The simple idea (no memorising)
Early ovarian cancer causes only vague symptoms — bloating, feeling full quickly, tummy pressure, needing to pee often. They're so ordinary that women (and doctors) can miss them, so the cancer is often found late, after it has spread across the peritoneum (the belly's lining) — a pattern called transcoelomic spread, often with fluid in the abdomen (ascites).
A modern insight: many aggressive "ovarian" cancers actually start in the end of the fallopian tube — which is why prevention in high‑risk women removes tubes and ovaries.
Family history matters
Inherited gene faults — BRCA1, BRCA2 and Lynch syndrome — sharply raise risk. For high‑risk carriers, removing the tubes and ovaries after childbearing dramatically lowers that risk. (For the record: BRCA1 is on chromosome 17, BRCA2 on chromosome 13.)
The tumour‑marker fingerprints (a classic exam table)
Different tumours leak different markers — a lovely set of one‑to‑one clues:
| Tumour | Marker / sign |
|---|---|
| Epithelial ovarian cancer | CA‑125 (for monitoring, not screening) |
| Dysgerminoma | LDH |
| Yolk‑sac tumour | AFP (with Schiller–Duval bodies) |
| Granulosa‑cell tumour | inhibin (with Call–Exner bodies) |
| Fibroma | Meigs syndrome = fibroma + ascites + pleural effusion |
(Meigs is a lovely trap: a benign fibroma can mimic advanced cancer with fluid in the belly and chest — yet it's harmless and curable.)
Treatment in a line
The mainstay is surgery to remove as much tumour as possible plus platinum‑based chemotherapy, with newer targeted maintenance drugs in selected cases. Young women with germ‑cell tumours can often keep their fertility.
Why it matters
Ovarian cancer's quietness is exactly why the clues matter so much — vague‑but‑persistent symptoms, family history, and marker fingerprints are how we catch what has no screening test.
Quick check ✅
- Why is ovarian cancer often diagnosed late?
- Match the markers: AFP → ? · inhibin → ? · LDH → ?