Ovarian cancer is a silent disease that can sneak up on women, and it’s often referred to as such due to the way it can develop without noticeable symptoms. Because there’s no reliable screening method for women, subtle symptoms can go unchecked until the cancer has spread, which can have devastating consequences.
Ovarian cancer accounts for more deaths than any other gynecologic cancer, with the World Health Organization estimating that it claimed 223,237 lives globally in 2025.
Understanding Ovarian Cancer
Leslie Randall, MD, a Gynecologic Oncology Service Line and Clinical Research Director, has dedicated her career to treating patients with this complex disease. She notes that a lack of awareness is a significant barrier to getting prompt treatment, and that the vast majority of cases are caught in the more advanced stages.
Dr. Randall shares her must-know facts about ovarian cancer, from the warning signs and risk factors to the treatment protocols that are moving the needle for the community. Genetics play a role in ovarian cancer, with certain factors raising a woman’s risk, including family history, particularly when it involves ovarian cancer.
Research finds that up to 25 percent of ovarian cancers are linked to inherited mutations, such as the BRCA1 and BRCA2, RAD51C, RAD51D, or BRIP1 genes, and mutations tied to Lynch Syndrome. Genetic tests can help identify mutations that might increase a woman’s risk of ovarian cancer. Women can use disease risk detection methods to identify their risk.
Warning Signs and Risk Factors
Other factors that can raise a woman’s risk of ovarian cancer include a previous diagnosis of endometriosis or breast cancer, as well as reproductive history. Age is also a risk factor, with most diagnoses occurring after menopause.
Never having been pregnant, starting menstruation early, and entering menopause later in life can all increase a woman’s risk. A 2024 study showed that long-term estrogen-only hormone therapy can also up a woman’s odds of developing ovarian cancer.
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Dr. Randall encourages women to keep up with routine gynecologic care and communicate any relevant medical or family history with their providers. They should be aware of the warning signs of ovarian cancer, which can be vague and easily mistaken for other conditions.
The most common symptoms are abdominal bloating and early satiety, as well as pelvic pain, urinary frequency, fatigue, back pain, changes in bowel habits, and menstrual irregularities. Individually, these symptoms may seem like things that can be ascribed to irritable bowel syndrome, premenstrual syndrome, perimenopause, or stress.
Treatment and Management
The real red flag is persistence, according to Dr. Randall. If symptoms escalate or last for two to three weeks or more, they need to be evaluated. Treatment for ovarian cancer is patient-specific, starting with a combination of imaging, blood tests, and a pelvic exam.
A tissue biopsy then confirms the type of tumor, which helps doctors map out an individualized plan. The amount of information received after diagnosis can feel overwhelming, and having open conversations with healthcare providers early in the treatment journey can help women make informed decisions and feel confident in their personalized plan.
Treatment typically includes surgery to remove as much of the cancer as possible, followed by chemotherapy. However, the specifics are rarely one-size-fits-all, and decisions around timing, the extent of surgery, and the types of medications used hinge on factors like genetic makeup, where the cancer started, and its stage of development.
Oncologists are increasingly using a tumor’s genetic biomarkers to determine therapy, an approach that can improve outcomes and reduce side effects. For some patients, this may mean adding currently approved targeted drugs or immunotherapy to the mix.
Maintenance therapy has become a standard part of ovarian cancer care, involving ongoing treatment to prolong the remission period. It usually involves using targeted medications, such as PARP inhibitors and angiogenesis inhibitors, to prevent or delay disease recurrence.
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A Holistic Approach to Care
Dr. Randall notes that maintenance therapy isn’t a one-size-fits-all decision, and the selection of an appropriate maintenance therapy is a thoughtful process, taking into account the tumor’s specific genetic profile, prior treatments, and overall health.
Understanding these nuances allows doctors to tailor care for a woman’s unique situation. Additionally, an important consideration is whether oral pills or infusions are better for a woman’s specific needs.
Despite the challenges, Dr. Randall is optimistic about the future of ovarian cancer treatment, citing innovative research that has the potential to deliver meaningful impact for patients. Ovarian cancer mortality has dropped by more than 40 percent since the mid-1970s, with most of the progress taking place in the last 20 years.
Catching the disease as early as possible is still the goal, and Dr. Randall hopes for more progress in developing screening and diagnostic tests. She also emphasizes the importance of a more holistic approach to care, including better resources for nutrition, exercise, mental health, and symptom management to support patients through their care.
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