Ovarian cancer (kanser ovari) is the fifth most common cancer in Malaysian women, and more than half of cases with a recorded stage are found late, at stage 3 or 4. Its early signs are easy to miss: bloating, tummy or pelvic pain, feeling full quickly and needing to pee more often. These are usually caused by something less serious, but if they happen frequently (the NHS says roughly 12 or more times a month), see a doctor. A pap smear does not check for ovarian cancer, and finding it early can make it more treatable.
Apa itu kanser ovari?
According to the NHS, ovarian cancer affects the ovaries, the 2 small organs that store eggs and produce female hormones. It mostly affects women over 50, but can affect anyone with ovaries. You can still get it after your ovaries have been removed, because it can also start in the fallopian tubes or the lining inside the tummy (peritoneum); these cancers are often grouped together and treated the same way.
According to Cancer Research UK, there are several types:
- Epithelial ovarian cancer, which starts in the cells covering the ovary, is the most common type. Fallopian tube cancer and primary peritoneal cancer are counted as types of epithelial ovarian cancer.
- Germ cell tumours start in the cells that develop into eggs. They are rare and usually affect people up to their early 30s.
- Stromal tumours, such as granulosa cell tumours, are also rare.
- Borderline tumours are not cancer and are usually cured with surgery.
Most ovarian cysts are not cancer; see our guide to cyst ovari.
Kanser ovari di Malaysia
According to the Malaysia National Cancer Registry Report 2017-2021 from the Ministry of Health:
- 4,714 cases of ovarian cancer were registered in 2017 to 2021, compared with 3,575 in 2012 to 2016;
- it was the fifth most common cancer in women (after breast, colorectal, lung and womb cancer) and the tenth most common overall;
- the lifetime risk was 1 in 143, the same for Malay, Chinese and Indian women (1 in 200 for Other Bumiputera);
- it was most common at age 65 to 69;
- 54.1% of cases with a recorded stage were found at a late stage (stage 3 or 4).
| Women, 2017-2021 | Ovarian cancer cases | Rank among cancers in this group |
|---|---|---|
| Malay | 2,548 | 4th |
| Chinese | 1,330 | 6th |
| Indian | 354 | 4th |
| Other Bumiputera | 379 | 7th |
Source: Malaysia National Cancer Registry Report 2017-2021, tables of the ten most common cancers by ethnicity.
Tanda dan simptom kanser ovari
The NHS says the symptoms of ovarian cancer are not always obvious. Symptoms include frequently (roughly 12 or more times a month) having:
- a swollen tummy or feeling bloated;
- pain or tenderness in your tummy or the area between your hips (pelvic pain);
- no appetite or feeling full quickly after eating;
- an urgent need to pee or needing to pee more often.
Other symptoms can include indigestion, constipation or diarrhoea, back pain, feeling tired all the time, losing weight without trying, and unusual vaginal bleeding, including between periods, heavier periods or bleeding after the menopause.
These symptoms are very common and can be caused by many different conditions, according to the NHS. What matters is if they are new for you, keep happening or are getting worse. For other causes, see our guides to perut kembung and kerap kencing.
Punca dan faktor risiko
According to the NHS, the risk of ovarian cancer increases with age, and you may have a higher chance of getting it if you:
- have inherited a faulty gene, such as the BRCA genes or those linked to Lynch syndrome;
- have had breast cancer or bowel cancer;
- have had radiotherapy for a previous cancer;
- have endometriosis or diabetes;
- started your periods young, went through the menopause late (over 55), or have not had a baby, as these may mean you have ovulated more;
- have never used hormonal contraception, such as the pill or an implant;
- are taking hormone replacement therapy (HRT); Cancer Research UK says the increase in risk is small;
- are overweight;
- smoke.
Cancer Research UK says some things lower the risk: taking the combined contraceptive pill (the longer you take it, the lower the risk), having children, and breastfeeding. You cannot always prevent ovarian cancer, but the NHS advises not smoking and keeping a healthy weight.
BRCA and family history
Sometimes ovarian cancer runs in families. Cancer Research UK says having a first-degree relative (mother, sister or daughter) with ovarian cancer increases the risk, and faulty genes such as BRCA1 and BRCA2 make it more likely, although not certain.
