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Ovarian cancer is one of the most difficult gynecologic cancers to diagnose early, making awareness and timely evaluation essential. In a recent episode of the Healthful Woman podcast, Dr. Monica Prasad Hayes, GYN oncologist and fellowship director at Mount Sinai Hospital, offered insight into how ovarian cancer develops, how it is identified, and what treatment approaches are available.

What Is Ovarian Cancer?

Ovarian cancer forms in the cells of the ovaries and affects roughly 1 in 70 women in their lifetime. About 10 to 20% of cases arise from inherited genetic mutations that increase cancer risk; two of these genes include BRCA1 and BRCA2. Although it can occur at any age, it is most often diagnosed in women over 60.

Unlike cancers that produce easily detectable masses, ovarian tumors can grow quietly. Because ovaries are small and located within the pelvis, early changes are rarely noticed without imaging. Dr. Hayes shares, “You can’t palpate your ovaries and you don’t often feel anything until the ovarian cyst is quite large.” This delay in detection is one reason ovarian cancer is often identified at a more advanced stage.

Early Symptoms to Watch For

The earliest signs of ovarian cancer are frequently mistaken for other concerns. When these symptoms persist or progressively worsen, they may signal an underlying concern. Women should seek medical evaluation if the following symptoms occur more often than usual or continue for more than a few weeks:

• Abdominal bloating or swelling
• Feeling full after eating small amounts
• Chronic constipation
• Increased urinary urgency or frequency
• Unexplained weight gain from fluid buildup

How Ovarian Cancer Is Diagnosed

Evaluation typically begins with pelvic imaging. An ultrasound is often the first diagnostic tool because it is quick and does not involve radiation. MRI or CAT scans can reveal ovarian enlargement or abnormal fluid.

If imaging uncovers abnormalities, the next step is obtaining tissue for evaluation. This may occur during surgery or through a needle biopsy in cases where surgery is not immediately possible. At this time, we examine the cells under a microscope to determine whether cancer is present and to identify the stage.

Dr. Hayes shares, “Five-year survival around 20% to 30%, what we really typically see is probably around 40% to 50%.” A five-year survival rate for stage four disease is lower, around 20%.

Treatment Options for Ovarian Cancer

Surgery and chemotherapy are common forms of treatment. Surgeons aim to remove as much tumor tissue as possible, followed by several months of chemotherapy to target microscopic cancer cells.

For patients with more advanced disease, treatment may begin with chemotherapy first, known as neoadjuvant chemotherapy. After several cycles, surgeons perform an interval procedure, followed by additional chemotherapy.

Once treatment is completed, patients often continue with long-term monitoring or maintenance therapies. Secondary surgeries may be considered in select cases of recurrence, although research continues to determine when repeat operations are beneficial.

Advances in Research and Prevention

Dr. Hayes emphasized the urgent need for improved strategies to detect ovarian cancer early. Currently, there is no reliable, universally accepted screening test. Researchers are studying blood markers such as CA-125 and the potential role of transvaginal ultrasound in screening high-risk individuals.

Women with a strong genetic predisposition may choose closer surveillance or discuss preventive surgery with their OB-GYN. Removing the ovaries significantly lowers the risk of ovarian cancer but triggers early menopause and does not eliminate risk entirely. Because of this, the decision requires careful consideration.

Learn More with Carnegie Imaging for Women

To hear the full discussion with Dr. Hayes, listen to the Healthful Woman podcast episode on ovarian cancer. If you have concerns about symptoms, personal risk, or screening options, schedule an appointment with the specialists at Carnegie Imaging for Women.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!