swelling, change in bowel habit or abdominal pains needs investigating.


Dr Anji Anand
Symptoms of ovarian cancer are non- specific and often occur when disease is at an advanced stage. Common symptoms are fullness and bloating (often mistaken for irritable bowel syndrome), abdominal discomfort, back pain, changes in bowel habits, indigestion or heart burn, unexplained weight loss and fatigue. If any of these symptoms are persistent over a few weeks then you must see your GP for a check-up without delay.


Mr Jafaru Abu
It is wrong to say that ovarian cancer is a "silent killer". It isn't. About 95% of women with ovarian cancer do report symptoms. The only problem is that most of the symptoms are vague and could be non-gynaecological. The common symptoms are: abdominal bloating (increased girth), feeling full quickly after small meals and difficulties eating, fatigue, bowel related symptoms or change in bowel habit such as constipation and diarrhoea, urinary symptoms, abdominal/pelvic pain, and menstrual irregularities, loss of appetite and loss of weight.

Prof. Gordon Rustin
Factors such as starting periods at an early age and having no pregnancies only slightly increase the risk of developing ovarian cancer.


Dr Anji Anand
Women who have never had children, who had unsuccessful fertility treatments, or had their first child after the age of 30 have an increased risk of ovarian cancer. Also women who started menstruation early (before age of 12) and go through menopause later in life are also at risk. Advancing age, obesity, a family history of breast or ovarian cancer and taking oestrogen only hormone replacement therapy after menopause are some of the other risk factors.


Mr Jafaru Abu
There is a strong association between ovarian cancer and age. The incidence rises exponentially from 35-40, peaking at around the age of 80. In the UK, about 75% of all ovarian cancers are diagnosed in women above the age of 55. About 20% are related to some major life style patterns such as hormone replacement therapy, exposure to asbestos, tobacco smoking, irradiation, strong family history (about 3% of cases occur in those with ovarian cancer in their families), infertility, personal history of cancer and genetic factors (5-15% of ovarian cancer cases are due to inherited conditions, majority of which are due to BRCA1 and 2 mutations).

Prof. Gordon Rustin
Ovarian cancer is most common in postmenopausal women.


Dr Anji Anand
A woman's risk of developing ovarian cancer increases with age.Although ovarian cancer can develop at any age, women over the age of 55 are more likely to develop ovarian cancer. About 70% of women with ovarian cancer are older than 55 years.


Mr Jafaru Abu
75% of ovarian cancer cases occur in women above the age of 55.

Prof. Gordon Rustin
Screening is only recommended for women who have a mutation in the BRCA gene which is also associated with an increased risk of breast cancer.


Dr Anji Anand
If there is a strong family history of ovarian cancer (ie more than one member of family has ovarian cancer or even breast cancer) then you must see your GP and discuss this. You may get referred to a family history clinic or even to the specialist clinical genetics clinic. You may receive counselling and also undergo genetic testing (blood test) to establish whether there is an inherited faulty gene. (i.e BRCA1/ BRCA2)


Mr Jafaru Abu
The risk of ovarian cancer is 3 times higher in those whose mother or sister either has or has had ovarian cancer compared with women from families who have not had the disease. There is no nationwide screening for ovarian cancer. However, women who are at risk or have a family history may be offered an annual scan as well as a blood test called CA125. The latter is an ovarian cancer tumour marker and is raised in about 80% of cases. However there is no evidence so far that these tests can pick up cancer early to save lives. For instance, CA125 is only raised in about 50% of women with the early stage disease. The advice is that if you think you are at an increased risk of ovarian cancer, you should talk to your GP.

Prof. Gordon Rustin
Suspicious symptoms should prompt an ultrasound scan and measurement of CA125 in the blood in a postmenopausal woman, and HE4 in a premenopausal woman. A CT and or MRI scan may then need to be performed.A biopsy, if required, will confirm the diagnosis.


