U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

National Institutes of Health

What You Need 

To Know About TM

Ovarian

National Cancer Institute

Cancer

U.S. DEPARTMENT OF HEALTH AND

HUMAN SERVICES

National Institutes of Health

National Cancer Institute

Contents

About This Booklet 1

The Ovaries 2

Understanding Cancer 3

Risk Factors 5

Symptoms 6

Diagnosis 7

Staging 9

Treatment 11

Supportive Care 20

Nutrition and Physical Activity 21

Follow-up Care 22

Complementary Medicine 23

Sources of Support 24

The Promise of Cancer Research 26

Dictionary 28

National Cancer Institute Information Resources 38

National Cancer Institute Publications 39
About This Booklet

This National Cancer Institute (NCI) booklet is

about ovarian epithelial cancer. It is the most common

type of ovarian cancer. It begins in the tissue that

covers the ovaries. 

You will read about possible causes, symptoms,

diagnosis, and treatment. You will also find lists of

questions to ask your doctor. It may help to take this

booklet with you to your next appointment.

Important terms appear in italics. The Dictionary at

the back of this booklet explains these terms.

Definitions of more than 4,000 terms are also on the

NCI Web site at http://www.cancer.gov/dictionary.

Most words in the Dictionary have a “sounds-like”

spelling to show how to pronounce them.

This booklet is not about ovarian germ cell tumors

or other types of ovarian cancer. To find out about these

types of ovarian cancer, please visit our Web site at

http://www.cancer.gov/cancertopics/types/ovarian.

Or, contact our Cancer Information Service. We can

answer your questions about cancer. We can send

you NCI booklets, fact sheets, and other materials.

You can call 1–800–4–CANCER (1–800–422–6237)

or instant message us through the LiveHelp service at

http://www.cancer.gov/help. 

1
The Ovaries

The ovaries are part of a woman’s reproductive

system. They are in the pelvis. Each ovary is about the

size of an almond.

The ovaries make the female hormones—estrogen

and progesterone. They also release eggs. An egg

travels from an ovary through a fallopian tube to the

womb (uterus). 

When a woman goes through her “change of life”

(menopause), her ovaries stop releasing eggs and make

far lower levels of hormones.

2

This picture is of the ovaries and nearby organs.

Uterus

Vagina

Fallopian tubes

Lymph nodes

Ovaries
Understanding Cancer

Cancer begins in cells, the building blocks that make

up tissues. Tissues make up the organs of the body.

Normally, cells grow and divide to form new cells

as the body needs them. When cells grow old, they die,

and new cells take their place. 

Sometimes, this orderly process goes wrong. New

cells form when the body does not need them, and old

cells do not die when they should. These extra cells

can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant:

• Benign tumors are not cancer: 

— Benign tumors are rarely life-threatening.

— Generally, benign tumors can be removed. They

usually do not grow back. 

— Benign tumors do not invade the tissues around

them. 

— Cells from benign tumors do not spread to other

parts of the body. 

• Malignant tumors are cancer: 

— Malignant tumors are generally more serious than

benign tumors. They may be life-threatening. 

— Malignant tumors often can be removed. But

sometimes they grow back. 

— Malignant tumors can invade and damage nearby

tissues and organs. 

— Cells from malignant tumors can spread to other

parts of the body. Cancer cells spread by

breaking away from the original (primary) tumor

and entering the lymphatic system or

bloodstream. The cells invade other organs and

form new tumors that damage these organs. The

spread of cancer is called metastasis.

3
Benign and Malignant Cysts

An ovarian cyst may be found on the surface of an

ovary or inside it. A cyst contains fluid. Sometimes it

contains solid tissue too. Most ovarian cysts are benign

(not cancer). 

Most ovarian cysts go away with time. Sometimes,

a doctor will find a cyst that does not go away or that

gets larger. The doctor may order tests to make sure

that the cyst is not cancer.

Ovarian Cancer

Ovarian cancer can invade, shed, or spread to other

organs:

• Invade: A malignant ovarian tumor can grow and

invade organs next to the ovaries, such as the

fallopian tubes and uterus.

• Shed: Cancer cells can shed (break off) from the

main ovarian tumor. Shedding into the abdomen

may lead to new tumors forming on the surface of

nearby organs and tissues. The doctor may call these

seeds or implants.

• Spread: Cancer cells can spread through the

lymphatic system to lymph nodes in the pelvis,

abdomen, and chest. Cancer cells may also spread

through the bloodstream to organs such as the liver

and lungs.

When cancer spreads from its original place to

another part of the body, the new tumor has the same

kind of abnormal cells and the same name as the

original tumor. For example, if ovarian cancer spreads

to the liver, the cancer cells in the liver are actually

ovarian cancer cells. The disease is metastatic ovarian

cancer, not liver cancer. For that reason, it is treated as

ovarian cancer, not liver cancer. Doctors call the new

tumor “distant” or metastatic disease.

4
Risk Factors

Doctors cannot always explain why one woman

develops ovarian cancer and another does not.

However, we do know that women with certain risk

factors may be more likely than others to develop

ovarian cancer. A risk factor is something that may

increase the chance of developing a disease. 

Studies have found the following risk factors for

ovarian cancer:

• Family history of cancer: Women who have a

mother, daughter, or sister with ovarian cancer have

an increased risk of the disease. Also, women with a

family history of cancer of the breast, uterus, colon,

or rectum may also have an increased risk of

ovarian cancer.

If several women in a family have ovarian or breast

cancer, especially at a young age, this is considered

a strong family history. If you have a strong family

history of ovarian or breast cancer, you may wish to

talk to a genetic counselor. The counselor may

suggest genetic testing for you and the women in

your family. Genetic tests can sometimes show the

presence of specific gene changes that increase the

risk of ovarian cancer. 

• Personal history of cancer: Women who have had

cancer of the breast, uterus, colon, or rectum have a

higher risk of ovarian cancer. 

• Age over 55: Most women are over age 55 when

diagnosed with ovarian cancer.

• Never pregnant: Older women who have never

been pregnant have an increased risk of ovarian

cancer.

5
• Menopausal hormone therapy: Some studies have

suggested that women who take estrogen by itself

(estrogen without progesterone) for 10 or more

years may have an increased risk of ovarian cancer. 

