Roughly 1 in 75 women will be diagnosed with ovarian cancer at some point during their lifetimes. According to the National Ovarian Cancer Coalition, in women between the ages of 35–74, ovarian cancer is the fifth leading cause of cancer-related deaths. (1)
Considering how serious ovarian cancer tends to be in its later stages, both preventive care (including physical exams, diet & exercise, and avoiding toxins like talc), plus learning to recognize early signs and symptoms of ovarian cancer, are extremely important.
What are the early signs of ovarian cancer? In its early stages ovarian cancer might not cause any noticeable symptoms. Advanced-stage ovarian cancer is more likely to cause symptoms, but these are often said to be “nonspecific symptoms” that can be misattributed to other health problems. Once a woman does start experiencing ovarian cancer symptoms, they usually include pelvic pain, bloating, constipation, increased urination and others.
Over 90 percent of women who are diagnosed with ovarian cancer and treated during the disease’s earliest stages will survive for at least five years. Treatment for ovarian cancer can include chemotherapy, radiation and one or more surgeries. Natural remedies — like eating a healthy diet, resting and managing stress — can also help support women during recovery and manage side effects caused by cancer treatments.
What Is Ovarian Cancer?
Ovarian cancer, a disease that affects women only, is caused when malignant (cancerous) cells form inside or on top of the ovaries. The ovaries are two almond-shaped organs located on each side of a woman’s uterus. They store and release eggs and produce female hormones, including estrogen and progesterone.
There are three kinds of cells found in the ovaries, and each type of cell can potentially develop into a different type of cancerous tumor. The type of cell where the cancer begins determines the type of ovarian cancer a woman is diagnosed with. (2)
- Epithelial tumors (the most common type, accounting for about 90 percent of cases) — These cover the outer surface of the ovaries. These tumors can be non-cancerous and don’t always spread or lead to disease. Borderline epithelial ovarian cancers (including atypical proliferative serous carcinoma and atypical proliferative mucinous carcinoma) tend to affect young women and are slow-growing cancers that are not usually life-threatening.
- Germ cell tumors — These start from the cells that produce the eggs (called the ova). Less than 2 percent of ovarian cancers are germ cell tumors. Roughly 9 out of 10 patients with this type of cancer survive at least five years after diagnosis.
- Stromal tumors — These start from structural tissue cells that hold the ovary together and produce the female hormones. About 1 percent of ovarian cancers are ovarian stromal cell tumors. Stromal tumors are usually diagnosed at an earlier stage than other ovarian tumors. This type tends to occur in older women and commonly causes abnormal vaginal bleeding.
Symptoms and Signs
Ovarian cancer symptoms can be mild and vague at first, but usually become more intense and noticeable over time as the disease progresses.
The most common ovarian cancer symptoms include: (3)
- Bloating in the abdominal region
- Pelvic pain or increased pressure and tenderness in the abdomen
- Increased urination or feeling like you need to urinate urgently
- Trouble eating, feeling full quickly, loss of appetite and sometimes weight loss
- Digestive issues including constipation, gas, upset stomach or heartburn
- Back pain
- Pain during sex
- Irregular periods
- Depending on the type of tumor that forms, facial or body hair may grow
If they do occur, what are the early signs of cancer that a woman may experience? Each woman with ovarian cancer is different and can experience a unique set of symptoms, depending on the type of cancer, the stage and where it’s located. Some of the first signs of ovarian cancer to become noticeable are usually abdominal bloating or swelling, discomfort in the pelvis, quickly feeling full, urinary symptoms (urgency or frequency), and unexplained changes in bowel habits.
Is the pain constant with ovarian cancer? Pain in the belly, pelvic region or abdomen usually gets worse and more constant with time. It might start out as mild pain that is confused with menstrual pains or a stomach ache, but then becomes much more uncomfortable over the course of several months or more.
