The female reproductive system consists of the vulva, vagina, uterus (womb), fallopian tubes, and ovaries. Women have two ovaries, positioned on either side of the uterus, which produce eggs during the reproductive years for potential fertilisation.
Ovarian cancer occurs when abnormal cells grow uncontrollably in the ovaries. It is among the most common cancers affecting women in Malaysia and is more frequently diagnosed in women over the age of 40.
Early symptoms are often unclear and many cases are identified at an advanced stage, which can negatively affect treatment outcomes. This makes awareness of subtle, persistent symptoms especially important. Listening to your body and seeking medical advice early can make a real difference.
Epithelial ovarian cancer is the most common form and it develops from the outer lining of the ovaries and often does not cause noticeable symptoms in the early stages.
Germ cell ovarian cancer is a rare type of cancer that arises from the cells that develop into eggs (germ cells). It can be benign or malignant and is more commonly seen in adolescents and younger women.
Stromal cell ovarian cancer is an uncommon and typically slow-growing cancer originating from ovarian stromal cells. Some of these tumours produce hormones such as oestrogen, progesterone, or testosterone, which may lead to symptoms including abnormal uterine bleeding, acne, or excessive facial hair growth. It is more frequently diagnosed in women aged 50 and above.
The exact cause of ovarian cancer remains unknown, and the presence of risk factors does not guarantee disease development. Likewise, some women without known risk factors may still be diagnosed.
Factors associated with an increased risk include:
Family history of ovarian cancer
Genetic mutations such as BRCA1, BRCA2, or those linked to Lynch syndrome
History of breast, colorectal, or uterine cancer
Endometriosis
Infertility or never having given birth
Long-term use of oestrogen without progesterone (10 years or more)
Early onset of menstruation or late menopause
Obesity
Smoking
Early-stage ovarian cancer often causes subtle or non-specific symptoms, which may delay diagnosis. Common symptoms include:
Unusual vaginal bleeding or discharge
Pelvic or abdominal pain
Back pain
Abdominal bloating or swelling
Feeling full quickly or loss of appetite
Changes in bowel habits, such as constipation
Frequent or urgent urination
Fatigue
Unintentional weight loss
If these symptoms are new, persistent, or worsening especially over several weeks, trust your instincts and seek medical advice.
Ovarian cancer staging is determined through physical examinations, imaging tests, and biopsy results. The stages range from 1 to 4, with higher stages indicating more extensive disease spread.
Stage 1: Cancer is confined to one or both ovaries and may involve the ovarian surface or abdominal fluid.
Stage 2: Cancer has spread to nearby pelvic structures such as the uterus or fallopian tubes.
Stage 3: Cancer has extended beyond the pelvis, commonly affecting the omentum, intestines, diaphragm, or liver surface.
Stage 4: Cancer has spread to distant organs such as the lungs, liver, or spleen.
Diagnosis involves a combination of clinical evaluation and diagnostic testing. Doctors begin by reviewing symptoms and medical history, followed by physical examination.
Diagnostic methods may include:
Blood tests to measure tumour markers such as CA-125.
Imaging studies, including transvaginal ultrasound, CT scan, or MRI.
Laparoscopy to examine the ovaries and obtain tissue samples.
Biopsy to confirm cancer type and grade.
Treatment depends on the cancer type, stage, and individual patient factors. Common treatment approaches include surgery, chemotherapy, and radiotherapy, with targeted and hormone therapies used in selected cases.
Surgery: Surgery is often extensive and aims to remove as much cancer as possible. Procedures may include bilateral salpingo-oophorectomy (BSO) which is the removal of both ovaries and fallopian tubes or total abdominal hysterectomy (removal of the uterus, cervix, ovaries, and fallopian tubes). Surgery is frequently combined with chemotherapy, especially in advanced cases.
Chemotherapy: Chemotherapy involves oral or intravenous medications that destroy cancer cells throughout the body.
Radiotherapy: Radiotherapy uses high-energy radiation to shrink tumours and relieve symptoms. While useful for symptom control or pre-surgical treatment, it is not commonly the primary treatment for ovarian cancer.
Targeted Therapy: Targeted treatments block specific pathways that support tumour growth, such as blood vessel formation. These therapies may be used alongside chemotherapy.
Hormone Therapy: Certain ovarian cancers rely on hormones to grow. Hormone therapy works by reducing oestrogen levels, thereby slowing cancer progression. It can be given orally or by injection.
There is no guaranteed way to prevent ovarian cancer. However, certain factors may help lower risk:
Having children
Breastfeeding for one year or longer
Long-term use of oral contraceptive pills
Undergoing a hysterectomy or tubal ligation
Currently, there are no routine screening tests proven effective for early ovarian cancer detection. Pap smear and HPV tests are not reliable screening tools for ovarian cancer and rarely detect it at an early stage.
Although routine screening is not available, early diagnosis often begins with recognising symptoms and having open conversations with your doctor especially if you have risk factors. For women at high risk, blood tests measuring CA-125 levels may be used as part of ongoing monitoring.
If something doesn’t feel right, don’t ignore it. Early assessment allows for timely treatment and better outcomes. At Prince Court Medical Centre, our gynaecologists and oncologists provide comprehensive care from screening and diagnosis to personalised treatment plans and long-term support.
Contact us today to book an appointment if you have concerns or would like to learn more about ovarian cancer and its treatment options.Be the first in line to receive the latest updates and promotions, delivered directly to your inbox.
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