Scientists have also studied whether taking certain

fertility drugs, using talcum powder, or being obese are

risk factors. It is not clear whether these are risk

factors, but if they are, they are not strong risk factors.

Having a risk factor does not mean that a woman

will get ovarian cancer. Most women who have risk

factors do not get ovarian cancer. On the other hand,

women who do get the disease often have no known

risk factors, except for growing older. Women who

think they may be at risk of ovarian cancer should talk

with their doctor. 

Symptoms

Early ovarian cancer may not cause obvious

symptoms. But, as the cancer grows, symptoms may

include:

• Pressure or pain in the abdomen, pelvis, back, or

legs

• A swollen or bloated abdomen 

• Nausea, indigestion, gas, constipation, or diarrhea

• Feeling very tired all the time

Less common symptoms include:

• Shortness of breath

• Feeling the need to urinate often

• Unusual vaginal bleeding (heavy periods, or

bleeding after menopause)

6
Most often these symptoms are not due to cancer,

but only a doctor can tell for sure. Any woman with

these symptoms should tell her doctor.

Diagnosis

If you have a symptom that suggests ovarian cancer,

your doctor must find out whether it is due to cancer or

to some other cause. Your doctor may ask about your

personal and family medical history. 

You may have one or more of the following tests.

Your doctor can explain more about each test: 

• Physical exam: Your doctor checks general signs of

health. Your doctor may press on your abdomen to

check for tumors or an abnormal buildup of fluid

(ascites). A sample of fluid can be taken to look for

ovarian cancer cells.

• Pelvic exam: Your doctor feels the ovaries and

nearby organs for lumps or other changes in their

shape or size. A Pap test is part of a normal pelvic

exam, but it is not used to collect ovarian cells. The

Pap test detects cervical cancer. The Pap test is not

used to diagnose ovarian cancer. 

• Blood tests: Your doctor may order blood tests. The

lab may check the level of several substances,

including CA-125. CA-125 is a substance found on

the surface of ovarian cancer cells and on some

normal tissues. A high CA-125 level could be a sign

of cancer or other conditions. The CA-125 test is not

used alone to diagnose ovarian cancer. This test is

approved by the Food and Drug Administration for

monitoring a woman’s response to ovarian cancer

treatment and for detecting its return after treatment.

7
• Ultrasound: The ultrasound device uses sound

waves that people cannot hear. The device aims

sound waves at organs inside the pelvis. The waves

bounce off the organs. A computer creates a picture

from the echoes. The picture may show an ovarian

tumor. For a better view of the ovaries, the device

may be inserted into the vagina (transvaginal

ultrasound).

• Biopsy: A biopsy is the removal of tissue or fluid to

look for cancer cells. Based on the results of the

blood tests and ultrasound, your doctor may suggest

surgery (a laparotomy) to remove tissue and fluid

from the pelvis and abdomen. Surgery is usually

needed to diagnose ovarian cancer. To learn more

about surgery, see page 15 in the “Treatment”

section.

Although most women have a laparotomy for

diagnosis, some women have a procedure known as

laparoscopy. The doctor inserts a thin, lighted tube

(a laparoscope) through a small incision in the

abdomen. Laparoscopy may be used to remove a

small, benign cyst or an early ovarian cancer. It may

also be used to learn whether cancer has spread.

A pathologist uses a microscope to look for cancer

cells in the tissue or fluid. If ovarian cancer cells are

found, the pathologist describes the grade of the

cells. Grades 1, 2, and 3 describe how abnormal the

cancer cells look. Grade 1 cancer cells are not as

likely as to grow and spread as Grade 3 cells.

8
Staging

To plan the best treatment, your doctor needs to

know the grade of the tumor (see page 8) and the

extent (stage) of the disease. The stage is based on

whether the tumor has invaded nearby tissues, whether

the cancer has spread, and if so, to what parts of the

body. 

Usually, surgery is needed before staging can be

complete. The surgeon takes many samples of tissue

from the pelvis and abdomen to look for cancer. 

Your doctor may order tests to find out whether the

cancer has spread: 

• CT scan: Doctors often use CT scans to make

pictures of organs and tissues in the pelvis or

abdomen. An x-ray machine linked to a computer

takes several pictures. You may receive contrast

material by mouth and by injection into your arm or

hand. The contrast material helps the organs or

tissues show up more clearly. Abdominal fluid or a

tumor may show up on the CT scan.

• Chest x-ray: X-rays of the chest can show tumors

or fluid. 

• Barium enema x-ray: Your doctor may order a

series of x-rays of the lower intestine. You are given

an enema with a barium solution. The barium

outlines the intestine on the x-rays. Areas blocked

by cancer may show up on the x-rays.

• Colonoscopy: Your doctor inserts a long, lighted

tube into the rectum and colon. This exam can help

tell if cancer has spread to the colon or rectum.

9
These are the stages of ovarian cancer:

• Stage I: Cancer cells are found in one or both

ovaries. Cancer cells may be found on the surface of

the ovaries or in fluid collected from the abdomen. 

• Stage II: Cancer cells have spread from one or both

ovaries to other tissues in the pelvis. Cancer cells

are found on the fallopian tubes, the uterus, or other

tissues in the pelvis. Cancer cells may be found in

fluid collected from the abdomen.

• Stage III: Cancer cells have spread to tissues

outside the pelvis or to the regional lymph nodes.

Cancer cells may be found on the outside of the

liver.

• Stage IV: Cancer cells have spread to tissues

outside the abdomen and pelvis. Cancer cells may

be found inside the liver, in the lungs, or in other

organs.

10
Treatment

Many women with ovarian cancer want to take an

active part in making decisions about their medical

care. It is natural to want to learn all you can about

your disease and treatment choices. Knowing more

about ovarian cancer helps many women cope. 

Shock and stress after the diagnosis can make it

hard to think of everything you want to ask your

doctor. It often helps to make a list of questions before

an appointment. To help remember what your doctor

says, you may take notes or ask whether you may use a

tape recorder. You may also want to have a family

member or friend with you when you talk to your

doctor—to take part in the discussion, to take notes, or

just to listen.

You do not need to ask all your questions at once.

You will have other chances to ask your doctor or

nurse to explain things that are not clear and to ask for

more details.