Dr Anji Anand
There is no effective screening test for ovarian cancer that we can routinely recommend. But if you have symptoms of ovarian cancer, you must see your GP without delay. He/she will examine your abdomen for any signs (swelling or mass) and may get a blood test done. The blood test checks for a protein called CA125, high levels of which could indicate ovarian cancer. An internal (trans-vaginal) ultrasound scan can show any abnormalities of the ovaries. If the blood test and ultrasound scan are abnormal, you will be referred to a specialist gynaecology unit where you may undergo further tests such as a CT scan.


Mr Jafaru Abu
If you think you have any of the symptoms of ovarian cancer you should see your GP who will examine you first and then may order some blood tests, which will usually include CA125. If the result of the blood test and the examination suggests you may have ovarian cancer, your GP will then refer you to a Specialist in gynaecological cancer. Your specialist will again examine you and may arrange some imaging investigations such as an ultrasound scan or computed tomography (CT) scan. These investigations should give your specialist a good idea as to whether you may have ovarian cancer or not and be able to proceed to the next stage of your management.

Prof. Gordon Rustin
For the common types of ovarian cancer, the aim is to remove all visible cancer by radical surgery.Carboplatin and paclitaxel are the most commonly used chemotherapy drugs, but there are many more that can be used. Chemotherapy can be given before surgery in certain cases and can be successfully given again and again if the cancer comes back.


Dr Anji Anand
Ovarian cancer is treated primarily by surgery- this involves removal of the uterus, the fallopian tubes, and both the ovaries. Surgery is generally followed by chemotherapy which reduces the risk of recurrence (stops the cancer from coming back). If the cancer is advanced at diagnosis, surgery may not be appropriate and chemotherapy is given to shrink the cancer before surgery.


Mr Jafaru Abu
The mainstay of treatment for ovarian cancer is primary surgery. Surgery usually involves a big up and down cut on your tummy under a general anaesthesia. The extent of surgery will depend on the stage of the disease. The aim of surgery is usually to remove all visible cancer. Sometimes, if the CT shows that the cancer is too advanced; your specialist may recommend that you have chemotherapy first to help shrink the cancer and make it operable at a later date. This is called delayed surgery.

Prof. Gordon Rustin
Showing that in certain types of ovarian cancer in young women called germ cell tumours, it is safe to perform fertility sparing surgery and avoid chemotherapy. Showing in a large clinical trial that if ovarian cancer recurs based on just a rise in CA125 levels, patients have a better quality of life and live just as long if chemotherapy is delayed until they develop symptoms, rather than treating them immediately. Develop drugs called vascular disruptive agents and show in patients that they can shut down the blood supply to their cancers.


Dr Anji Anand
I was instrumental in developing and implementing High dose rate brachytherapy for cervix and endometrial cancers at Nottingham Radiotherapy Centre in 2011. I also developed a protocol for IMRT (Intensity modulated radiotherapy) for gynaecological cancers in 2013, this has been implemented over the last year and patients are now routinely treated with IMRT at Nottingham. I am the principal investigator for several national and international clinical trials.


Mr Jafaru Abu
Highlights include performing very complex surgery on women with advanced ovarian cancer. To see my patients post-surgery making a good recovery is always very fulfilling for me. I also perform lots of minimally invasive surgery (key-hole surgery) for other types of cancer - womb and cervical cancers. Their post-operative recovery is usually remarkable. Performing keyhole fertility preservation surgery on young women with cervical cancer to give them hope of having children in the future is very fulfilling. About 2 years ago, a young woman with 5 previous miscarriages was pregnant when she was diagnosed with cervical cancer. Faced with the prospect of having a termination, I offered her an innovative procedure of removing the neck of her womb and keyhole surgery to remove lymph glands in the pelvis when she was about 12-14 weeks pregnant. She went on to have a caesarean section delivery with a healthy baby.

Ovarian Cancer

Ovarian Cancer Infographic

Take a look at our infographics where you can learn more about ovarian cancer.

  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runners Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.
  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runner Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.