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Ovarian cancer is cancer that starts in one or both of your ovaries. If you've been told you have this cancer, you may be shocked, afraid and worried about what will happen to you. Ovarian cancer is serious, but it can be treated.

Ovarian cancer doesn't usually cause any symptoms early on, so in most women it has already spread from the ovary by the time it's picked up. This makes it harder to cure. But doctors can't say for sure what will happen to you.

• There isn't a good screening test to find this cancer before it causes symptoms.¹
• Even if you have symptoms, the only way your doctor can tell for sure that you have this cancer is by doing an operation to look at your ovaries.
• Treatment helps you live longer and eases your symptoms. Sometimes it can cure your cancer, especially if it's caught early.

To understand how ovarian cancer starts and how it's treated, it helps to know more about your ovaries.

• Your ovaries are two small, almond-shaped organs on either side of your womb.
• They sit in your pelvis, the lower part of your abdomen between your hips.
• They make eggs so you can get pregnant.
• They also make estrogen and progesterone, the female sex hormones that you need to get pregnant.

After menopause, your ovaries stop making eggs, you stop getting periods and your hormone levels fall.

Your ovaries are part of your reproductive system. This is the name for the parts of your body that let you get pregnant and have a baby.

These parts include:

• Your two ovaries
• Your two fallopian tubes
• Your womb and the lining of your womb (the endometrium)
• Your cervix
• Your vagina.

Your ovaries also sit close to your bladder and bowels.

Lots of women have growths on their ovaries, and most of them aren't cancer. Most are harmless lumps filled with fluid. Doctors call these cysts. For more information, see Cysts.

When your body's cells are healthy, they grow and divide to make new cells as your body needs them. When old cells die, the new ones take their place.

But sometimes this process breaks down. Too many new cells are made and not enough old cells die. All of these cells can stick together to make a lump called a tumor.

• If a tumor is malignant, this means it is cancerous and can spread to other parts of the body.
• If a tumor is benign, this means it is not cancerous and it won't spread to other parts of the body.

If a tumor is cancerous, this means it can invade and destroy the surrounding tissue. A non-cancerous tumor may grow bigger, but it will not spread to other parts of the body.

Most ovarian cancers start on the outside of your ovary. Only about 1 in 20 start inside your ovary.

One way that ovarian cancer spreads is when some cancer cells break away from the ovary and travel to nearby organs such as your womb, bladder and bowels.

If this happens, new spots of cancer cells can grow in your pelvis and abdomen.

Common places for the new spots to grow are:

• On the muscle between your chest and your abdomen (called the diaphragm)
• On the fold of fat inside your abdomen (called the omentum)
• On the lining of your abdomen (called the peritoneum).

Cancer cells can damage the lining of your abdomen. If this happens, the lining makes fluid to try to soothe the upset. This fluid can build up in your abdomen and make you look and feel bloated. Doctors call the fluid ascites.

Two other ways that ovarian cancer spreads are by traveling in your lymphatic system and in your bloodstream. If it does this, it can spread to more distant parts of your body, such as your lungs. The new spots of cancer that show up in other parts of your body are called metastases.

We don't know why some women get ovarian cancer and others don't. But certain things can make it more likely that you'll get the disease. Doctors call these things risk factors. If you have a risk factor for a disease, it doesn't mean you'll get the disease for sure. It just means your chance of getting it is higher.

Some of the risk factors for ovarian cancer are having it run in your family, getting older and having few or no children. To find out more, see Factors that affect your risk.

If someone in your family has had ovarian cancer, you may worry that you'll get it too. And you may wonder if there's anything you can do to lower your risk. For more information, see Ovarian cancer and your family.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.