Granulosa cell tumors (GCT) — rare ovarian tumors in the stromal cell group — can cause additional symptoms, which include:
- Abnormal uterine bleeding
- Diagnosis of endometrial hyperplasia (thickening of the uterus that causes bleeding)
- Breast tenderness
- Unusual vaginal secretions
- Signs of increased testosterone (male pattern traits like facial hair growth, for example)
- In prepubescent girls, early onset puberty (70–80 percent) with early male trait characteristics
Causes and Risk Factors
All types of cancers develop when abnormal cells in a part of the body grow uncontrollably, usually forming tumors and sometimes spreading to other parts of the body. Recent research suggests that many cases of ovarian cancer may actually start in the fallopian tubes, a pair of tubes along which eggs travel from the ovaries to the uterus.
Metastasis is the term for cancer cells moving into the bloodstream or lymph system and spreading to other parts of the body. Sometimes cancerous cells can be found in the ovaries if they have spread (metastasized) from other parts of the body, such as the breasts or colon. This is not considered ovarian cancer, since the original site of the malignancy determines the type of cancer. Ovarian cancer can also spread to parts of the the digestive system or pelvis.
A number of risk factors have been identified that can increase a woman’s chance of developing epithelial ovarian cancer, but are less likely to increase the risk for germ cell tumors and stromal tumors. Still, even though certain risk factors may contribute to some cases of cancer, it’s not entirely clear why some women develop ovarian cancer and others do not.
Ovarian cancer risk factors include: (4)
- Genetic predisposition
- Personal or family history of breast, ovarian or colon cancer
- Being over the age of 40. Most cases of ovarian cancer occur in women between 50–60 years old, although younger women can be affected too
- History of infertility
- Smoking and high alcohol consumption
- Having had children after the age of 35 or never having had any children
- Taking hormone replacement therapy (including estrogens) after menopause
- Beginning menstruation at an early age or starting menopause at a later age
- Exposure to certain chemicals and toxins, including talcum powder which can sometimes be found in sanitary napkins, diaphragms and condoms.
Is there a connection between ovarian cysts and ovarian cancer? Ovarian cysts that are considered small, around 3 centimeters, are relatively common (such as in women who have polycystic ovarian syndrome) and the majority of the time are benign (non-cancerous). However, if a woman develops cysts that are bigger than 6 centimeters and they persist throughout multiple menstrual cycles, or they develop during childhood or after menopause when cysts are less common, then this should be further investigated. These types of cysts are considered “abnormal,” and may not be cancerous, but could possibly contribute to ovarian cancer in some cases.
Staging and Diagnosis
The American Cancer Society estimates that about 22,280 new cases of ovarian cancer are diagnosed each year in the U.S., and that about 14,240 women will die from ovarian cancer annually. (5) Women with ovarian cancer who are treated right away — when the disease is still in its early stages — have a much better chance of survival and recovery. But sadly, only about 20 percent of all cases are found early, in either stage I or II. When ovarian cancer is caught in its later stages, meaning stage III or higher, the survival rate can be as low as 28 percent.
Staging refers to how much the disease has grown and spread in the body. The “grade” of cancer is also used to describe how cells behave and how aggressively they are growing. Early stages are usually treatable with surgery and chemotherapy. Later stages usually require more aggressive treatment and ongoing monitoring.
- The stages of ovarian cancer are indicated using Roman numerals ranging from I (1) to IV (4). I is the lowest stage indicating that the cancer is confined to the ovaries. Stage IV is the most advanced, indicating that the cancer has spread to other areas of the body. (6)
- Other factors that are used to stage cancer include: the size of the tumor (T), whether the cancer has spread to lymph nodes (N), and whether the cancer has spread (metastasis) to distant sites (M). Numbers or letters are assigned to T, N and M to describe how aggressive someone’s ovarian cancer has become.
- For example, ovarian cancer that is “stage 1, TI, N0, M0” would describe cancer that is only in the ovary (or ovaries) or fallopian tube(s) but has not spread to nearby lymph nodes (N0) or to distant sites (M0).