Your doctor may refer you to a gynecologic

oncologist, a surgeon who specializes in treating

ovarian cancer. Or you may ask for a referral. Other

types of doctors who help treat women with ovarian

cancer include gynecologists, medical oncologists, and

radiation oncologists. You may have a team of doctors

and nurses. 

Getting a Second Opinion

Before starting treatment, you might want a second

opinion about your diagnosis and treatment plan. Many

insurance companies cover a second opinion if you or

your doctor requests it. 

It may take some time and effort to gather medical

records and arrange to see another doctor. In most

11
cases, a brief delay in starting treatment will not make

treatment less effective. To make sure, you should

discuss this delay with your doctor. Sometimes women

with ovarian cancer need treatment right away.

There are a number of ways to find a doctor for a

second opinion:

• Your doctor may refer you to one or more

specialists. At cancer centers, several specialists

often work together as a team. 

• NCI’s Cancer Information Service, at

1–800–4–CANCER, can tell you about nearby

treatment centers. Information Specialists also

can assist you online through LiveHelp at

http://www.cancer.gov/help.

• A local or state medical society, a nearby hospital, or

a medical school can usually provide the names of

specialists.

• The American Board of Medical Specialties

(ABMS) has a list of doctors who have had training

and passed exams in their specialty. You can find

this list in the Official ABMS Directory of Board

Certified Medical Specialists. The Directory is in

most public libraries. Also, ABMS offers this

information at http://www.abms.org. (Click on

“Who’s Certified.”)

• NCI provides a helpful fact sheet called “How To

Find a Doctor or Treatment Facility If You Have

Cancer.” Page 39 tells how to get NCI fact sheets.

Treatment Methods

Your doctor can describe your treatment choices and

the expected results. Most women have surgery and

chemotherapy. Rarely, radiation therapy is used.

12
Cancer treatment can affect cancer cells in the

pelvis, in the abdomen, or throughout the body:

• Local therapy: Surgery and radiation therapy are

local therapies. They remove or destroy ovarian

cancer in the pelvis. When ovarian cancer has

spread to other parts of the body, local therapy may

be used to control the disease in those specific areas.

• Intraperitoneal chemotherapy: Chemotherapy can

be given directly into the abdomen and pelvis

through a thin tube. The drugs destroy or control

cancer in the abdomen and pelvis. 

• Systemic chemotherapy: When chemotherapy is

taken by mouth or injected into a vein, the drugs

enter the bloodstream and destroy or control cancer

throughout the body. 

You may want to know how treatment may change

your normal activities. You and your doctor can work

together to develop a treatment plan that meets your

medical and personal needs. 

Because cancer treatments often damage healthy

cells and tissues, side effects are common. Side effects

depend mainly on the type and extent of the treatment.

Side effects may not be the same for each woman, and

they may change from one treatment session to the

next. Before treatment starts, your health care team will

explain possible side effects and suggest ways to help

you manage them. 

You may want to talk to your doctor about taking

part in a clinical trial, a research study of new

treatment methods. Clinical trials are an important

option for women with all stages of ovarian cancer.

The section on “The Promise of Cancer Research” on

page 26 has more information about clinical trials.

13
14

You may want to ask your doctor these

questions before your treatment begins:

• What is the stage of my disease? Has the

cancer spread from the ovaries? If so, to

where?

• What are my treatment choices? Do you

recommend intraperitoneal chemotherapy for

me? Why? 

• Would a clinical trial be appropriate for me?

• Will I need more than one kind of treatment?

• What are the expected benefits of each kind of

treatment?

• What are the risks and possible side effects of

each treatment? What can we do to control side

effects? Will they go away after treatment

ends?

• What can I do to prepare for treatment?

• Will I need to stay in the hospital? If so, for

how long?

• What is the treatment likely to cost? Will my

insurance cover the cost?

• How will treatment affect my normal

activities? 

• Will treatment cause me to go through an early

menopause?

• Will I be able to get pregnant and have

children after treatment?

• How often should I have checkups after

treatment?
Surgery

The surgeon makes a long cut in the wall of the

abdomen. This type of surgery is called a laparotomy. 

If ovarian cancer is found, the surgeon removes:

• both ovaries and fallopian tubes (salpingooophorectomy)

• the uterus (hysterectomy)

• the omentum (the thin, fatty pad of tissue that covers

the intestines)

• nearby lymph nodes 

• samples of tissue from the pelvis and abdomen

If the cancer has spread, the surgeon removes as

much cancer as possible. This is called “debulking”

surgery. 

If you have early Stage I ovarian cancer, the extent

of surgery may depend on whether you want to get

pregnant and have children. Some women with very

early ovarian cancer may decide with their doctor to

have only one ovary, one fallopian tube, and the

omentum removed.

You may be uncomfortable for the first few days

after surgery. Medicine can help control your pain.

Before surgery, you should discuss the plan for pain

relief with your doctor or nurse. After surgery, your

doctor can adjust the plan if you need more pain relief.

The time it takes to heal after surgery is different for

each woman. You will spend several days in the

hospital. It may be several weeks before you return to

normal activities. 

15
If you haven’t gone through menopause yet, surgery

may cause hot flashes, vaginal dryness, and night

sweats. These symptoms are caused by the sudden loss

of female hormones. Talk with your doctor or nurse

about your symptoms so that you can develop a

treatment plan together. There are drugs and lifestyle

changes that can help, and most symptoms go away or

lessen with time. 

16

You may want to ask your doctor these

questions about surgery:

• What kind of surgery do you recommend for

me? Will lymph nodes and other tissues be

removed? Why?

• How soon will I know the results from the

pathology report? Who will explain them to

me?

• How will I feel after surgery?

• If I have pain, how will it be controlled?

• How long will I be in the hospital?

• Will I have any long-term effects because of

this surgery?

• Will the surgery affect my sex life?
Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer

cells. Most women have chemotherapy for ovarian

cancer after surgery. Some women have chemotherapy

before surgery.

Usually, more than one drug is given. Drugs for

ovarian cancer can be given in different ways:

• By vein (IV): The drugs can be given through a thin

tube inserted into a vein. 

• By vein and directly into the abdomen: Some

women get IV chemotherapy along with

intraperitoneal (IP) chemotherapy. For IP

chemotherapy, the drugs are given through a thin

tube inserted into the abdomen. 

• By mouth: Some drugs for ovarian cancer can be

given by mouth. 

