Serous ovarian cancer is the most common type of ovarian cancer. In fact, 75 percent of all ovarian cancer cases are serous ovarian cancer. This cancer begins in the tissue that lines your ovaries and spreads quickly to the uterus and surrounding organs.

Serous ovarian cancer is usually treated with surgery to remove the tumor and any surrounding tissue. How much tissue needs to be removed and how much additional treatment is needed depends on the stage of cancer at diagnosis and your overall health.

Serous ovarian cancer responds well to treatment if it is diagnosed during an early stage. However, most cases are diagnosed at a later stage and carry a low survival rate.

The exact cause of serous ovarian cancer is still unknown, according to the Ovarian Cancer Research Alliance (OCRA). However, there are several known risk factors that have been shown to increase your chances of ovarian cancer.

These risk factors include:

  • Genetics. Serous ovarian cancer is linked to an inherited genetic mutation in the BRCA1 or BRCA2 gene. Mutations in either gene cause a significant increase in your lifetime risk for ovarian cancer. Having certain genetic conditions, like Lynch syndrome, Peutz-Jeghers syndrome, and Li-Fraumeni syndrome, can also increase your risk of serous ovarian cancer.
  • Family history. A family history of any type of ovarian cancer, fallopian tube cancer, or breast cancer increases your risk of developing serous ovarian cancer.
  • Age. Your risk for serous ovarian cancer increases with age, especially after menopause.
  • Weight. Studies show that obesity can increase your risk for serous ovarian cancer.
  • Ethnicity. You’re at a greater risk for serous ovarian cancer if you have Northern European or Ashkenazi Jewish heritage. People with these heritages have a higher incidence of a genetic mutation in the BRCA gene, according to the Centers for Disease Control and Prevention (CDC).
  • Reproductive history. Your risk for serous ovarian cancer can be impacted by past childbirth, pregnancy, and other reproductive health milestones. For instance, your risk of serous ovarian cancer is higher if you have never given birth or did not give birth until 35 or later.
  • Medical treatments. Taking hormone replacement therapy after menopause can increase your risk of ovarian cancer.

It can be hard to recognize the symptoms of serous ovarian cancer. Often, the early stages don’t cause any symptoms at all. When symptoms do appear, it’s common for people with serous ovarian cancer to assume the cause is a more common and mild condition.

According to the OCRA, symptoms of serous ovarian cancer include:

There are four stages of serous ovarian cancer, according to the CDC. These stages use the International Federation of Obstetrics and Gynecology (FIGO) staging system. Higher FIGO stages mean the cancer has spread beyond the ovaries.

Serous ovarian cancer stages include:

  • Stage 1: cancer is only in the ovaries
    • Stage 1A: cancer is only in one ovary
    • Stage 1B: cancer is in both ovaries
    • Stage 1C: cancer is in one or both ovaries and the tumor ruptures before or during surgical removal, causing cancer cells to spread
  • Stage 2: cancer has spread beyond the ovaries into the pelvic region
    • Stage 2A: cancer has spread to the uterus
    • Stage 2B: cancer has spread anywhere else in the pelvic region
  • Stage 3: cancer has spread beyond the pelvic region to the abdominal cavity or lymph nodes
    • Stage 3A: cancer has spread to the abdomen or lymph nodes, but growth is very small and not visible
    • Stage 3B: cancer has visibly spread to the abdomen or lymph nodes and growth is less than 2 cm
    • Stage 3C: cancer has visibly spread to the abdomen or lymph nodes and growth is greater than 2 cm
  • Stage 4: cancer has spread to organs that are further away in the body
    • Stage 4A: cancer has spread to fluid around the lungs
    • Stage 4B: cancer has spread to the liver, spleen, or any other organ

Serous ovarian cancer is also described by grade, according to the Minnesota Ovarian Cancer Alliance. The grade of a cancer cell refers to how atypical it looks under a microscope and how it behaves in the body.

There are two grades of serous ovarian cancer:

  • High-grade serous carcinoma (HGSC). HGSC is a fast-growing and rapidly spreading serous cancer. It is the most common type of serous ovarian cancer.
  • Low-grade serous carcinoma (LGSC). LGSC is rare. It causes slow-growing tumors that can be difficult to treat.

Serous vs. epithelial ovarian cancer

Serous ovarian cancer is a type of epithelial ovarian cancer. The epithelium is the tissue in your body that covers your organs and blood vessels.

Epithelial ovarian cancer is cancer that starts in the epithelium covering your ovaries. About 85 to 90 percent of all ovarian cancer cases are epithelial ovarian cancer.

Serous ovarian cancer is the most common type of epithelial ovarian cancer, but it’s not the only type. There are also endometrioid and mucinous epithelial cancers.

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There are several tests doctors can use during a diagnosis of serous ovarian cancer. However, the only way to confirm a diagnosis is for a healthcare professional to take a biopsy of the affected organ tissue, according to the American Cancer Society.

Samples of this tissue can be tested for cancer cells under a microscope so that a diagnosis can be confirmed.