This matters in Malaysia. In the MaGiC study of 790 women with ovarian cancer at 23 hospitals in Malaysia, 13.5% had a harmful change in the BRCA1 or BRCA2 gene, and about 80% of patients chose genetic testing when it was offered through their cancer doctor. Knowing a woman carries a BRCA change can help guide her treatment and help her relatives understand their own risk.
The NHS advises talking to a doctor if ovarian cancer runs in your family, as you may be referred to a specialist for genetic testing.
Is there a screening test? (pap smear and CA125)
A pap smear does not test for ovarian cancer. According to the NHS, cervical screening is a test to check the health of the cervix and help prevent cervical cancer; see our guide to the pap smear and HPV test.
Cancer Research UK says there is no national screening programme for ovarian cancer in the UK because there is no test that reliably picks it up early. A large UK trial found that ultrasound scans did not find cancers earlier or save lives; the CA125 blood test found some cancers earlier, but this did not save lives. CA125 and ultrasound are still important for diagnosing ovarian cancer in women who have symptoms.
How ovarian cancer is diagnosed
According to the NHS, if a doctor thinks you may have ovarian cancer you will usually have:
- a blood test for a protein called CA125, which is sometimes linked to ovarian cancer;
- an ultrasound scan, either inside the vagina (transvaginal) or over the tummy, to look for changes in the ovaries.
The NHS says that if your CA125 level is high, you will have an ultrasound scan, and other tests will then be needed to confirm the diagnosis. Sometimes the ovaries are too small to show on a scan, especially after the menopause, and if the scan is normal the doctor should look for other causes of your symptoms. To confirm the diagnosis, a specialist may arrange a CT scan, a needle biopsy of cells or fluid, a laparoscopy (a camera through a small cut in the tummy) or surgery.
Tahap kanser ovari (stage 1 to 4)
The stage describes how far the cancer has spread. According to Cancer Research UK, which uses the FIGO system, there are four stages. The table also shows 5-year survival for women diagnosed in England in 2016 to 2020; figures in Malaysia may differ, and no one can predict an individual’s outcome.
| Stage | What it means (Cancer Research UK) | 5-year survival, England |
|---|---|---|
| Tahap 1 | The cancer is only in the ovaries | 95 out of 100 |
| Tahap 2 | It has grown outside the ovaries or fallopian tubes and is growing within the pelvis | More than 70 out of 100 |
| Tahap 3 | It has spread outside the pelvis into the abdominal cavity or to lymph nodes | More than 30 out of 100 |
| Tahap 4 | It has spread to distant parts of the body, such as the liver or lungs | Around 15 out of 100 |
This is why early diagnosis matters: the NHS says ovarian cancer is often diagnosed late, but finding it early can mean it is more treatable. Because the symptoms are not always obvious, do not wait for them to become severe before seeing a doctor.
Rawatan kanser ovari
According to the NHS, treatment depends on the size and type of cancer, where it is, whether it has spread and your general health. The main treatments are surgery and chemotherapy:
| Treatment | What it involves (NHS) |
|---|---|
| Surgery | Removing one or both ovaries and fallopian tubes, and often the womb (hysterectomy); if the cancer has spread, surgery aims to remove as much of it as possible, which may include fatty tissue in the tummy, lymph nodes and sometimes part of the bowel |
| Chemotherapy | Medicine that kills cancer cells; it may be given before and after surgery, on its own, or for cancer that has come back |
| Targeted medicines | Medicines that target what helps cancer cells grow or survive; an option for some types of advanced cancer or cancer that has come back |
| Radiotherapy | Sometimes used for advanced cancer or to ease symptoms such as bleeding or pain |
| Hormone treatment | For some cancers that need oestrogen to grow, but rarely used |
One targeted medicine, olaparib (a PARP inhibitor), is used for some women with BRCA-related ovarian cancer. A Malaysian cost-effectiveness analysis estimated that it adds years of life compared with routine monitoring, but found that at current prices it was not cost-effective for the public sector, so access can depend on cost.
Treatment can affect periods and fertility in younger women; the NHS says there may be options to preserve fertility that your specialist team can advise on. If ovarian cancer is advanced, it might be very hard to treat and it may not be possible to cure it; treatment then aims to limit the cancer and its symptoms and help you live longer.
