Ovarian Cancer: Causes, Symptoms, Stages, Treatment and Cost in India

Ovarian cancer is one of the most serious cancers affecting women. It begins in the ovaries, the fallopian tubes or the lining of the abdomen (peritoneum), and is often called a silent cancer because its early symptoms, such as bloating and a feeling of fullness, are easily mistaken for digestive problems. As a result, many women from Africa, the Middle East, Central Asia and South Asia are diagnosed only when the disease has already spread within the abdomen. Yet there is real reason for hope. Expert surgery that removes all visible tumour, combined with modern chemotherapy and newer maintenance drugs such as PARP inhibitors, has significantly improved survival, and many women live for years with good quality of life.

This guide explains what ovarian cancer is, who is at risk, the symptoms to look for, how it is diagnosed and staged, and the treatments and costs in India.

What is Ovarian Cancer?

The ovaries are two small organs on each side of the uterus that produce eggs and the hormones oestrogen and progesterone. Ovarian cancer occurs when abnormal cells in or around the ovary grow uncontrollably. Research now shows that many of the most common type actually begin in the end of the fallopian tube before spreading to the ovary.

Types of Ovarian Cancer

• Epithelial ovarian cancer (about 90 percent): includes high-grade serous (the most common and aggressive), low-grade serous, endometrioid, clear cell and mucinous types.
• Germ cell tumours: usually affect girls and young women; they respond very well to treatment and are often curable while preserving fertility.
• Sex cord-stromal tumours: such as granulosa cell tumours, which may produce hormones.
• Borderline tumours: low-malignant-potential tumours with an excellent outlook.

Stages of Ovarian Cancer (FIGO)

• Stage I: cancer is limited to one or both ovaries or fallopian tubes.
• Stage II: cancer has spread to other pelvic organs such as the uterus or bladder.
• Stage III: cancer has spread to the lining of the abdomen and/or lymph nodes in the abdomen.
• Stage IV: cancer has spread to distant organs such as the liver, lungs or the fluid around the lungs.

Causes and Risk Factors

• Age: most cases occur after menopause, although younger women can be affected.
• Inherited gene mutations: BRCA1 and BRCA2 mutations and Lynch syndrome greatly increase the risk. In communities where marriage between relatives is common, as in parts of the Middle East and South Asia, inherited mutations may run strongly in families.
• Family history of ovarian, breast, uterine or colorectal cancer.
• Never having been pregnant, early first period or late menopause.
• Endometriosis, linked to clear cell and endometrioid types.
• Obesity and long-term hormone replacement therapy after menopause.

Factors that lower the risk include pregnancy, breastfeeding, use of oral contraceptive pills and removal of the fallopian tubes.

Symptoms of Ovarian Cancer

Symptoms are often vague, but when they are new, frequent (more than about 12 times a month) and persistent, they should be checked:

• Persistent bloating or increase in abdominal size
• Pelvic or abdominal pain
• Feeling full quickly or difficulty eating
• Needing to pass urine more often or urgently
• Changes in bowel habits
• Unexplained tiredness, back pain or weight loss
• Abnormal vaginal bleeding, especially after menopause

Warning Signs That Need Urgent Care

• Rapid swelling of the abdomen with breathlessness (fluid in the abdomen or chest)
• Severe sudden pelvic pain, which may mean twisting or rupture of an ovarian mass
• Vomiting with inability to pass stool or gas (bowel blockage)

How is Ovarian Cancer Diagnosed?

• Pelvic examination
• Transvaginal and abdominal ultrasound to look at the ovaries
• CA-125 blood test: raised in many epithelial cancers; other markers such as HE4, CEA, AFP, beta-hCG and LDH help with other types
• CT scan or MRI of the abdomen and pelvis; PET-CT in selected cases
• Biopsy: a guided biopsy or examination of fluid, or diagnosis at surgery
• Diagnostic laparoscopy to judge whether all tumour can be removed
• Genetic testing: BRCA testing is recommended for women with epithelial ovarian cancer, as it guides treatment and helps relatives

Treatment Options for Ovarian Cancer

Ovarian cancer should ideally be treated by a gynaecologic oncologist. Studies consistently show better results when surgery is done by specialists in high-volume centres.

Surgery

Surgery aims to confirm the stage and remove all visible cancer, as the amount of tumour left behind is one of the most important factors for survival. It usually includes removal of the uterus, both ovaries and tubes, the omentum (a fatty apron in the abdomen), lymph nodes where indicated and any visible deposits. In advanced cases this is called cytoreductive or debulking surgery and may involve parts of the bowel, diaphragm, spleen or liver surface.

Young women with early-stage disease or germ cell tumours may be offered fertility-sparing surgery, keeping the uterus and one ovary. See our ovarian cancer surgery package for details.

Chemotherapy

Most women need chemotherapy, usually carboplatin and paclitaxel given every three weeks for six cycles. When the cancer is very extensive, 3 cycles may be given before surgery (neoadjuvant chemotherapy) to shrink it, followed by interval debulking surgery and the remaining cycles.

HIPEC

Hyperthermic intraperitoneal chemotherapy (HIPEC) delivers heated chemotherapy directly into the abdomen at the end of interval cytoreductive surgery. It is available at specialised centres in India and may benefit selected patients with stage III disease.