- Ovarian cancer that is “IVB, any T, any N, M1b” would describe cancer that has spread to the inside of the spleen or liver, to lymph nodes other than the retroperitoneal lymph nodes, and/or to other organs or tissues outside the peritoneal cavity, such as the lungs and bones.
How do you detect ovarian cancer early?
When a woman visits her doctor for an annual pelvic/vaginal exam, her doctor will be looking for any abnormalities. If abnormalities are found during these routine exams, then further testing is done to diagnose or rule out ovarian cancer, including transvaginal ultrasound and/or a tumor marker blood test called the CA-125.
- To diagnose a woman with ovarian cancer, doctors can use a combination of tests and exams including: pelvic exam in order to feel your pelvic organs, examination of external genitalia (vagina and cervix), imaging tests such as ultrasound or CT scans, and blood tests to help determine your overall health and to test for tumor markers.
- A CA-125 assessment is performed on a blood sample and measures the concentration of CA-125 in the blood. CA-125 is a protein released by cancer cells and sometimes inflamed cells that are non-cancerous. Sometimes a woman can have elevated CA-125 levels but not have cancer, so this is only part of a diagnostic system, but alone cannot be used to diagnose a woman with cancer.
- Sometimes if surgery is performed to remove an ovary, a doctor can make a diagnosis of ovarian cancer depending on the health of the ovary.
- A pap test alone will not detect ovarian cancer. Pap tests screen for cervical cancer, but will not tell you that you have ovarian cancer. However, these tests can be used to spot signs of abnormalities, although women who have normal pap tests can still have ovarian cancer.
Ovarian cancer is usually diagnosed and treated by gynecologists (who specialize in women’s reproductive health) and oncologists (who specialize in treating cancer). Doctors typically use the treatment approaches below to manage ovarian cancer: (7)
- Chemotherapy — Chemo targets cells that are growing and dividing rapidly. The standard treatment for ovarian cancer consists of a combination of debulking surgery (to surgically remove as much of the cancer as possible) followed by six rounds of chemotherapy. (8) Unfortunately, chemo can also destroy many healthy cells that divide quickly, causing widespread side effects (such as nausea, indigestion, diarrhea, hair loss, low immune function, fatigue and anemia).
- Hormone therapy — helps to shrink tumors by cutting off hormones that promote their growth.
- Radiation therapy — used to help shrink tumors.
- Targeted drug therapies or immunotherapy — usually used to treat advanced stage cancers and work by targeting specific cells.
- Surgery — Most women who are diagnosed with ovarian cancer will need to undergo surgery at least once. Sometimes several surgeries are needed during the course of treatment.
- Medications — Drugs including angiogenesis inhibitors and targeted therapies may be recommended either in conjunction with chemotherapy or alone. New drugs are also being developed that may help shrink tumors. Medications that are sometimes used for this purpose include the drugs called Avastin and Sovenifib.
Natural Ways to Help Ease Treatment
Below are tips and natural remedies that may help make treatment more comfortable and support your overall health during recovery:
1. Eat a Healthy Diet
There’s some evidence that women who eat a diet high in antioxidant-rich vegetables and other plant foods have increased protection against ovarian cancer (and other types of cancers too) and may recover more easily. (9 )In a study known as the Swedish Mammography Cohort, higher vegetable intake (≥ 3 servings per day) as compared to low intake (< 1 serving/day) was associated with a 39 percent lower risk for ovarian cancer. (10)
Aim to eat at least 2½ cups of fruits and vegetables every day, focusing on having a variety that come in different colors. Vegetables that provide flavonoid antioxidants seem to be especially protective against ovarian cancer.
