Epithelial Ovarian Cancer: A Guide for Newly Diagnosed Women

Being told you have epithelial ovarian cancer can feel overwhelming, especially as you try to take in unfamiliar medical terms while thinking about treatment and what lies ahead. It is completely natural to feel anxious or unsure in those early conversations with your doctor.

Epithelial ovarian cancer is the most common form of ovarian cancer, and it is often diagnosed at a later stage. Even so, there are established treatment approaches and supportive care options available. 

Understanding what this diagnosis means and how treatment is planned can help you feel more informed, supported, and better prepared for the next steps.

What is epithelial ovarian cancer?

Epithelial ovarian cancer is a type of ovarian cancer that starts in the cells on the outer surface of your ovaries. It shows up in about 90% of ovarian cancer cases.

One of the frustrating things about this cancer is that it's usually found later, as the early signs, such as bloating, abdominal discomfort, or changes in appetite, are easy to overlook or attribute to other causes. 

How is epithelial ovarian cancer different from other types?

Ovarian cancer is not a single disease. There are different types of ovarian tumours, and they act differently depending on which part of the ovary they started in.

Epithelial ovarian cancer grows from the cells on the outer surface of the ovary. That's why it's the type that doctors encounter most often.

The less common types start somewhere else, including:

• Germ cell tumour:

  • This type of ovarian cancer grows from the cells that make eggs. 

  • These tend to show up more in younger women.

• Sex cord-stromal tumour:

  • Sex cord-stromal tumour starts in the tissue that produces hormones.

  • It may cause hormonal symptoms.

Because these rarer types start in different cells, they tend to grow differently and respond to different treatments. The outlook can also be quite different.

What happens next after diagnosis?

Receiving a diagnosis of epithelial ovarian cancer does not mean everything happens all at once. Before treatment begins, your medical team will take time to fully understand your cancer and plan the next steps carefully.

This usually involves imaging scans, blood tests, and sometimes surgery to determine the grade and the stage of ovarian cancer.

It might sound like a lot right now, but you don’t need to understand every detail immediately. Your care team will guide you through this one step at a time, explaining what each test means when it matters and giving you space to make decisions without rushing you. 

How your doctor understands your cancer

As part of this next step, your doctor will gather more detailed information about your cancer, including the grade and subtype. This helps them understand how your cancer is likely to grow and spread so they can figure out the best way to treat it.

Subtypes of epithelial ovarian cancer

When your doctor talks about subtype, they're referring to which specific type of epithelial cell your cancer started from. 

The main subtypes include:

• High-grade serous carcinoma

• Endometrioid

• Clear cell

• Low-grade serous carcinoma

• Mucinous

Why does this matter? Because each one grows at a different pace and responds differently to treatment. Knowing your subtype helps your doctor choose which treatment option is most likely to work for you.

What are the high-grade and low-grade?

Grade is about what your cancer cells look like when the pathologist examines them under a microscope. Low-grade cancers grow more slowly and still look similar to normal, healthy cells. High-grade cancers look quite different, and they tend to grow and spread faster.

If you have questions about your diagnosis, subtype, or what these findings mean for your treatment, speaking with our experienced O&G specialist can help bring clarity and reassurance. Schedule a consultation with Thomson Medical to discuss your individual situation in detail.

Treatment options for epithelial ovarian cancer

This may be the part you’re most curious about and also the most anxious to read. But knowing what treatment involves can help you feel more prepared for what lies ahead, even if the road forward still feels uncertain.

Surgery

Treatment for epithelial ovarian cancer often begins with surgery. This is usually the first step in removing as much of the cancer as your surgeon safely can.

Depending on how advanced the cancer is, that might mean removing one or both of your ovaries, fallopian tubes, womb, and some surrounding tissue. These changes may affect your menstrual cycle, bring on menopause, and impact your ability to become pregnant in the future.

Before surgery, your doctor will take time to talk through these possibilities with you. You are encouraged to share what matters most to you, whether that includes hopes for pregnancy, preserving fertility, or other personal priorities.

