Ovarian cancer: Teenagers and young adults

This section is for teenagers and young adults. It’s about a type of cancer called ovarian cancer.

We have more info for young people about:

• germ cell tumours of the ovary – causes and symptoms
• having tests for ovarian cancer 
• treating ovarian cancer

For more information about ovarian cancer in women of all ages, read our general ovarian cancer section.

Ovarian cancer starts in the ovaries, which are part of the reproductive system. This is in the lower part of your tummy (abdomen), in the area between your hips (called the pelvis). Your reproductive system is made up of your vagina and the organs involved in getting pregnant and having a baby.

Your reproductive system

Your reproductive system is made up of the:

• vagina – the passage from the cervix to outside your body
• cervix – the opening from the womb to the vagina
• womb (also called uterus) – where a baby grows during pregnancy
• fallopian tubes – which connect your ovaries to the womb
• ovaries – which store all your eggs and release one every month after puberty

Facts about ovaries

You have 2 ovaries – 1 on each side of your womb. They’re about 4cm long.

At puberty your ovaries start making hormones called oestrogen and progesterone. These cause your breasts to grow and your periods to start.

Every month after puberty, your ovaries release an egg, which travels down the fallopian tubes to the womb. The womb’s lining gets thicker, ready for an egg to be fertilised by a man’s sperm. If this doesn’t happen, the womb’s lining comes out of your vagina as blood. This is a period.

When a woman is about 50 her periods stop because her ovaries have run out of eggs so they stop making hormones. This is called the menopause.

Types of ovarian cancer 

There are 3 types of ovarian cancer: epithelial tumours, germ cell tumours and stromal cell tumours.

Teenagers are mostly affected by the germ cell tumour type. You may hear your type of germ cell tumour being called:

• dysgerminoma
• teratoma
• yolk sac tumour

Germ cell tumours of the ovary are rare. They start in the egg-producing cells of the ovary. Treatment will usually cure germ cell tumours.

Your specialist will explain more about the type of germ cell tumour that you have. If you have a type of ovarian cancer or germ cell tumour that's not listed here, you can talk to one of Macmillan's cancer support specialists to find out more.

This section is for teenagers and young adults.

Germ cell tumours of the ovary are the most common type of ovarian cancer in teenagers and young women. If you have a different type of ovarian cancer and want to know more you can talk to Macmillan Cancer Support.

Germ cell tumours are a rare type of ovarian cancer. They start in the egg-producing cells of the ovary in girls and young women (aged 10 to 30). Tumours are often only in 1 ovary. They can usually be successfully treated, even if they’ve spread to other places in the body.

Germ cell tumours can also develop in teenage boys’ or men’s testicles, or rarely in other parts of the body. This page is about germ cell tumours that start in the ovary, but we have more information about testicular cancer.

Causes

The cause of germ cell tumours is unknown. Research into possible causes is going on all the time.

Germ cells are a normal part of the ovary, but something causes them to change. This makes them grow too quickly and make a tumour.

Signs and symptoms

• pain or swelling in your tummy (abdomen) 
• a feeling of fullness or bloating in your tummy
• needing to pee more often
• irregular periods

Remember – these symptoms happen for lots of reasons other than cancer. But if you have any of them it’s important to speak to your GP.

If you're worried about ovarian cancer

If you think you might have some of these symptoms, go and see your GP. They'll be able to talk to you about your symptoms. If they think they could be because of cancer, they can do some tests to find out more.

We have more information for young people about:

• having tests for ovarian cancer
• treatment of overian cancer

If you're looking for information about ovarian cancer in women of all ages, read our general ovarian cancer section.

There are some tests that you might have at your doctor's or at the hospital, to help them see if you have ovarian cancer.

Visiting your GP

If you think you might have any symptoms of ovarian cancer, you should speak to your GP. They'll be able to talk to you about your symptoms. If they think these could be because of cancer they can do tests to find out more.

Tests

These might include:

• a blood test
• an ultrasound of the ovaries
• an internal examination, to check the organs in your pelvis

For an internal examination, you lie on your back with your feet together and your knees apart. The doctor will gently put 1 or 2 fingers inside your vagina and press a little on your lower tummy. It shouldn’t be painful but it can feel uncomfortable.

This test might make you feel embarrassed, but doctors are used to doing this investigation and it’s over quickly. If a male doctor examines you, there will usually be a female nurse present, but if not you can ask for one. You can have someone you feel close to with you during the examination, or if you prefer you can ask whoever is with you to go out until it’s over. You can do whatever makes you feel most comfortable.

After these tests, your GP may arrange for you to see a doctor at the hospital who specialises in problems of the reproductive system (a gynaecologist).

At the hospital

The specialist will carry out an internal examination to check if there’s anything unusual in the shape and position of your ovaries and womb. Your GP may have already done an internal examination. 

More tests

The specialist will arrange for you to have some more tests. Different tests are used to diagnose germ cell tumours of the ovary.

Blood tests check for chemicals in the blood called tumour markers. Some germ cell tumours produce high levels of these.