Chemotherapy is given in cycles. Each treatment

period is followed by a rest period. The length of the

rest period and the number of cycles depend on the

anticancer drugs used.

You may have your treatment in a clinic, at the

doctor’s office, or at home. Some women may need to

stay in the hospital during treatment.

The side effects of chemotherapy depend mainly on

which drugs are given and how much. The drugs can

harm normal cells that divide rapidly: 

• Blood cells: These cells fight infection, help blood

to clot, and carry oxygen to all parts of your body.

When drugs affect your blood cells, you are more

likely to get infections, bruise or bleed easily, and

feel very weak and tired. Your health care team

checks you for low levels of blood cells. If blood

tests show low levels, your health care team can

suggest medicines that can help your body make

new blood cells.

17
• Cells in hair roots: Some drugs can cause hair loss.

Your hair will grow back, but it may be somewhat

different in color and texture.

• Cells that line the digestive tract: Some drugs can

cause poor appetite, nausea and vomiting, diarrhea,

or mouth and lip sores. Ask your health care team

about medicines that help with these problems.

Some drugs used to treat ovarian cancer can cause

hearing loss, kidney damage, joint pain, and tingling or

numbness in the hands or feet. Most of these side

effects usually go away after treatment ends.

You may find it helpful to read NCI’s booklet

Chemotherapy and You: A Guide to Self-Help During

Cancer Treatment. Page 39 tells how to get NCI

booklets.

18

You may want to ask your doctor these

questions about chemotherapy:

• When will treatment start? When will it end?

How often will I have treatment?

• Which drug or drugs will I have?

• How do the drugs work?

• Do you recommend both IV and IP

(intraperitoneal) chemotherapy for me? Why?

• What are the expected benefits of the

treatment?

• What are the risks of the treatment? What side

effects might I have?

• Can I prevent or treat any of these side effects?

How?

• How much will it cost? Will my health

insurance pay for all of the treatment?
Radiation Therapy

Radiation therapy (also called radiotherapy) uses

high-energy rays to kill cancer cells. A large machine

directs radiation at the body. 

Radiation therapy is rarely used in the initial

treatment of ovarian cancer, but it may be used to

relieve pain and other problems caused by the disease.

The treatment is given at a hospital or clinic. Each

treatment takes only a few minutes.

Side effects depend mainly on the amount of

radiation given and the part of your body that is

treated. Radiation therapy to your abdomen and pelvis

may cause nausea, vomiting, diarrhea, or bloody stools.

Also, your skin in the treated area may become red,

dry, and tender. Although the side effects can be

distressing, your doctor can usually treat or control

them. Also, they gradually go away after treatment

ends.

NCI provides a booklet called Radiation Therapy

and You: A Guide to Self-Help During Cancer

Treatment. Page 39 tells how to get NCI booklets.

19
Supportive Care

Ovarian cancer and its treatment can lead to other

health problems. You may receive supportive care to

prevent or control these problems and to improve your

comfort and quality of life.

Your health care team can help you with the

following problems:

• Pain: Your doctor or a specialist in pain control can

suggest ways to relieve or reduce pain. More

information about pain control can be found in the

NCI booklets Pain Control: A Guide for People with

Cancer and Their Families, Get Relief from Cancer

Pain, and Understanding Cancer Pain. Page 39 tells

how to get NCI booklets.

• Swollen abdomen (from abnormal fluid buildup

called ascites): The swelling can be uncomfortable.

Your health care team can remove the fluid

whenever it builds up.

• Blocked intestine: Cancer can block the intestine.

Your doctor may be able to open the blockage with

surgery. 

• Swollen legs (from lymphedema): Swollen legs can

be uncomfortable and hard to bend. You may find

exercises, massages, or compression bandages

helpful. Physical therapists trained to manage

lymphedema can also help.

• Shortness of breath: Advanced cancer can cause

fluid to collect around the lungs. The fluid can make

it hard to breathe. Your health care team can remove

the fluid whenever it builds up.

• Sadness: It is normal to feel sad after a diagnosis of

a serious illness. Some people find it helpful to talk

about their feelings. See the “Sources of Support”

section on page 24 for more information.

20
You can get information about supportive care

on NCI’s Web site at http://www.cancer.gov/

cancerinfo/coping and from NCI’s Cancer Information

Service at 1–800–4–CANCER or LiveHelp

(http://www.cancer.gov/help). 

Nutrition and Physical Activity

It’s important for women with ovarian cancer to take

care of themselves. Taking care of yourself includes

eating well and staying as active as you can.

You need the right amount of calories to maintain a

good weight. You also need enough protein to keep up

your strength. Eating well may help you feel better and

have more energy.

21
Sometimes, especially during or soon after

treatment, you may not feel like eating. You may be

uncomfortable or tired. You may find that foods do not

taste as good as they used to. In addition, the side

effects of treatment (such as poor appetite, nausea,

vomiting, or mouth sores) can make it hard to eat well.

Your doctor, a registered dietitian, or another health

care provider can suggest ways to deal with these

problems. Also, the NCI booklet Eating Hints for

Cancer Patients has many useful ideas and recipes.

Page 39 tells how to get NCI booklets.

Many women find they feel better when they stay

active. Walking, yoga, swimming, and other activities

can keep you strong and increase your energy.

Whatever physical activity you choose, be sure to talk

to your doctor before you start. Also, if your activity

causes you pain or other problems, be sure to let your

doctor or nurse know about it.

Follow-up Care

You will need regular checkups after treatment for

ovarian cancer. Even when there are no longer any

signs of cancer, the disease sometimes returns because

undetected cancer cells remained somewhere in your

body after treatment. 

Checkups help ensure that any changes in your

health are noted and treated if needed. Checkups may

include a pelvic exam, a CA-125 test, other blood tests,

and imaging exams.

If you have any health problems between checkups,

you should contact your doctor. 

22
You may wish to get the NCI booklet Facing

Forward Series: Life After Cancer Treatment. It

answers questions about follow-up care and other

concerns. It also suggests ways to talk with your doctor

about making a plan of action for recovery and future

health. Page 39 tells how to get NCI booklets.

Complementary Medicine

It’s natural to want to help yourself feel better. Some

people with cancer say that complementary medicine

helps them feel better. An approach is called

complementary medicine when it is used along with

standard cancer treatment. Acupuncture, massage

therapy, herbal products, vitamins or special diets, and

meditation are examples of such approaches.

