1. Initial investigation and referral
Your general practitioner (GP) will assess your symptoms (for example, persistent abdominal bloating/pain, lack of appetite or urinary incontinence), conduct a physical examination and arrange blood tests.
Your GP should also discuss your needs (including physical, psychological, social and information needs) and recommend sources of reliable information and support.
You may have one or more of these tests:
- Pelvic examination: The doctor will look at your abdomen and vagina to check for masses or lumps.
- Blood tests: You may have a blood test to assess your general health.
- Computed tomography (CT) scan: Computer technology and x-rays are used to create detailed images of the body.
- Transvaginal ultrasound: A handheld device inserted into your vagina produces high-frequency sound waves that are used to create an image of your ovaries. It is important that this procedure is performed by a practitioner experienced in gynaecological ultrasounds.
If ovarian cancer is suspected, you will be referred to a specialist for further testing within one to two weeks. Your GP will provide the specialist with information about your medical history, whether there is a history of cancer in your family, and results of the initial tests.
It can be helpful to bring a family member or friend with you to your appointments.
2. Diagnosis and staging
The specialist might conduct further tests to find out whether cancer is present and, if it is, the stage of development and if it has spread.
Further tests you may have:
Magnetic resonance imaging (MRI) scan
MRI's are when magnetic fields and radio waves are used to take pictures of the inside of your body.
CT guided biopsy
Small samples are removed from your ovary gland to be examined under a microscope.
Your doctor may give you a local anaesthetic and pass a needle through your skin to take a fluid sample to be examined under a microscope.
Other investigations may also be considered. If you are diagnosed with high-grade serous epithelial ovarian you should be referred to a familial cancer centre for genetic testing.
It can be helpful to contact cancer peer support groups and support groups for carers.
Here is a list of questions to ask your doctor.
To ensure you receive the best care, your specialist will arrange for a team of health professionals to plan your treatment based on your preferences and needs. The team will be made up of health professionals who have experience managing and supporting a woman with ovarian cancer. Your specialist will tell you when the team will be discussing your case.
Your team should discuss the different treatment options with you including the likely outcomes, expected timeframes, possible side effects and the risks and benefits.
Your team should also discuss the option of fertility preservation and provide clear information about the risk of early menopause and hormonal changes. You might want to ask for more time before deciding on your treatment, or ask for a second opinion. You may be referred to a fertility service to help you evaluate your options. Your doctor may also suggest you consider taking part in a clinical trial.
Let your team know about any complementary therapies you are using or thinking about trying. Some therapies may not be appropriate, depending on your medical treatment.
There are a number of ways to treat ovarian cancer including surgery, radiation therapy and chemotherapy or drug therapy. In some cases more than one type of treatment may be used to get the best outcome.
Surgery is the most common treatment for ovarian cancer. It is important that this surgery is performed by a gynaecological oncologist who is very experienced in performing ovarian surgery and performs several operations every year.
Chemotherapy or targeted therapy
Chemotherapy or targeted therapy may be given to you before or after surgery or as your main treatment.
Radiation therapy (also called radiotherapy)
Radiation therapy may benefit some women.
For more information about treatment and treatment side effects ask your doctor or visit our treatment section.
Your doctor should discuss your needs with you during and after treatment (including physical, psychological, social and information needs) and may refer you to another service or health professional for different aspects of your care.
4. After treatment
Treatment for ovarian cancer sometimes results in hormonal changes and, in some cases, early menopause. This can lead to side effects such as night sweats, hot flushes and reduced libido. Fortunately, there are many ways to reduce or manage the side effects of treatment.
After your treatment is completed, your doctor should provide you with a treatment summary with details of the care you received including:
- diagnostic tests that were performed and their results
- types of treatment used and when they were performed
- treatment plans from other health professionals
- supportive care services provided to you.
To monitor your health, and make sure the cancer has not returned, you will need regular check-ups.
You and your GP should receive a follow-up care plan that tells you about:
- the type of follow-up that is best for you
- care plans for managing any side effects of treatment should they occur
- how to get specialist medical help quickly if you think the cancer has returned or worsened.
Your doctor should:
discuss your needs with you and refer you to appropriate health professionals and/or community organisations, if support is required
provide information on the signs and symptoms to look out for that might mean a return of the cancer
provide information on prevention and healthy living
5. If cancer returns
Sometimes ovarian cancer can come back after treatment. This is why it is important you have regular check-ups. Usually this will be detected at your routine follow-up appointments or if you notice symptoms are coming back.
6. Living with cancer
Some people experience side effects (for example, tiredness) that continue beyond the end of treatment. Sometimes side effects don’t begin until months after treatment has finished. For more information about side effects ask your doctor.
Advance care plan:
Your doctor may discuss with you the option of developing an advance care plan. An advance care plan is a formal way of setting out your wishes for future medical care. For more information about advance care planning ask your doctor or visit advancecareplanning.org.au.
This type of treatment could be used at different stages to help you with pain relief, to reduce your symptoms or help improve your quality of life. For more information about palliative care ask your doctor or visit palliativecare.org.au.
7. Questions of cost
There can be cost implications at each stage of the cancer care pathway, including costs of treatment, accommodation and travel. There can be substantial out-of-pocket costs if you are having treatment in a private health service, even if you have private health insurance.
You can discuss these costs with your doctor and/or private health insurer for each type of treatment you may have. If you are experiencing financial difficulties due to your cancer treatment you can contact the social worker at your local hospital.
For more information visit costs of treatment.
For more information about accommodation and travel costs visit our support section.
8. Further support
Ovarian cancer support
For information about ovarian cancer call Ovarian Cancer Australia on 1300 660 334 or visit ovariancancer.net.au.
You can also speak to specially trained staff at Cancer Council 13 11 20. They can answer your questions about the effects of cancer, explain what will happen during treatment and link you to support groups and other community resources.
If you need an interpreter, call TIS (Translating and Interpreting Service) on 13 14 50.
For support and advice for carers, call the Carers Association on 1800 242 636.
More support options
Australian Cancer Survivorship Centre
Has general and tumour-specific information, primarily focused on the post-treatment survivorship phase
• Telephone: (03) 9656 5207
• Website: www.petermac.org/cancersurvivorship
Information on depression, anxiety and related disorders, available treatment and support services
• Telephone: 1300 22 4636
• Website: www.beyondblue.org.au
Look Good, Feel Better
A non-medical, free community service program dedicated to teaching women how to manage the appearance-related side-effects caused by cancer treatment
• Telephone: 1800 650 960 (Monday to Thursday 9.00am to 5.00pm)
• Website: www.lgfb.org.au
Information on cancer prevention, screening, diagnosis, treatment and supportive care for Australians affected by cancer, and their families and carers
• Telephone: 1800 624 973
• Website: www.canceraustralia.gov.au
Ovarian Cancer Australia
Specific information on ovarian cancer
• Telephone: 1300 660 334
• Website: www.ovariancancer.net.au
Australian organisation for young people living with cancer offers support, information, and resources
• Telephone: 1800 226 833
• Website: www.canteen.org.au
Care Search: Palliative Care Knowledge network
Information for patients and carers on living with illness, practical advice on how to care, and finding services
• Telephone: (08) 7221 8233
• Website: www.caresearch.com.au
National Health Services Directory
A directory providing information on local hospital and community services
• Website: www.nhsd.com.au
Clinical versions of the optimal care pathways have been developed for clinicians and general practitioners here.