Below are some of the best cancer-fighting foods to include in your diet:
- Leafy greens like kale and spinach
- Sea vegetables
- Fresh herbs and spices like turmeric, ginger, basil, parsley or oregano
- Raw garlic
- Citrus fruits, berries, apples and pears, kiwi, coconut flakes, figs and dates
- Mushrooms, carrots, beets, tomatoes and bell peppers, artichokes, okra, green peas, winter or acorn squash, Brussels sprouts, turnips, sweet potatoes
- Cruciferous veggies like broccoli and cauliflower
- Organic, grass-fed or pasture-raised meats
- Wild-caught fish like salmon, mackerel, sardines or herring
- Green tea
- Olive and coconut oil
- Beans and legumes, such as black beans, lentils, chickpeas or adzuki beans
- Nuts like almonds or walnuts, flax seeds and chia seeds
- 100 percent whole grains like quinoa, brown rice, buckwheat and rolled oats
To fight inflammation, reduce digestive symptoms, and support overall health, reduce or avoid these processed foods: factory-farm-raised red meat (such as beef, pork or lamb) and processed meats (such as hot dogs, salami and some deli/luncheon meats), refined grains, foods or drinks with added sugar, refined vegetable oils, fried foods, fast food and hydrogenated fats.
Eating a nutrient-dense diet will also make it easier to maintain a healthy weight. Being overweight or obese has been linked to higher risk for ovarian cancer and other types of cancer, such as colon cancer. You can work towards losing weight if needed by eating an anti-inflammatory diet, managing stress, getting enough sleep and regularly exercising.
2. Rest & Focus on Relaxation
Being diagnosed with ovarian cancer can be very stressful, especially if the cancer is caught in its later stages and needs to be treated aggressively. Make a point to incorporate stress-relieving activities into your day. You might need to nap or rest if you’re feeling fatigued and run down, and you will probably need more sleep than usual (at least eight hours per night). Give calming activities like yoga, meditation, reading, walking outside, massage therapy or acupuncture a try to keep your stress under control. Trying to relax and take care of yourself can help support your immune system while you fight to beat cancer.
3. Manage Nausea, Constipation & Indigestion
If you’re struggling with nausea, bloating, lack of appetite or constipation during your recovery, these steps may be able to help:
- Eat enough fiber, but not too much that it worsens symptoms. Aim for about 20–30 grams per day, but adjust the amount you consume as needed.
- Drink enough water throughout the day. Prevent dehydration when exercising, when you’re sick or when it’s very hot/humid outside.
- Limit or avoid alcohol and caffeine, which can make digestive systems worse.
- Avoid eating very big, high-fat meals. Spacing out meals may make digestion easier.
- If you have constipation, try consuming foods and beverages that act as natural laxatives, including: prune juice, psyllium husk, aloe vera, chia and flax seeds, flaxseed oil, cooked leafy greens, probiotic-rich foods like coconut kefir, kombucha, sauerkraut and kimchi, and coconut water. You can also consider taking magnesium supplements or using fiber supplements.
- If you have nausea, sip on ginger herbal tea or use ginger essential oil. You can also diffuse peppermint or lemon essential oil in your home, try slowly walking outdoors to get fresh air, keep your home cool, and try meditation and acupuncture.
- If pelvic pain causes you discomfort, you can try a natural pain reliever. It may also be helpful to try chiropractic care, physical therapy, gentle stretching and taking warm baths to help relax your muscles. Always check with your health care provider first before taking other medications or supplements or starting a new exercise program.
1. Visit Your Gynecologist for Yearly Exams
Currently there is no accurate early screening test for ovarian cancer that is available. This is why experts highly encourage women to visit their doctors for an annual rectal and vaginal pelvic examination. Let your doctor know about your medical history, any family history of cancer, and any other risk factors that apply to you. It’s best to be proactive if you have a family history of breast and ovarian cancers, so bring this up with your doctor and talk about ways to reduce your risk.
2. Consider Genetic Testing
If your doctor believes that you may be at an increased risk for developing ovarian cancer (due to factors like having a family history), then he or she might refer you to a genetic counselor who can perform tests to identify if you carry genetic mutations. Certain gene mutations can increase your risk of both breast cancer and ovarian cancers, but only a small percentage of ovarian cancers are caused by inherited gene mutations.
