Ovarian Cysts and Ovarian Cancer

Am Fam Physician. 2009;80(8):821-822

See related article on adnexal masses.

What are ovarian cysts?

During your period each month, you usually get a small cyst on your ovaries. These cysts are a normal part of your period. Sometimes they cause pain, but usually they do not cause any symptoms. Your doctor may find these cysts during an exam or ultrasound. Most cysts go away with time, but your doctor may want to check you again in four to six weeks to make sure they are gone. In women who are menopausal, the ovaries have stopped working and should not form cysts. There are different types of cysts that are not cancerous, but sometimes (especially in older women), the cysts can be ovarian cancer.

What is ovarian cancer?

Ovarian cancer is an abnormal growth of tissue in the ovaries that can spread to other organs in the body and lead to death.

What are the symptoms of ovarian cancer?

You may have pain in your stomach or pelvis, bloating, or increased stomach size. You may also have a strong urge to urinate, may urinate often, or may leak urine. You could also get full quickly when eating, have trouble eating, or lose weight. If you have any of these symptoms every day for two weeks, talk to your doctor right away.

What tests will I need?

Your doctor may do an ultrasound. An ultrasound uses sound waves to form a picture of organs in your body. It is the best and safest way to look at the ovaries and uterus. An ultrasound can be done on the lower part of your stomach or through your vagina. It lasts about 20 minutes and gives your doctor information about the size and appearance of your ovaries and other pelvic organs.

Your doctor may also test your blood for a raised level of a protein called CA 125. Patients with ovarian cancer may produce more of this protein, but there are also noncancerous conditions that can cause a raised CA 125 level.

Will I need surgery for an ovarian cyst?

It depends on your age, symptoms, and how your ovaries look on the ultrasound. If you are still having periods, your cysts are probably not cancerous and only need to be watched. Women who are menopausal are the most likely to need surgery because the risk of ovarian cancer increases with age.

What type of surgery will I have?

Most women who need surgery for an ovarian cyst have a laparoscopy (lah-pah-rohs-KOH-pee). This is done with a lighted tool that looks like a thin telescope. It is inserted through a small cut around your belly button. Your doctor can use a camera to see inside your body and examine your organs. Often, the cyst can be removed through the same small cut.

Sometimes, a patient will need a laparotomy (lah-pah-ROT-o-me). This type of surgery requires a larger cut on your stomach. The tissue that is removed during surgery is examined to make sure that there are no cancer cells in it. If the removed tissue has cancer cells, your doctor will do other tests to figure out what stage the cancer is in.