Symptoms
Symptoms at an early stage can be mild and vague. The following symptoms need assessment if they last more than a few weeks:
- Abdominal bloating or an increase in waist size
- Pain or pressure in the pelvis or abdomen
- Loss of appetite or feeling full quickly
- A frequent or urgent need to pass urine
Sometimes a mass is found by chance during an examination, ultrasound, CT or MRI performed for another reason.
Risk factors
- Never having been pregnant
- Starting periods at a young age or a late menopause
- A family history of ovarian, breast or uterine cancer; BRCA1/BRCA2 gene changes
- Lynch syndrome in the family
Women with these cancers in their family should discuss genetic counselling and testing.
How is it diagnosed?
Assessment begins with an examination and a transvaginal ultrasound; CT or MRI is added if needed. These scans give important information about the location, size and structure of the mass but cannot make a definitive diagnosis on their own.
The CA-125 blood test helps the assessment. However, it can also be raised in many conditions such as endometriosis, fibroids, infection and pregnancy, and on its own it is not meaningful, especially before the menopause. A raised level after the menopause increases suspicion.
Ovarian cancer can only be diagnosed definitively by pathological examination of the tissue removed. Suspicious masses are therefore removed whole, without breaking them, whenever possible.
Surgery and staging
For masses suspected to be cancer, tissue is sent for rapid pathological examination (frozen section) during the operation. If cancer is confirmed, staging is performed in the same operation:
- Removal of the uterus, fallopian tubes and both ovaries
- Removal of the fatty tissue covering the abdominal organs (omentum)
- Fluid and tissue samples from the abdomen and, when needed, removal of lymph nodes
- In advanced disease, removal of all visible tumour (cytoreduction)
Leaving no visible tumour at the end of the operation is one of the most important factors in the outcome of treatment. In young women who wish to have children, with very early-stage disease and suitable tumour types, it may be possible to preserve the uterus and the healthy ovary.
Small masses with a low probability of cancer can be operated on laparoscopically; open surgery is usually preferred when advanced disease is suspected.
Treatment and follow-up after surgery
Apart from some very early, low-grade tumours, chemotherapy is recommended after surgery for most patients. In widespread disease, several cycles of chemotherapy may be given before surgery. Some patients receive maintenance treatment afterwards.
After treatment, check-ups are carried out every 2–4 months for the first two years and less frequently afterwards; examination and CA-125 measurement form the basis of follow-up.
Frequently asked questions
A cyst was found on my ovary – could it be cancer?
The great majority of ovarian cysts are benign; cancer is a rare cause, especially before the menopause. The ultrasound appearance, your age and, if needed, the CA-125 result are assessed together to decide between monitoring and surgery.
My CA-125 is raised – does this mean cancer?
No. CA-125 can be raised in many benign conditions such as endometriosis, fibroids, menstruation, infection and pregnancy. The result must be interpreted together with imaging findings.
Is there a screening test for ovarian cancer?
No screening test has been proven to allow early diagnosis in the general population. Special follow-up and risk-reducing surgery are discussed with women at high risk (for example, BRCA carriers).
Book a consultation
Prof. Dr. Derya Sivri Aydın sees patients at Medical Park Bahçelievler Hospital, Istanbul. International patients are supported by the hospital's International Patient Services Center.
The information on this page is for general guidance only; the right diagnosis and treatment for you are decided after a consultation. Last updated: November 2026.