Talk with your doctor if you are thinking about

trying anything new. Things that seem safe, such as

certain herbal teas, may change the way your cancer

treatment works. These changes could be harmful. And

certain complementary approaches could be harmful

even if used alone.

You may find it helpful to read the NCI booklet

Thinking About Complementary & Alternative

Medicine: A guide for people with cancer. Page 39

tells how to get NCI booklets.

You also may request materials from the National

Center for Complementary and Alternative Medicine,

which is part of the National Institutes of Health. You

can reach their clearinghouse at 1–888–644–6226

(voice) and 1–866–464–3615 (TTY). Also, you can

visit their Web site at http://www.nccam.nih.gov.

23
Sources of Support

Learning you have ovarian cancer can change your

life and the lives of those close to you. These changes

can be hard to handle. It is normal for you, your

family, and your friends to have many different and

sometimes confusing feelings.

You may worry about caring for your family,

keeping your job, or continuing daily activities.

Concerns about treatments and managing side effects,

hospital stays, and medical bills are also common.

Doctors, nurses, and other members of your health care

team can answer questions about treatment, working,

24

You may want to ask your doctor these

questions before you decide to use

complementary medicine:

• What benefits can I expect from this approach? 

• What are its risks? 

• Do the expected benefits outweigh the risks? 

• What side effects should I watch for? 

• Will the approach change the way my cancer

treatment works? Could this be harmful? 

• Is this approach under study in a clinical trial? 

• How much will it cost? Will my health

insurance pay for this approach? 

• Can you refer me to a complementary

medicine practitioner? 
and other activities. Meeting with a social worker,

counselor, or member of the clergy can be helpful if

you want to talk about your feelings or concerns.

Often, a social worker can suggest resources for

financial aid, transportation, home care, or emotional

support.

Support groups also can help. In these groups,

patients or their family members meet with other

patients or their families to share what they have

learned about coping with the disease and the effects of

treatment. Groups may offer support in person, over

the telephone, or on the Internet. You may want to talk

with a member of your health care team about finding

a support group.

It is natural for you to be worried about the effects

of ovarian cancer and its treatment on your sexuality.

You may want to talk with your doctor about possible

sexual side effects and whether these effects will be

permanent. Whatever happens, it may be helpful for

you and your partner to talk about your feelings and

help one another find ways to share intimacy during

and after treatment.

For tips on coping, you may want to read the NCI

booklet Taking Time: Support for People With Cancer.

NCI’s Information Specialists at 1–800–4–CANCER

and at LiveHelp (http://www.cancer.gov/help) can

help you locate programs, services, and publications.

For a list of organizations offering support, you may

want to get the NCI fact sheet “National Organizations

That Offer Services to People With Cancer and Their

Families.” Page 39 tells how to get NCI fact sheets.

25
The Promise of Cancer Research

Doctors all over the country are conducting many

types of clinical trials (research studies in which people

volunteer to take part). They are studying new and

better ways to prevent, detect, and treat ovarian cancer.

Clinical trials are designed to answer important

questions and to find out whether new approaches are

safe and effective. Research already has led to

advances, and researchers continue to search for more

effective methods.

Women who join clinical trials may be among the

first to benefit if a new approach is effective. And even

if the women in a trial do not benefit directly, they may

still make an important contribution by helping doctors

learn more about ovarian cancer and how to control it.

Although clinical trials may pose some risks,

researchers do all they can to protect their patients.

Researchers are conducting studies with women

across the country:

• Prevention studies: For women who have a family

history of ovarian cancer, the risk of developing the

disease may be reduced by removing the ovaries

before cancer is detected. This surgery is called

prophylactic oophorectomy. Women who are at high

risk of ovarian cancer are taking part in trials to

study the benefits and harms of this surgery. Other

doctors are studying whether certain drugs can help

prevent ovarian cancer in women at high risk.

• Screening studies: Researchers are studying ways

to find ovarian cancer in women who do not have

symptoms. 

26
• Treatment studies: Doctors are testing novel drugs

and new combinations. They are studying biological

therapies, such as monoclonal antibodies.

Monoclonal antibodies can bind to cancer cells.

They interfere with cancer cell growth and the

spread of cancer.

If you are interested in being part of a clinical trial,

talk with your doctor. You may want to read the NCI

booklets Taking Part in Clinical Trials: What Cancer

Patients Need To Know and Taking Part in Clinical

Trials: Cancer Prevention Studies. NCI also offers an

easy-to-read brochure called If You Have Cancer...

What You Should Know About Clinical Trials. These

NCI publications describe how clinical trials are

carried out and explain their possible benefits and

risks. Page 39 tells how to get NCI booklets.

NCI’s Web site includes a section on clinical

trials at http://www.cancer.gov/clinicaltrials. It

has general information about clinical trials as well

as detailed information about specific ongoing studies

of ovarian cancer. NCI’s Information Specialists

at 1–800–4–CANCER or at LiveHelp at

http://www.cancer.gov/help can answer questions and

provide information about clinical trials. 

27
Dictionary

A dictionary of more than 4,000 terms is on the NCI

Web site at http://www.cancer.gov/dictionary. 

Abdomen (AB-doh-men): The area of the body that

contains the pancreas, stomach, intestines, liver,

gallbladder, and other organs.

Acupuncture (AK-yoo-PUNK-chur): The technique of

inserting thin needles through the skin at specific

points on the body to control pain and other symptoms.

It is a type of complementary and alternative medicine.

Ascites (ah-SYE-teez): Abnormal buildup of fluid in

the abdomen that may cause swelling. In late-stage

cancer, tumor cells may be found in the fluid in the

abdomen. Ascites also occurs in patients with liver

disease.

Barium enema: A procedure in which a thick liquid

containing barium is put into the rectum and colon.

Barium is a silver-white metallic compound that helps

to show the image of the lower gastrointestinal tract on

an x-ray.

Benign (beh-NINE): Not cancerous. Benign tumors

may grow larger but do not spread to other parts of the

body.

Biological therapy (by-oh-LAH-jih-kul THAYRuh-pee): Treatment to stimulate or restore the ability of

the immune system to fight cancer, infections, and

other diseases. Also used to lessen side effects that may

be caused by some cancer treatments. Also called

immunotherapy, biotherapy, or biological response

modifier (BRM) therapy. 

