Ovarian Cancer: Symptoms, Diagnosis, Treatment and Prognosis

Ovarian cancer is one of the most serious gynecological cancers and often remains undetected until advanced stages. Early awareness, timely diagnosis, and appropriate treatment play a crucial role in improving survival outcomes.

Introduction

Ovarian cancer is a malignant tumor that develops in the ovaries or surrounding structures such as the fallopian tubes and the inner lining of the abdomen (peritoneum). The ovary consists of three main types of cells: epithelial cells, germ cells, and stromal cells. Abnormal growth of these cells can lead to the formation of cancerous tumors, which may invade nearby tissues or spread to other parts of the body.

Symptoms of Ovarian Cancer

Early-stage ovarian cancer often produces mild or no symptoms, making early detection difficult. Many women experience symptoms for months before diagnosis, often mistaking them for gastrointestinal or menstrual issues.

Common symptoms include abdominal bloating, pelvic or abdominal pain, back pain, irregular menstruation, postmenopausal bleeding, pain during or after intercourse, loss of appetite, fatigue, indigestion, nausea, constipation, diarrhea, early satiety, and urinary urgency or frequency.

As the disease progresses, symptoms may worsen due to the growing tumor pressing on surrounding organs or due to metastasis. Because the ovaries are located deep within the pelvis, ovarian cancer is often diagnosed at an advanced stage.

Diagnosis of Ovarian Cancer

Diagnosis begins with a detailed medical history and physical examination, including a pelvic examination. Blood tests such as CA-125 tumor marker assessment, transvaginal ultrasound, and imaging studies play an important role.

Definitive diagnosis requires surgical evaluation with biopsy, analysis of abdominal fluid, and staging procedures. CT scans and MRI are used to assess the extent of disease and guide treatment planning.

Treatment Options

Treatment of ovarian cancer typically involves surgery and chemotherapy. Surgery aims to remove as much of the tumor as possible, while chemotherapy helps destroy remaining cancer cells. In selected cases, radiotherapy may also be considered.

For early-stage disease, surgery alone may be sufficient. Advanced-stage ovarian cancer requires a combination of cytoreductive surgery and multi-agent chemotherapy.

Prognosis

The prognosis of ovarian cancer depends on the stage at diagnosis. Due to the absence of effective screening tests, many cases are diagnosed late, resulting in lower survival rates. Early detection significantly improves outcomes.

Case Study: Successful management of ovarian cancer with DVT

A 47-year-old female patient from Kydganj, Prayagraj, presented as a known case of ovarian cancer. She was unmarried, nulliparous, and had a history of deep vein thrombosis, for which an inferior vena cava (IVC) filter was placed in April 2025.

She underwent exploratory laparotomy with excision of a right adnexal mass, total abdominal hysterectomy, and omentectomy. Histopathology confirmed mucinous carcinoma of the ovary, with a pre-treatment CA-125 level of 317 U/mL.

The patient completed six cycles of adjuvant chemotherapy. Post-treatment CA-125 levels reduced to 7.04 U/mL, and PET-CT imaging showed no evidence of residual or recurrent disease. She is currently symptom-free and under regular follow-up.

Conclusion

Ovarian cancer requires a high index of suspicion due to its vague symptoms. Awareness, early diagnosis, and comprehensive treatment can significantly improve survival and quality of life.