Targeted and Maintenance Therapy

• PARP inhibitors (olaparib, niraparib) as maintenance tablets after chemotherapy, particularly effective in women with BRCA mutations or HRD-positive tumours
• Bevacizumab, an anti-angiogenic drug given with and after chemotherapy
• Newer antibody-drug conjugates and clinical trials for recurrent disease

Treatment of Recurrent Ovarian Cancer

Ovarian cancer can return, but it often responds again to treatment. Options include further chemotherapy, secondary surgery in selected cases and targeted drugs, allowing many women to live with the disease as a long-term condition.

Cost of Ovarian Cancer Treatment in India

Indicative starting prices at JCI/NABH-accredited hospitals in Delhi/NCR are:

The final cost depends on the stage, the extent of surgery, the number of chemotherapy cycles, the drugs used and hospital stay. Contact Satyug Healthcare at +91-8860606766 / +91-9910655125 (WhatsApp) for a free medical opinion and cost estimate.

Recovery and Living with Ovarian Cancer

After open debulking surgery, most women stay in hospital for 6 to 10 days. Chemotherapy usually begins 3 to 4 weeks later. International patients who complete surgery and chemotherapy in India should plan to stay for around 4 to 5 months, although after the first cycles some women continue chemotherapy in their home country under the guidance of their Indian oncologist.

• Follow-up: clinical examination and CA-125 every 3 months for the first 2 years, then less often.
• Menopause symptoms: removal of both ovaries causes early menopause in younger women; doctors can advise on managing hot flushes and bone health.
• Nutrition and exercise help recovery and energy levels.
• Emotional support: counselling and support groups help women and families cope.

Prevention and Early Detection

There is no reliable screening test for ovarian cancer in women at average risk. However, women with BRCA mutations or a strong family history should consult a genetic counsellor. Preventive removal of the tubes and ovaries after completing childbearing can greatly reduce their risk. Knowing the warning symptoms and seeing a doctor early remains the best protection for all women.

Why Choose India for Ovarian Cancer Treatment?

• Dedicated gynaecologic oncology teams with expertise in radical cytoreductive surgery and HIPEC
• Access to PARP inhibitors and targeted drugs, including affordable generic versions
• Genetic testing and counselling facilities
• Female doctors and staff available for women patients
• Treatment costs much lower than in Western countries and the Gulf, with no waiting lists

Step-by-Step Process to Travel to India for Treatment

1. Share your reports - send your latest reports, scans/CD, angiography or echo films and passport copy to Satyug Healthcare on WhatsApp (+91-8860606766 / +91-9910655125) or email.
2. Free medical opinion & cost estimate - within 24-72 hours we share opinions and written cost estimates from 2-3 JCI/NABH-accredited hospitals and specialists.
3. Choose hospital & doctor - compare doctor experience, hospital, room category and total cost; we help you decide with no extra charge.
4. Visa Invitation Letter (VIL) - the hospital issues a VIL for the patient and up to two attendants; we arrange it within 24-48 hours.
5. Apply for Indian e-Medical Visa - apply online for the e-Medical Visa (patient) and e-Medical Attendant Visa (family) using the VIL; most approvals come in 3-5 working days.
6. Book flights & accommodation - we suggest flights and arrange a guest house, service apartment or hotel near the hospital to suit your budget.
7. Free airport pickup - our representative receives you at the airport and takes you to your hotel or directly to the hospital.
8. Hospital admission & treatment - a dedicated coordinator and language interpreter stay with you for registration, tests, doctor consultations, the procedure and billing.
9. Discharge & follow-up - you receive the discharge summary, prescriptions and fitness-to-fly certificate; follow-up checks are done before you fly.
10. Return home & tele-follow-up - we arrange airport drop and stay connected for online follow-up consultations with your doctor in India.

Frequently Asked Questions

Can ovarian cancer be cured?

Early-stage ovarian cancer is often curable. Advanced cancer is harder to cure, but complete removal of visible tumour, chemotherapy and maintenance drugs allow many women to live for many years, and some are cured.

Is a raised CA-125 always cancer?

No. CA-125 can be raised by endometriosis, fibroids, pelvic infections, menstruation, pregnancy, liver disease and other conditions. It is used together with scans and clinical findings.

Can I have children after ovarian cancer?

Women with early-stage disease, borderline tumours or germ cell tumours can sometimes have fertility-sparing surgery. Egg or embryo freezing may also be discussed before treatment.

How long will I need to stay in India?

Surgery alone needs about 3 weeks. Surgery with six cycles of chemotherapy takes about 4 to 5 months, though part of the chemotherapy may be given at home after discussion with your doctor.

What is a PARP inhibitor?

It is a tablet that blocks a DNA repair enzyme in cancer cells. Taken as maintenance after chemotherapy, it can delay the return of cancer, especially in women with BRCA mutations.

Should my daughters and sisters be tested?

If you are found to carry a BRCA or Lynch syndrome mutation, your female and male relatives can be tested. Those who carry the mutation can take preventive steps to lower their risk.

Will I lose my hair during chemotherapy?

Paclitaxel commonly causes hair loss, which is temporary. Hair usually begins to grow back a few weeks after chemotherapy ends.

What reports should I send for a treatment plan?

Please share your ultrasound, CT or MRI scans, CA-125 and other tumour markers, any biopsy or surgical reports and a brief medical history. Our team will get opinions from leading gynaecologic oncologists within 48 hours.

Disclaimer: This article is for general information only and is not a substitute for a consultation with a qualified doctor.