Ultrasound scans use sound waves to build up a picture of your ovaries and the area around them on a computer screen. The person doing the scan will rub some gel on your tummy and gently move a small device over your tummy to produce the picture. You may also have an ultrasound scan done through the vagina (transvaginal ultrasound), to get a clearer picture. A small probe about the size of a tampon is gently put inside your vagina. It’s not painful but it can be a bit uncomfortable. You can have someone with you during the test if you want to.

CT scans take a series of X-rays, which build up a 3D picture of the area of the body being scanned. It can show up the size and position of a tumour.

Laparoscopy is a test that’s sometimes done to look inside your tummy at your ovaries. It’s done under a general anaesthetic. You can usually go home the same day. The surgeon makes 3 to 4 small cuts in the skin in your lower tummy (just above the bikini line). Then they put a thin, flexible tube with a camera on the end (called a laparoscope) through one of the cuts to look at the ovaries. Sometimes the surgeon will remove the ovary at the same time as the laparoscopy but they will discuss this with you before you have the surgery. The removed ovary will be looked at under a microscope to find out exactly what type of tumour it is. 

Having tests and waiting for the results can be an anxious time. Talking about how you feel and getting support from family, friends, your specialist nurse or your doctor can help.

We've got more information for young people about:

• germ cell tumours of the ovary – causes and symptoms
• treatment of ovarian cancer 
• living with and after ovarian cancer

If you're looking for information about ovarian cancer in women of all ages, read our ovarian cancer section.

Most girls and young women can be cured of germ cell tumours of the ovary.

Your treatment will depend on the type of germ cell tumour you have and whether it has spread outside the ovaries. Treatment is usually a combination of surgery and chemotherapy, although you may only need surgery.

Before you have treatment, your specialist needs to know the type of germ cell tumour you have and what stage it is. The stage of a cancer describes the size of the tumour and whether it has spread outside the ovary to any other parts of your body.

Your specialist will tell you the exact stage of the cancer after the operation to remove your ovary. Most germ cell tumours are diagnosed early when they’re in one or sometimes both ovaries but haven’t spread anywhere else in the body. Waiting to hear about the stage of the cancer can be worrying. But this information is important because it helps your doctors plan the right treatment.

Another important part of ovarian cancer treatment is to try to make sure it doesn’t make you infertile (unable to get pregnant). Your doctors will think very carefully about this when planning your treatment.

Surgery

You may have an operation to remove the affected ovary and the fallopian tube. If it’s a very early germ cell tumour this might be the only treatment you need. After your operation you’ll come back to the clinic for regular checks. If there are any signs of the cancer coming back, it’s treated straight away.

Having the affected ovary and fallopian tube removed won’t stop you from having a baby in the future. You can still get pregnant with only 1 ovary.

Before surgery you’ll have a general anaesthetic. During the operation, the surgeon will make a cut in the lower tummy. The ovary is removed through this cut. The operation is called a laparotomy.

If the cancer has spread, the surgeon may still do an operation to try to remove as much of the tumour as they can. If possible they will try to leave the other ovary and the womb. You will have more treatment after your operation to treat any of the tumour that they could not remove.

Removing both ovaries and the womb is only done if there’s no other way of successfully treating the cancer. Unfortunately this means you will not be able to get pregnant in the future. This can be very upsetting news. You may not have thought about having children yet, so it may be difficult to take in. If this happens there will be lots of support to help you.

Chemotherapy 

Chemotherapy is given after your operation to:

• get rid of any cancer cells that weren’t removed with surgery
• stop the cancer from coming back

Your specialist will explain more about this to you. Germ cell tumours are very sensitive to chemotherapy and this treatment cures most girls. If it’s a very early germ cell tumour you might not even need chemotherapy.

Germ cell tumours are often treated with the drugs bleomycin, etoposide and cisplatin. When these are given together it’s called BEP for short.

Chemotherapy is given in cycles of treatment that usually take 3 weeks. You’ll have 3 to 4 cycles. You’ll spend the first 3 to 5 days of each cycle having your chemotherapy. You’ll usually stay in hospital for those days. You’ll come back to the clinic for another injection of chemotherapy a week later, and then again the following week.

Different chemotherapy drugs cause different side effects. Some girls just have a few side effects, and others have more.

Most side effects are temporary and gradually disappear once treatment stops. The most common side effects are:

• hair loss
• tiredness
• feeling sick or being sick (this can often be controlled with medicine)
• being more at risk of getting an infection

Doctors can’t be certain whether you’ll be able to get pregnant (fertility) in the future after you’ve had chemotherapy. They may talk to you about storing your eggs before chemotherapy starts. Stored eggs can be used with fertility treatments when you’re ready to try to get pregnant. Read more in Macmillan's section on fertility in young women.

Surgery and chemotherapy

You'll usually have chemotherapy after your surgery. You might have more surgery after you’ve finished chemotherapy if there’s still some tumour left behind.

Radiotherapy

Radiotherapy treats cancer by using high-energy X-rays to destroy cancer cells. Some types of germ cell tumour are sensitive to radiotherapy, but it is rarely used.

We have more information about:

• germ cell tumours of the ovary – causes and symptoms
• having tests for ovarian cancer

If you're looking for information about ovarian cancer in women of all ages, read our general ovarian cancer information.