Biopsy (BY-op-see): The removal of cells or tissues for

examination by a pathologist. The pathologist may

study the tissue under a microscope or perform other

tests on the cells or tissue.

28
CA-125: A substance sometimes found in an increased

amount in the blood, other body fluids, or tissues.

Increased levels of CA-125 may suggest the presence

of some types of cancer. 

Cervical cancer (SER-vih-kul KAN-ser): Cancer that

forms in tissues of the cervix (organ connecting the

uterus and vagina). It is usually a slow-growing cancer

that may not have symptoms, but can be found with

regular Pap smears (procedure in which cells are

scraped from the cervix and looked at under a

microscope).

Chemotherapy (kee-moh-THAYR-uh-pee): Treatment

with drugs that kill cancer cells.

Colonoscopy (koh-luh-NAHS-kuh-pee): An

examination of the inside of the colon using a thin,

lighted tube (called a colonoscope) inserted into the

rectum. Samples of tissue may be collected for

examination under a microscope.

Contrast material: A dye or other substance that helps

show abnormal areas inside the body. It is given by

injection into a vein, by enema, or by mouth. Contrast

material may be used with x-rays, CT scans, or other

imaging tests.

CT scan: Computed tomography scan. A series of

detailed pictures of areas inside the body taken from

different angles; the pictures are created by a computer

linked to an x-ray machine. Also called computerized

tomography and computerized axial tomography

(CAT) scan.

Digestive tract (dy-JES-tiv): The organs through which

food and liquids pass when they are swallowed,

digested, and eliminated. These organs are the mouth,

esophagus, stomach, small and large intestines, rectum,

and anus.

29
Estrogen (ES-truh-jin): A type of hormone made by

the body that helps develop and maintain female sex

characteristics and the growth of long bones. Estrogens

can also be made in the laboratory. They may be used

as a type of birth control and to treat symptoms of

menopause, menstrual disorders, osteoporosis, and

other conditions. 

Fallopian tube (fuh-LOH-pee-in): A slender tube

through which eggs pass from an ovary to the uterus.

In the female reproductive tract, there is one ovary and

one fallopian tube on each side of the uterus.

Gene: The functional and physical unit of heredity

passed from parent to offspring. Genes are pieces of

DNA, and most genes contain the information for

making a specific protein. 

Genetic counselor: A specially trained health

professional concerned about the genetic risk of

disease. This type of professional considers an

individual’s family and personal medical history.

Counseling may lead to genetic testing. 

Genetic testing: Analyzing DNA to look for a genetic

alteration that may indicate an increased risk for

developing a specific disease or disorder.

Gynecologic oncologist (guy-nuh-koh-LAH-jik 

on-KOL-oh-jist): A doctor who specializes in treating

cancers of the female reproductive organs.

Gynecologist (guy-nuh-KAH-loh-jist): A doctor who

specializes in treating diseases of the female

reproductive organs.

Hormone: A chemical made by glands in the body.

Hormones circulate in the bloodstream and control the

actions of certain cells or organs. Some hormones can

also be made in a laboratory.

30
Hysterectomy (hiss-ter-EK-toe-mee): Surgery to

remove the uterus and, sometimes, the cervix. When

the uterus and part or all of the cervix are removed, it

is called a total hysterectomy. When only the uterus is

removed, it is called a partial hysterectomy.

Infection: Invasion and multiplication of germs in the

body. Infections can occur in any part of the body and

can spread throughout the body. The germs may be

bacteria, viruses, yeast, or fungi. They can cause a

fever and other problems, depending on where the

infection occurs. When the body’s natural defense

system is strong, it can often fight the germs and

prevent infection. Some cancer treatments can weaken

the natural defense system. 

Intestine (in-TES-tin): The long, tube-shaped organ in

the abdomen that completes the process of digestion.

The intestine has two parts, the small intestine and the

large intestine. Also called the bowel.

Intraperitoneal chemotherapy (IN-truh-PAYR-ih-tohNEE-ul kee-moh-THAYR-uh-pee): Treatment in which

anticancer drugs are put directly into the abdominal

cavity through a thin tube.

IV: Intravenous (IN-truh-VEE-nus). Injected into a

blood vessel.

Laparoscope (LAP-uh-ruh-skope): A thin, lighted tube

used to look at tissues and organs inside the abdomen.

Laparoscopy (lap-uh-RAHS-koh-pee): The insertion of

a thin, lighted tube (called a laparoscope) through the

abdominal wall to inspect the inside of the abdomen

and remove tissue samples. 

Laparotomy (lap-uh-RAH-toh-mee): A surgical

incision made in the wall of the abdomen.

Local therapy: Treatment that affects cells in the tumor

and the area close to it.

31
Lymph node (limf node): A rounded mass of lymphatic

tissue that is surrounded by a capsule of connective

tissue. Lymph nodes filter lymph (lymphatic fluid), and

they store lymphocytes (white blood cells). They are

located along lymphatic vessels. Also called a lymph

gland. 

Lymphedema (LIMF-uh-DEE-muh): A condition in

which excess fluid collects in tissue and causes

swelling. It may occur in the arm or leg after lymph

vessels or lymph nodes in the underarm or groin are

removed or treated with radiation.

Lymphatic system (lim-FAT-ik SIS-tem): The tissues

and organs that produce, store, and carry white blood

cells that fight infections and other diseases. This

system includes the bone marrow, spleen, thymus,

lymph nodes, and lymphatic vessels (a network of thin

tubes that carry lymph and white blood cells).

Lymphatic vessels branch, like blood vessels, into all

the tissues of the body.

Malignant (muh-LIG-nant): Cancerous. Malignant

tumors can invade and destroy nearby tissue and

spread to other parts of the body.

Medical oncologist (MEH-dih-kul on-KOL-oh-jist): 

A doctor who specializes in diagnosing and treating

cancer using chemotherapy, hormonal therapy, and

biological therapy. A medical oncologist often is the

main health care provider for someone who has cancer.

A medical oncologist also gives supportive care and

may coordinate treatment given by other specialists.

Menopausal hormone therapy (MEN-uh-PAH-zul):

Hormones (estrogen, progesterone, or both) given to

women after menopause to replace the hormones no

longer produced by the ovaries. Also called hormone

replacement therapy or HRT.