When to see a doctor
According to the NHS, see a doctor if:
- you have any symptoms of ovarian cancer, such as frequent bloating, tummy or pelvic pain, feeling full quickly or needing to pee more often;
- you have seen a doctor before, but your symptoms have not gone away, are worse or more frequent;
- you have vaginal bleeding after the menopause.
It helps to tell your doctor how often the symptoms happen and whether anyone in your family has had ovarian, breast or bowel cancer. For bleeding after the menopause, see also our guides to kanser rahim and menopaus.
Frequently asked questions (FAQ)
Apa tanda awal kanser ovari (early signs of ovarian cancer)?
According to the NHS, the main symptoms are frequently (roughly 12 or more times a month) having a swollen tummy or feeling bloated, pain in your tummy or pelvis, no appetite or feeling full quickly after eating, and an urgent need to pee or needing to pee more often. These symptoms are very common and usually caused by something else, but see a doctor if they keep happening.
Apa punca kanser ovari (what causes ovarian cancer)?
The exact cause is not always known, but the NHS lists factors that raise the risk: getting older, inheriting a faulty gene such as BRCA or one linked to Lynch syndrome, having had breast or bowel cancer, endometriosis, diabetes, starting periods young or a late menopause, not having had a baby, never using hormonal contraception, taking HRT, being overweight and smoking.
How common is ovarian cancer in Malaysia?
According to the Malaysia National Cancer Registry Report 2017-2021, 4,714 cases of ovarian cancer were registered from 2017 to 2021, making it the fifth most common cancer in Malaysian women. The lifetime risk was 1 in 143 for Malay, Chinese and Indian women, and 54.1% of cases with a recorded stage were found at a late stage (stage 3 or 4).
Can a pap smear detect ovarian cancer?
No. A pap smear (cervical screening) checks the health of the cervix and helps prevent cervical cancer, according to the NHS; it does not check the ovaries. Cancer Research UK says there is no test that reliably picks up ovarian cancer early in women without symptoms, so it is important to know the symptoms and see a doctor if they keep happening.
Can young women get ovarian cancer?
Yes, although it is less common. The NHS says ovarian cancer mostly affects women over 50. Some rarer types, such as germ cell tumours, usually affect people up to their early 30s, according to Cancer Research UK. In Malaysia, the registry found ovarian cancer was most common at age 65 to 69, but cases were recorded in younger women too.
Kanser ovari tahap 4 boleh sembuh (can stage 4 ovarian cancer be cured)?
According to the NHS, more advanced ovarian cancer can be very hard to treat and it may not be possible to cure it. In that case, treatment aims to limit the cancer and its symptoms and help you live longer. Cancer Research UK data from England show around 15% of women diagnosed at stage 4 survive 5 years or more, compared with 95% at stage 1.
Does ovarian cancer run in families?
Sometimes. The NHS says inheriting a faulty gene such as BRCA1 or BRCA2 raises the risk, and advises talking to a doctor if ovarian cancer runs in your family, as you may be referred for genetic testing. In a Malaysian study of 790 women with ovarian cancer, 13.5% had a harmful change in the BRCA1 or BRCA2 gene.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Ovarian cancer — NHS
- Symptoms of ovarian cancer — NHS
- Causes of ovarian cancer — NHS
- Tests and next steps for ovarian cancer — NHS
- Treatment for ovarian cancer — NHS
- Cervical screening — NHS
- Types of ovarian cancer — Cancer Research UK
- Risks and causes of ovarian cancer — Cancer Research UK
- Screening for ovarian cancer — Cancer Research UK
- Stages and grades of ovarian cancer — Cancer Research UK
- Survival for ovarian cancer — Cancer Research UK
- Malaysia National Cancer Registry Report 2017-2021 — National Cancer Institute, Ministry of Health Malaysia
- Yoon SY, et al. Oncologist-led BRCA counselling improves access to cancer genetic testing in middle-income Asian country, with no significant impact on psychosocial outcomes. J Med Genet. 2022;59(3):220-229
- Yong CM, et al. Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia. PLoS One. 2024;19(2):e0298130
