Aggressive ovarian cancer: what to know

The label aggressive may reflect the cancer's microscopic type, grade, pattern of growth or spread. It does not by itself determine the next step. Imaging, pathology, overall health and genetic or tumour testing help the gynaecological oncology team choose care.

Ovarian cancer can spread across surfaces inside the abdomen and pelvis. It may irritate the lining of the abdomen, involve nearby organs or cause fluid to collect. Bloating, increasing abdominal size, pelvic or abdominal discomfort, reduced appetite, feeling full early and urinary changes can occur, but these symptoms also have many non-cancer causes.

A pelvic ultrasound can examine the ovaries and nearby structures, while other scans assess the wider abdomen and chest. Tissue examined by a pathologist confirms the cancer type. Genomic tumour profiling or BRCA genetic testing may provide information relevant to treatment and family counselling.

Meet with a gynaecological oncology team before surgery is planned. Depending on disease extent and fitness for an operation, chemotherapy may come before or after ovarian cancer debulking surgery. Surgery can include removal of ovaries and other involved tissue, with the goal and extent discussed in advance.

Write down changes in abdominal swelling, eating, bowel movements, urination, breathing and pain. Small frequent meals and early nutrition advice may help when fullness limits intake. Palliative care can help manage symptoms, decisions and emotional strain while cancer-directed treatment continues.

Seek emergency care for severe or sudden abdominal pain, repeated vomiting with inability to keep fluids down, a swollen abdomen with inability to pass stool or gas, fainting, chest pain or sudden breathlessness. These problems can signal bowel blockage, a blood clot, bleeding or another urgent condition.

Contact the oncology service promptly for fever during treatment, worsening abdominal swelling, reduced urine, new leg swelling, persistent vomiting, uncontrolled pain or a wound that is opening or leaking. Use the service's after-hours number when these changes occur outside clinic times.

Ask about the exact cancer type, where it has spread and whether surgery or chemotherapy should come first. Clarify what an operation may remove, how fertility or early menopause could be affected, which tumour and inherited genetic tests are suitable, how treatment response will be assessed and whom to call for new abdominal or breathing symptoms.