Ovarian cancer causes the affected ovaries to become larger. In younger women, the cause of an enlarged ovary may be a noncancerous, fluid-filled sac (ovarian cyst). However, after menopause, enlarged ovaries can be a sign of ovarian cancer.

Many women have no symptoms until cancer develops. The first symptom may be a vague discomfort in the lower abdomen, similar to indigestion. Other symptoms may include bloating, loss of appetite (because the stomach is compressed), gas, and back pain. Ovarian cancer rarely causes vaginal bleeding.

Eventually, the abdomen may become swollen due to enlarged ovaries or fluid in the abdomen (called ascites). At this time, pelvic pain, anemia, and weight loss are common.

In rare cases, germ cell or stromal cell tumors produce estrogen, which causes endometrial tissue to overgrow and enlarge the breasts. Or these tumors may produce male hormones (androgens), which cause excess body hair growth, or thyroid-like hormones, which can cause symptoms of an overactive thyroid (hyperthyroidism).

• Ultrasound imaging
• Sometimes a CT or MRI scan
• Blood test

Diagnosing ovarian cancer at an early stage can be difficult because symptoms usually don't appear until the cancer is very large or has spread outside the ovary, and many less serious diseases can cause similar symptoms.

If a doctor finds an enlarged ovary during a physical exam or suspects early-stage ovarian cancer based on symptoms, an ultrasound is done first. Computed tomography (CT) scans or magnetic resonance imaging (MRI) scans are sometimes used to help distinguish ovarian cysts from solid cancerous masses. If advanced cancer is suspected, a CT or MRI scan is done before surgery to determine the extent of cancer.

If cancer seems unlikely, the doctor will periodically re-examine the woman.

If doctors suspect cancer or test results are inconclusive, blood tests are usually done to measure levels of substances that may indicate the presence of cancer (tumor markers), such as cancer antigen 125 (CA 125). Abnormal tumor marker levels alone do not confirm a diagnosis of cancer, but when combined with other information, they can support a diagnosis.

The stage depends on how far cancer has spread. Stages range from I (oldest) to IV (advanced):

• Stage I: Cancer occurs in only one or both ovaries (or fallopian tubes).
• Stage II: Cancer has spread to nearby tissues in the uterus or pelvis (including the internal reproductive organs, bladder, and rectum).
• Stage III: Cancer has spread to lymph nodes outside the pelvis and/or other parts of the abdomen (such as the surface of the liver or spleen).
• Stage IV: Cancer has spread outside the pelvis (for example, into the lungs).

The prognosis for women with ovarian cancer depends on the stage. The percentage of women surviving 5 years after diagnosis and treatment (5-year survival rate) was:

• Stage 1: 85% to 95%
• Stage 2: 70% to 78%
• Stage 3: 40% to 60%
• Stage 4: 15% to 20%

The prognosis is worse when the cancer is more aggressive or when surgery cannot remove all visible abnormal tissue. About 70 percent of women with stage 3 or 4 cancer will have a recurrence.

Noncancerous (benign) ovarian tumors include cysts (mostly functional cysts) and tumors.Most cysts and noncancerous tumors cause no symptoms, but some can cause pelvic pain or heaviness.

A doctor may find the growth during a pelvic exam and then use an ultrasound to confirm the diagnosis.

Some cysts go away on their own. Cysts or tumors can be removed feasibly with a laparoscope through one or more small incisions in the abdomen. Laparoscopically can be performed in all the non cancerous ovarian tumor with better preservation of ovaries. In laparoscopically surgery ovaries look many times larger than their original size with laparoscope.

Importantly, ovarian cysts are fluid-filled sacs that form inside or on top of the ovary. These cysts are relatively common. Most are noncancerous (benign) and go away on their own. Carcinoid cysts are more likely to occur in women over the age of 40.

Additionally, noncancerous (benign) ovarian tumors usually grow slowly and rarely become cancerous. The most common include:

These tumors usually develop from three layers of tissue in the fetus, called the germ cell layer. All organs are made up of these tissues. Therefore, teratomas may contain tissue from other structures, such as nerves, glands, and skin.

Hemorrhagic is cyst is filled with blood stain fluids and sometimes chocolate fluid. If it ruptures then leads to leakage of fluid in the abdomen causing sudden pain. Sometimes it is also called endometrioma.

Furthermore, most active cysts and noncancerous ovarian tumors do not cause any symptoms. Occasionally, pain in the pelvic area or pain during intercourse.

Some cysts produce hormones that affect menstruation. As a result, your periods may be irregular or heavier than usual. Spots may appear between periods. In postmenopausal women, these cysts may cause vaginal bleeding.

If luteal cysts bleed, they may cause pain or tenderness in the pelvic area.

Sometimes sudden, severe abdominal pain is caused by a large cyst or lump that causes ovarian torsion, a condition called adnexal torsion.

Ovarian cancer may develop fluid accumulation in the abdomen (ascites). Ascites may cause pressure or heaviness in the abdomen.

• Diagnosis
• Pelvic exam
• Ultrasound imaging

Doctors sometimes find cysts or tumors during routine pelvic exams. Sometimes doctors suspect their presence based on symptoms. Often it is identified when imaging tests (such as ultrasound) are performed for other reasons.

When needed to confirm the diagnosis, an ultrasound (transvaginal ultrasound) is done using an ultrasound machine inserted into the vagina.

A pregnancy test is done to rule out pregnancy, including ectopic pregnancy (ectopic pregnancy).

If ovarian cysts are less than 2 inches (about 5 centimeters) in diameter, they usually go away on their own without treatment. Have regular ultrasound examinations.

If the cyst is larger than 2 inches (5 cm) and does not go away, it may need to be removed. If cancer cannot be ruled out, the ovaries are removed. If the cyst is cancerous, the cyst, ovaries, and affected fallopian tubes are removed.

Benign tumors, such as dermoid and cystic adenomas, require treatment.

If possible, remove the cyst or tumor by one of the following methods:

Laparoscopy involves making one or more small incisions in the abdomen. It is performed in a hospital and usually requires general anesthesia. However, women do not require to stay overnight.

The procedure used depends on the size of the growth and whether other organs are affected.

If technically feasible, doctors aim to protect the ovaries by removing only the cyst (cystectomy).