You’ll likely have several tests before surgery. Tests might include:

  • A physical exam. A healthcare professional will examine your uterus, ovaries, bladder, rectum, and vagina to look for any irregularities, tenderness, or changes.
  • Imaging tests. You might have an MRI, CT scan, or transvaginal ultrasound to look for signs of cancer. These tests can show doctors images of your ovaries, uterus, and surrounding pelvic region and help them make a diagnosis.
  • Lab tests. You’ll likely have blood drawn to check for certain antigens that can point to tumors present at high levels.
  • Paracentesis. This procedure uses a long needle to remove fluid buildup from your abdomen. The fluid is then tested for cancer.
  • PET scan. In this test, you’re given a safe dose of radioactive sugar. This sugar is used by your cells for energy. Since cancer cells grow faster and use more energy, this can help doctors see where they may be concentrated.

Discrimination in diagnosis

Reproductive health conditions and reproductive cancers are often talked about in a highly gendered way. It’s common to see ovarian cancer referred to as a “women’s health condition.”

For trans men and nonbinary people with ovaries, this can make getting a diagnosis of serous ovarian cancer incredibly difficult.

It can be a challenge to find medical professionals experienced in diagnosing ovarian cancer in anyone who isn’t a woman. It can also be difficult to find professionals experienced in communicating with trans people who were assigned female at birth about what to expect from testing and treatment.

Men, nonbinary, and intersex people are often left feeling that their identities or health concerns aren’t being respected.

It can help to research doctors, hospitals, and health systems in your area that have non-discrimination policies. If you need specialists to deal with serous ovarian cancer, your choices might be more limited.

You might also bring a family member or friend to appointments with you. They can help ensure you get the answers you need.

You can visit the National Center for Transgender Equality for more information about your healthcare rights.

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The first treatment for serous ovarian cancer is often surgery to remove the tumor and surrounding tissue. How much of this surrounding tissue is removed depends on your cancer stage at diagnosis and the choices you and your doctor make.

Options include:

  • Removing one ovary. Stage 1 serous ovarian can usually be treated by removing only the affected ovary and fallopian tube.
  • Removing both ovaries. Serous cancer that is on both ovaries but has not spread further can be treated by removing both ovaries. You may be able to preserve your eggs before this procedure or use donor eggs for a future pregnancy. Speak with your doctor to see if this is a possibility.
  • Removing both ovaries and uterus. You can have a procedure called a hysterectomy to remove the uterus or a bilateral salpingo-oophorectomy to remove both ovaries if the cancer is advanced. These may also be options if you have concerns about relapse and aren’t concerned about future pregnancy.

After surgery, you may need additional treatments to kill any remaining cancer cells, depending on how advanced the cancer was at the time of surgery and if there is a concern for any remaining cancer cells left behind.

Your exact treatment plan will depend on your cancer stage, cancer grade, overall health, and how well you respond to treatment.

It’s common to receive a combination of treatments. This might include:

  • Chemotherapy. Chemotherapy uses powerful medication to kill cancer cells. You can receive chemotherapy drugs orally, by IV, or even directly on the tumor during surgery.
  • Hormone therapy. Estrogen can encourage the growth of ovarian cancer cells. Hormone therapy is sometimes used to block this effect.
  • Targeted therapy. Target therapy is a treatment that looks for weaknesses in cancer cells to help destroy them.
  • Immunotherapy. Immunotherapy helps your immune system find and kill cancer cells.

The outlook for serous ovarian cancer is impacted by a number of factors. The grade and stage of your serous ovarian cancer, as well as your age at diagnosis and overall health, can make a big difference in your prognosis. Often, serous ovarian cancer is very treatable when it’s caught early.

The 5-year survival rate for people diagnosed in stage 1 or stage 2 is about 80 percent. Keep in mind that survival rates are always based on data collected over several years, and actual current survival rates are likely to be higher. New treatments are improving survival rates for serous ovarian cancer.

Treatments such as immunotherapy and targeted therapy have already made an impact, and treatments still undergoing clinical trials might improve rates even more in the years to come.

Living with serous ovarian cancer

A diagnosis of serous ovarian cancer can bring about a lot of emotions. It’s important to have places to turn to for support. Some helpful resources to check out include:

  • CancerCare’s Ovarian Cancer Patient Support Group. This online support group is led by an oncology social worker and offers 24/7 access to a password-protected forum for patients and caregivers.
  • Ovarian Cancer Research Alliance Support Group. You can live chat with other people living with ovarian cancer every Monday, Tuesday, and Friday at 1 p.m. eastern time.
  • Ovarian Cancer Research Alliance’s on-call oncology social worker. You can call 212-268-1002 to get connected to an oncology social worker who can help you navigate your healthcare and cancer concerns. A social worker will return your call within 24 hours if you’re not connected right away.
  • Inspire’s Ovarian Cancer Online Community. This online support forum lets you connect with others to share stories, resources, tips, successes, and more.
  • Local support groups through the National Ovarian Cancer Coalition (NOCC). You can look up support groups in your area using the NOCC to find face-to-face community and information about local resources.
  • Educational material from NOCC. NOCC has a resource library to help you learn about ovarian cancer and make informed decisions about your health.
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Serous ovarian cancer is a fast-spreading type of epithelial ovarian cancer. Symptoms of serous ovarian cancer can be easy to miss or mistake for symptoms of other conditions.

It’s a good idea to have symptoms that might be serous ovarian cancer, such as a lack of appetite, bloating, frequent urination, or pelvic pain, looked at by a medical professional.

Serous ovarian cancer is very treatable when it’s caught in its early stages, but survival rates are lower when its diagnosis happens later. Treatment for serous ovarian cancer generally begins with surgery to remove the tumor and surrounding tissue. After surgery, additional treatment will be used to get rid of any remaining cancer cells.