Ovarian Cancer Awareness: Challenges in Early Detection and How to Treat It

05 May 2025

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Raising awareness and education about ovarian cancer is crucial to improving early detection rates and ultimately saving lives. In this blog, we speak to Lara Theobald, M.D., a board-certified physician in medical oncology, internal medicine, palliative care and hospice at the INTEGRIS Health Cancer Institute, to learn more.

“Ovarian cancer remains one of the most challenging cancers to detect early, with only 20 percent of cases identified at an early stage,” Theobald says. “This is largely because it is often a silent disease, showing few symptoms until it has progressed.”

Ovarian cancer basics

What to know: Ovarian cancer starts in the ovaries, which are two small, almond-shaped organs located on either side of the uterus. Ovarian cancer ranks as the 18th-most common cancer and second among gynecological cancers in the U.S., yet it leads in fatalities among female reproductive cancers.

The ovaries have two primary functions: egg production and hormone secretion.

They produce and release eggs each month during a woman’s menstrual cycle in a process called ovulation.
The egg travels down the fallopian tubes, where it can potentially be fertilized by sperm and lead to a pregnancy.
The ovaries produce hormones, including estrogen and progesterone, that help with menstrual cycles, support pregnancy and help develop certain female sexual characteristics such as the breasts.

Three types of cells are found in the ovaries, all of which can become cancerous.

Epithelial cells cover the outer surface of the ovaries and are where most ovarian cancers originate.
Germ cells are responsible for producing eggs and can develop into germ cell tumors.
Stromal cells form the structural tissue of the ovaries and produce estrogen and progesterone.

Ovarian cancer develops when cells in the ovaries grow uncontrollably, forming a tumor.

Genetic mutations, such as in genes like BRCA1 and BRCA2, significantly increase the risk of these cells turning into cancer.
The risk of ovarian cancer also increases with age, especially after menopause.
A family history of ovarian or breast cancer can elevate risk.
Reproductive factors such as never having been pregnant or having a first pregnancy after age 35 may increase risk.
People with endometriosis (a condition in which tissue abnormally grows outside the uterus) and people with hormone replacement therapy are also at a higher risk.

The facts

At a glance: Ovarian cancer is a significant health concern, primarily affecting women over the age of 50. Globally, ovarian cancer affects approximately 300,000 women each year.

In the U.S., 2024 estimates from the American Cancer Society show more than 19,000 women will be diagnosed with ovarian cancer and more than 12,000 women will die from the disease.

That said, cancer statistics have declined over the past several decades.
Researchers think this trend has to do with more women using oral contraceptives and less use of hormonal therapy.

About half of women diagnosed with ovarian cancer are 63 years or older.

Ovarian cancer is more common in White women than Black women.

Ovarian cancer, when found early, is highly treatable – 94 percent of people live longer than five years after diagnosis.

The problem, however, is this type of cancer is hard to detect and usually isn’t found until it reaches a more advanced, less treatable stage.
Only 1 in 5 ovarian cancer diagnoses are discovered at an early stage.
For example, localized invasive epithelial ovarian cancer – the most common type of ovarian cancer – has a 93 percent five-year survival rate.
That survival rate plummets to 31 percent when advanced-cancer stage is categorized as “distant,” meaning it has spread to distant organs.

The challenges in diagnosing ovarian cancer

Why it matters: Between a lack of clear early-stage symptoms and ineffective screening tests, ovarian cancer is one of the more challenging cancers to diagnose. These factors contribute to it often being diagnosed later than other cancers, which can complicate treatment and impact outcomes.

Symptoms of ovarian cancer are often vague in the early stages of the disease.

Bloating, abdominal discomfort and changes in bowel habits are all symptoms, but these symptoms can easily be mistaken for common gastrointestinal issues.
As a result, the confusion often leads to delays in treatment.

A lack of routine screening tests make it difficult to definitively detect ovarian cancer in the early stages.

Unlike other cancers, there isn’t a single test that can accurately detect ovarian cancer.
A pelvic exam can sometimes be useful if your doctor can find a mass in the ovaries, but most early ovarian tumors are difficult or impossible to feel.
Some providers use transvaginal ultrasounds to identify masses or irregularities, but the imaging can be unreliable because it can’t determine whether the tumors are benign or malignant (many ovarian cysts and growths are non-cancerous).
A blood test that measures the level of CA-125 (a protein that can be elevated in women with ovarian cancer) can be used, but elevated levels also occur in a variety of non-cancerous conditions and may trigger false positives.

The anatomical location of the ovaries deep in the pelvic cavity make it difficult to detect abnormalities through a physical exam.

By the time a mass is large enough to feel, the cancer may have already progressed to a more advanced stage.

The role of oral contraceptives and other preventive measures

The bottom line: Oral contraceptives play a role in reducing the risk of ovarian cancer. Additionally, pregnancy and breastfeeding are known to lower ovarian cancer risk. In high-risk individuals, genetic counseling and preventive surgeries, like the removal of ovaries, may be considered to reduce the risk.

Constant ovulation is believed to increase the risk of cellular changes that can lead to cancer.

Therefore, anything that reduces the number of cycles a woman is exposed to during her life can help decrease the risk of developing ovarian cancer.

Birth control pills can reduce ovarian cancer by 30 to 50 percent.

Contraception suppresses ovulation, which reduces the number of times ovarian cells are exposed to the hormonal change, thereby decreasing the potential for cellular mutations to occur.

During pregnancy, ovulation is also temporarily halted because women aren’t exposed to the typical hormonal fluctuations of a menstrual cycle.

Women who have had multiple pregnancies typically have a lower risk compared to women who haven’t been pregnant.

Breastfeeding after pregnancy also suppresses ovulation.

How long you breastfeed impacts the risk reduction – longer periods of breastfeeding are associated with greater protection.

Surgical options exist as preventive measures for women who fall under a high risk category.

Women with BRCA1 or BRCA2 gene mutations can undergo a salpingo-oophorectomy to remove the ovaries and fallopian tubes.

How to treat ovarian cancer

The overview: Treatment options for ovarian cancer depend on the type and staging. Surgery is typically the first line of treatment. Chemotherapy is frequently used alongside surgery to target any remaining cancer cells and reduce the risk of recurrence. Radiation therapy, hormone therapy and immunotherapy may also be used.

Surgery to remove as much of the tumor as possible is the primary treatment option.

Surgical options include a hysterectomy (removal of the uterus), bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes) or an omentectomy (removal of the fatty tissue called omentum).

Chemotherapy is often used after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence.

It can also be used as a neoadjuvant therapy before surgery to reduce tumor size and make surgery more effective.
Common drugs include carboplatin and paclitaxel.

Radiation uses high-energy rays to target and kill cancer cells.

Although this treatment is less common, it can help treat cancer that has spread to other areas or for palliative care to reduce symptoms.

Hormone therapy blocks or reduces estrogen to starve cancer cells and limit growth.

This treatment is most effective for hormone-sensitive cancers (low-grade serous carcinoma or granulosa cell tumors), especially in recurrent or persistent cases.
Common drugs include tamoxifen or aromatase inhibitors.

Immunotherapy uses medications that boost the immune system to attack and destroy cancer cells.

This therapy is used for ovarian cancer that is resistant to more common therapies.
Checkpoint inhibitors, such as pembrolizumab, block proteins that prevent the immune system from attacking cancer cells.

Next steps: If you notice any symptoms that could be linked to ovarian cancer, reach out to your OBGYN today. Early detection is key to better outcomes, and regular check-ups can make all the difference.