32
Menopause (MEN-uh-pawz): The time of life when a

woman’s menstrual periods stop permanently. A

woman is in menopause when she hasn’t had a period

for 12 months in a row. Also called “change of life.”

Metastasis (meh-TAS-tuh-sis): The spread of cancer

from one part of the body to another. A tumor formed

by cells that have spread is called a “metastatic tumor”

or a “metastasis.” The metastatic tumor contains cells

that are like those in the original (primary) tumor. The

plural form of metastasis is metastases (meh-TAStuh-seez). 

Metastatic (MET-uh-STAT-ik): Having to do with

metastasis, which is the spread of cancer from one part

of the body to another.

Monoclonal antibody (MAH-noh-KLOH-nul AN-tihBAH-dee): A laboratory-produced substance that can

locate and bind to cancer cells wherever they are in the

body. Many monoclonal antibodies are used in cancer

detection or therapy; each one recognizes a different

protein on certain cancer cells. Monoclonal antibodies

can be used alone, or they can be used to deliver drugs,

toxins, or radioactive material directly to a tumor.

Omentum (oh-MEN-tum): A fold of the peritoneum

(the thin tissue that lines the abdomen) that surrounds

the stomach and other organs in the abdomen.

Ovarian cancer (oh-VAYR-ee-un): Cancer that forms

in tissues of the ovary. Most ovarian cancers are either

ovarian epithelial carcinomas (cancer that begins in the

tissue that covers the ovary) or malignant germ cell

tumors (cancer that begins in egg cells).

Ovarian epithelial cancer (oh-VAYR-ee-un ep-ihTHEE-lee-ul): Cancer that begins in the tissue that

covers the ovary.

33
Ovarian germ cell tumor (oh-VAYR-ee-un): An

abnormal mass of tissue that forms in germ (egg) cells

in the ovary. These tumors usually occur in teenage

girls or young women, usually affect just one ovary,

and can be benign (not cancer) or malignant (cancer).

The most common ovarian germ cell tumor is called

dysgerminoma.

Ovary (OH-vuh-ree): One of a pair of female

reproductive organs in which the ova, or eggs, are

formed. The ovaries are located in the pelvis, one on

each side of the uterus.

Pap test: A procedure in which cells are scraped from

the cervix for examination under a microscope. It is

used to detect cancer and changes that may lead to

cancer. A Pap test can also show noncancerous

conditions, such as infection or inflammation. Also

called a Pap smear.

Pathologist (puh-THOL-oh-jist): A doctor who

identifies diseases by studying cells and tissues under a

microscope. 

Pelvic exam: A physical examination in which the

health care professional will feel for lumps or changes

in the shape of the vagina, cervix, uterus, fallopian

tubes, ovaries, and rectum. The health care professional

will also use a speculum to open the vagina to look at

the cervix and take samples for a Pap test. 

Pelvis: The lower part of the abdomen, located

between the hip bones.

Progesterone (proh-JES-ter-own): A type of hormone

made by the body that plays a role in the menstrual

cycle and pregnancy. Progesterone can also be made in

the laboratory. It may be used as a type of birth control

and to treat menstrual disorders, infertility, symptoms

of menopause, and other conditions. 

34
Prophylactic oophorectomy (proh-fih-LAK-tik oh-ohfor-EK-toh-mee): Surgery intended to reduce the risk

of ovarian cancer by removing the ovaries before

disease develops.

Radiation oncologist (ray-dee-AY-shun on-KOLoh-jist): A doctor who specializes in using radiation to

treat cancer. 

Radiation therapy (ray-dee-AY-shun THAYR-uh-pee):

The use of high-energy radiation from x-rays, gamma

rays, neutrons, and other sources to kill cancer cells

and shrink tumors. Radiation may come from a

machine outside the body (external-beam radiation

therapy), or it may come from radioactive material

placed in the body near cancer cells (internal radiation

therapy, implant radiation, or brachytherapy). Systemic

radiation therapy uses a radioactive substance, such as

a radiolabeled monoclonal antibody, that circulates

throughout the body. Also called radiotherapy.

Registered dietitian (dy-uh-TIH-shun): A health

professional with special training in the use of diet and

nutrition to keep the body healthy. A registered

dietitian may help the medical team improve the

nutritional health of a patient.

Reproductive system: In women, this system includes

the ovaries, the fallopian tubes, the uterus (womb), the

cervix, and the vagina (birth canal). The reproductive

system in men includes the prostate, the testes, and the

penis.

Risk factor: Anything that increases a person’s chance

of developing a disease. Some examples of risk factors

for cancer include a family history of cancer, use of

tobacco products, certain foods, being exposed to

radiation or other cancer-causing agents, and certain

genetic changes. 

35
Salpingo-oophorectomy (sal-PIN-goh oh-oh-for-EKtoh-mee): Surgical removal of the fallopian tubes and

ovaries.

Side effect: A problem that occurs when treatment

affects healthy tissues or organs. Some common side

effects of cancer treatment are fatigue, pain, nausea,

vomiting, decreased blood cell counts, hair loss, and

mouth sores.

Surgeon: A doctor who removes or repairs a part of the

body by operating on the patient.

Surgery (SER-juh-ree): A procedure to remove or

repair a part of the body or to find out whether disease

is present. An operation. 

Systemic chemotherapy (sis-TEH-mik kee-mohTHAYR-uh-pee): Treatment with anticancer drugs that

travel through the blood to cells all over the body. 

Transvaginal ultrasound (tranz-VA-jih-nul UL-truhSOWND): A procedure used to examine the vagina,

uterus, fallopian tubes, ovaries, and bladder. An

instrument is inserted into the vagina that causes sound

waves to bounce off organs inside the pelvis. These

sound waves create echoes that are sent to a computer,

which creates a picture called a sonogram. Also called

transvaginal sonography (TVS).

Ultrasound (UL-truh-SOWND): A procedure in which

high-energy sound waves (ultrasound) are bounced off

internal tissues or organs and make echoes. The echo

patterns are shown on the screen of an ultrasound

machine, forming a picture of body tissues called a

sonogram. Also called ultrasonography.

Uterus (YOO-ter-us): The small, hollow, pear-shaped

organ in a woman’s pelvis. This is the organ in which a

baby grows. Also called the womb.