These open conversations help your doctor plan treatment that not only treats the cancer effectively but also respects you as a person with a future you're still planning for.

Chemotherapy

For many women, ovarian cancer chemotherapy is an important part of treatment after surgery. It is used to target cancer cells that are too small to see or remove during the operation. Sometimes, your doctor might recommend chemotherapy before surgery to help shrink the tumour first, making the surgery safer or more effective.

You'll go to the hospital for treatment, where they'll give you the chemo through a drip into your vein. Most treatment plans run on a three-week cycle, which means that you'll have treatment, then a break for your body to recover, then treatment again.

It’s natural to worry about side effects of chemotherapy, such as:

• Tiredness

• Nausea

• Hair loss

• Not feeling like eating

• Being more prone to picking up infections

While these effects can be rough, it’s important to know that most are temporary and improve after treatment ends. Your hair will grow back. Your energy will return. Your appetite will come back.

And you won't be going through this alone. Your doctor will keep close tabs on how you're doing throughout treatment. If the side effects are hitting you hard, they can adjust your dose or give you additional medications to help manage symptoms. The goal of chemotherapy is to treat your cancer effectively while keeping you as comfortable as they can.

Other treatment options

Depending on your cancer's subtype and grade, your doctor might also suggest targeted therapies (drugs designed to attack specific features of cancer cells) or intraperitoneal chemotherapy (chemo delivered directly into your abdomen).

These treatments aren't right for everyone, but they can be an effective option for the right patient.

Survival rate for epithelial ovarian cancer

If you've looked up ovarian cancer survival rates online, or if your doctor has mentioned them, you've probably felt your stomach drop, as those numbers can be scary.

Here are the five-year survival rates for epithelial ovarian cancer based on stage at diagnosis:

• Stage 1: about 95% of women live 5 years or longer

• Stage 2: more than 70% live 5 years or longer

• Stage 3: more than 30% live 5 years or longer

• Stage 4: around 15% live 5 years or longer

These statistics come from looking at hundreds or thousands of women who were diagnosed 5, 10, or even 15 years ago. They're averages, which means they lump together everyone – younger women and older women, otherwise healthy people and those with other serious conditions, people who responded well to treatment and those who didn't.

Your outlook depends on many factors that are specific to you: your age, your overall health, and how your particular cancer responds to the treatment you're getting.

It’s important to remember that you’re being treated with approaches and drugs that didn't even exist when many of these statistics were calculated. Cancer treatment has moved forward significantly in the last few years.

That said, while these numbers give you a general sense of the landscape, they can't give a perfect prediction of what's going to happen in your case. Many women do far better than the statistics would suggest.

Schedule a consultation with our gynaecologic oncology team to discuss your diagnosis, review your pathology results, and develop a personalised treatment plan. Second opinions are welcome and encouraged. 

FAQ

Is 90% of ovarian cancer epithelial?

Yes, about 90% of ovarian cancers are epithelial, making it the most common type. The remaining cases are rarer germ cell or stromal tumours.

What is the most common epithelial ovarian tumour?

The most common type of epithelial ovarian cancer is high-grade serous carcinoma (HGSC). It tends to grow and spread faster and often responds well to chemotherapy.

At what age do people get epithelial ovarian cancer?

Epithelial ovarian cancer is most diagnosed after menopause, with peak incidence between 60 and 65 years old. Younger women are more likely to develop other, rarer types of ovarian cancer.

Can epithelial ovarian cancer be 100% cured?

There is no guaranteed cure. However, stage 1 has a high chance of long-term control with surgery and chemotherapy. Advanced stages are more difficult to cure but can often be treated effectively.

How fast does epithelial ovarian cancer grow?

Growth speed varies by subtype and grade. High-grade cancers tend to grow and spread faster, while low-grade cancers progress more slowly. Overall growth can range from months to years.

Can epithelial ovarian cancer be prevented?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations based on your medical conditions, request an appointment with Thomson Medical.