Genes that can increase risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). Gene mutations associated with Lynch syndrome may also increase the risk of ovarian cancer. If a woman is found to have genetic mutations that may lead to ovarian cancer, she may consider undergoing surgery to remove her ovaries in order to prevent cancer. But this is ultimately a very personal decision, so the pros and cons of such a surgery need to be weighed by each individual woman.
3. Avoid Exposure to Toxins like Talc
Overall, findings from studies regarding chemical exposure and ovarian cancer risk have been mixed. Some studies have found that exposure to talcum powder — one chemical that may be able to travel through the vagina, uterus and fallopian tubes to the ovaries — may lead to a small or moderate increased ovarian cancer risk. Talc (a mineral containing magnesium, silicon and oxygen) is widely used in many products that women apply directly to their skin, including baby powder, makeup products and cosmetics, sanitary napkins, soaps, lotions and feminine hygiene products.
One study published in the journal Epidemiology found that talc exposure in the genital area increased ovarian cancer risk by 33 percent (the same risk didn’t apply when talc was used on other areas of the body). (11) Before buying any product that may contain talc, look for “talcum powder” or “cosmetic talc” on the label. Try to buy products that are certified talc-free, especially if you are using the product on or near your genital/pelvic area. You can also try homemade or alternative ingredients/products to cleanse and protect your skin, including baking soda, cornstarch, coconut oil, shea butter, non-nanoparticle zinc oxide and vitamin E oil.
4. Breastfeed After Giving Birth
Breastfeeding may lower your risk for developing ovarian cancer. Experts believe that breastfeeding can have positive effects on hormones after pregnancy, plus it benefits your baby in many ways too.
While I generally don’t recommend the use of birth control pills for all women, some studies have found that oral contraceptives (also known as birth control pills or the pill) may lower ovarian cancer risk. A hysterectomy (surgery to remove the uterus, but not the ovaries) also seems to reduce the risk of getting ovarian cancer by about one-third, although this surgery is only performed when absolutely necessary. (12)
5. Limit Alcohol Consumption & Quit Smoking
Studies have found that people who drink high amounts of alcohol or smoke/use tobacco products are more likely to develop various kinds of cancer, including ovarian cancer, compared to those who drink only moderately and don’t smoke. Women should ideally have no more than one alcoholic drink per day. For help quitting smoking, talk to your doctor about useful interventions; speak with a therapist; or start an online program that specializes in smoking cessation. (13)
If you’re dealing with any of the ovarian cancer symptoms described above (pelvic pain, painful sex, bloating or irregular periods for example) for more than several weeks, visit your doctor for an evaluation. Look for symptoms that occur more than 12 times during the course of one month and that are new or unusual for you. This is especially important if you’re at an increased risk for ovarian cancer, such as due to a family history.
If your symptoms persist despite trying common treatments, then get a second opinion to rule out cancer or another illness. Just keep in mind that ovarian cancer symptoms have a lot in common with symptoms caused by other conditions; just because you’re feeling some pain or discomfort doesn’t mean you have cancer, so don’t panic and speak with a specialist.
- Ovarian cancer is caused when malignant (cancerous) cells form inside or on the ovaries, which are two almond-shaped organs located on the side of a woman’s uterus that store eggs and produce female hormones, including estrogen and progesterone.
- Not every woman experiences early signs of ovarian cancer. When ovarian cancer symptoms do occur they usually include: bloating, pelvic pain, feeling full quickly, increased urination, irregular periods, constipation and painful sex.
- Risk factors for ovarian cancer include: family history of cancer, genetic mutations, being over 40, obesity, smoking, use of hormone replacement therapy, having had children after age 35, and exposure to certain chemicals like talc.
- Ovarian cancer is typically treated with chemotherapy, radiation, immunotherapy and/or surgery.
7 Natural Ways to Help Prevent Ovarian Cancer & Manage Symptoms During Treatment
- Eating a healthy diet
- Focusing on relaxation
- Treating nausea and digestive issues
- Getting annual exams by a gynecologist
- Avoiding toxin exposure
- Limiting alcohol/smoking