36
X-ray: A type of high-energy radiation. In low doses,

x-rays are used to diagnose diseases by making

pictures of the inside of the body. In high doses, x-rays

are used to treat cancer.

37
National Cancer Institute Information

Resources

You may want more information for yourself, your

family, and your doctor. The following NCI services

are available to help you.

Telephone

The NCI’s Cancer Information Service (CIS)

provides accurate, up-to-date information on cancer to

patients and their families, health professionals, and the

general public. Information Specialists translate the

latest scientific information into understandable

language and respond in English, in Spanish, or on

TTY equipment. Calls are free. The service is available

to callers in the United States and its territories.

Telephone: 1–800–4–CANCER (1–800–422–6237)

TTY: 1–800–332–8615 

Internet

The NCI’s Web site (http://www.cancer.gov)

provides information from numerous NCI sources. It

offers current information on cancer prevention,

screening, diagnosis, treatment, genetics, supportive

care, and ongoing clinical trials. It has information

about NCI’s research programs and funding

opportunities, cancer statistics, and the Institute itself.

Information Specialists provide live, online assistance

through LiveHelp at http://www.cancer.gov/help.

38
National Cancer Institute Publications

The NCI provides information about cancer,

including the publications mentioned in this booklet.

You can order these materials by telephone, on the

Internet, or by mail. You can also read them online and

print your own copy.

• By telephone: People in the United States and its

territories may order these and other NCI

publications by calling the NCI’s Cancer

Information Service at 1–800–4–CANCER. 

• On the Internet: Many NCI publications can 

be viewed, downloaded, and ordered from

http://www.cancer.gov/publications on the

Internet. People in the United States and its

territories may use this Web site to order printed

copies. This Web site also explains how people

outside the United States can mail or fax their

requests for NCI booklets.

• By mail: NCI publications can be ordered by

writing to the address below: 

Publications Ordering Service

National Cancer Institute

Suite 3035A

6116 Executive Boulevard, MSC 8322

Bethesda, MD 20892–8322

Treatment and Supportive Care

• Chemotherapy and You: A Guide to Self-Help

During Cancer Treatment (also available in Spanish:

La quimioterapia y usted: una guía de autoayuda

durante el tratamiento del cáncer) 

39
• Helping Yourself During Chemotherapy: 4 Steps for

Patients

• Radiation Therapy and You: A Guide to Self-Help

During Cancer Treatment (also available in Spanish:

La radioterapia y usted: una guía de autoayuda

durante el tratamiento del cáncer)

• Eating Hints for Cancer Patients: Before, During &

After Treatment (also available in Spanish: Consejos

de alimentación para pacientes con cáncer: antes,

durante y después del tratamiento) 

• Understanding Cancer Pain (also available in

Spanish: El dolor relacionado con el cáncer)

• Pain Control: A Guide for People with Cancer and

Their Families (also available in Spanish: Control

del dolor: guía para las personas con cáncer y sus

familias)

• Get Relief from Cancer Pain

• Biological Therapy: Treatments That Use Your

Immune System to Fight Cancer 

• “Biological Therapies for Cancer: Questions and

Answers” (also available in Spanish: “Terapias

biológicas del cáncer: preguntas y respuestas”)

• “How To Find a Doctor or Treatment Facility If You

Have Cancer” (also available in Spanish: “Cómo

encontrar a un doctor o un establecimiento de

tratamiento si usted tiene cáncer”)

• “Tumor Markers: Questions and Answers” (also

available in Spanish: “Marcadores tumorales”)

40
Living With Cancer

• Facing Forward Series: Life After Cancer Treatment

(also available in Spanish: Siga adelante: la vida

después del tratamiento del cáncer) 

• Facing Forward Series: Ways You Can Make a

Difference in Cancer

• Taking Time: Support for People with Cancer

• Coping with Advanced Cancer

• When Cancer Returns

• “National Organizations That Offer Services to

People With Cancer and Their Families” (also

available in Spanish: “Organizaciones nacionales

que brindan servicios a las personas con cáncer y 

a sus familias”) 

Clinical Trials

• Taking Part in Clinical Trials: What Cancer

Patients Need To Know (also available in Spanish:

La participación en los estudios clínicos: lo que los

pacientes de cáncer deben saber) 

• If You Have Cancer: What You Should Know About

Clinical Trials (also available in Spanish: Si tiene

cáncer...lo que debería saber sobre estudios

clínicos) 

• Taking Part in Clinical Trials: Cancer Prevention

Studies: What Participants Need To Know (also

available in Spanish: La participación en los

estudios clínicos: estudios para la prevención del

cáncer)

41
Complementary Medicine

• Thinking About Complementary and Alternative

Medicine: A Guide for People with Cancer

• “Complementary and Alternative Medicine in

Cancer Treatment: Questions and Answers” (also

available in Spanish: “La medicina complementaria

y alternativa en el tratamiento del cáncer: preguntas

y respuestas”)

Caregivers

• When Someone You Love Is Being Treated for

Cancer: Support for Caregivers

• When Someone You Love Has Advanced Cancer:

Support for Caregivers

• Facing Forward: When Someone You Love Has

Completed Cancer Treatment

42
¿Necesita información en español?

Llame al Servicio de Información sobre el

Cáncer y hable en español con un especialista en

información. El número es 1–800–422–6237.

The National Cancer Institute

The National Cancer Institute (NCI) is part of the

National Institutes of Health. NCI conducts and supports

basic and clinical research in the search for better ways to

prevent, diagnose, and treat cancer. NCI also supports 

the training of scientists and is responsible for

communicating its research findings to the medical

community and the public.

Copyright permission

The written text of NCI material is in the public

domain. It is not subject to copyright restrictions. You do

not need our permission to reproduce or translate NCI

written text. However, we would appreciate a credit line

and a copy of your translations. 

Private sector designers, photographers, and illustrators

retain copyrights to artwork they develop under contract to

NCI. You must have permission to use or reproduce these

materials. In many cases, artists will grant permission, but

they may require a credit line and/or usage fees. To inquire

about permission to reproduce NCI artwork, please write

to: Office of Communications, Publications Support

Branch, National Cancer Institute, 6116 Executive

Boulevard, Room 3066, MSC 8323, Rockville, MD

20892–8323.
NIH Publication No. 06–1561

Revised May 2006

Printed July 2006