Ovarian cancer: A step closer to demystifying early detection and prevention
June 25, 2025
Early detection and prevention of ovarian cancer has long been considered an enigma. The disease bears the dubious moniker “the cancer that whispers” because it causes vague symptoms, if any, that are often dismissed as part of aging. Symptoms may include bloating, changes in bowel and/or bladder habits, distension, inability to eat, pelvic or abdominal pain, and rapid weight loss.
Because of this vagueness – and with no reliable preventive screening available – ovarian cancer is often diagnosed at a late stage, claiming the lives of more than 12,000 women in the U.S. each year.
Further complicating early detection is that, despite its name, not all ovarian cancers start in the ovaries.
A 2025 study published in Cancer Discovery, showed that high-risk mesenchymal stromal/stem cells (hrMSCs) can damage DNA in the fallopian tube cells, causing some to mutate and become cancerous. This research adds to a hypothesis developed in 2017 that ovarian cancer develops in the fallopian tubes and travels to the ovaries.
The fallopian tubes are two channels of tissue that carry eggs between the ovaries and uterus. Tubal-based cancers are typically undetectable until the cancer has metastasized widely, including spreading to the ovaries. Past research suggests that about half of ovarian cancers may be tubal in origin.
Preventing these cancers – and catching them much earlier – means everything.
In March 2023, UT Southwestern Harold C. Simmons Comprehensive Cancer Center launched a Gynecologic Oncology Prevention Program for patients at high risk of cancer due to genetic variants or family history. The program has grown at an unbelievable pace, connecting women with advanced treatment options and demonstrating the need for further research in ovarian cancer prevention.
Current early detection and prevention strategies
Removal of fallopian tubes and ovaries – a procedure called risk-reducing salpingo-oophorectomy (RRSO) – has been the standard of prevention for patients with BRCA gene mutations or other genetic mutations that would predispose an individual to a higher-than-average risk for developing ovarian cancer. RRSO is typically recommended for women ages in their reproductive years; the recommended age depends on the specific mutation and the age of the youngest ovarian cancer death in the family.
RRSO can reduce the risk of ovarian cancer from as high as 46%, depending on the genetic mutation, to around 2%-4%. However, removing the ovaries puts young women into menopause and decreases their estrogen production. The symptoms and risks associated with early menopause can be mitigated or decreased with appropriate hormone replacement therapy, supportive care, proper diet, and exercise. All patients who have surgical menopause are encouraged to discuss the benefits and risks of hormone replacement therapy with their physicians.
Currently, there are no reliable screenings for women at average or high risk for ovarian cancer. The U.S. Preventive Services Task Force does not recommend routine ovarian cancer screening for asymptomatic patients known to be at average risk due to the possibility of false positives:
- Serum CA-125 can be elevated in women with noncancer conditions, such as endometriosis, pancreatitis, and gastroenteritis.
- Ultrasound does not reliably differentiate between cancerous and benign ovarian masses.
For women who are at high-risk and who choose not to get RRSO, doctors might recommend transvaginal ultrasound combined with a blood test for a tumor marker called serum CA-125 because studies have shown that this type of testing may identify more women with lower cancer burden.
The earlier that ovarian cancer is detected, the more likely the chances are for a positive outcome. Acknowledging the vague symptoms of ovarian cancer is very important to early detection. If you notice changes in bowel or bladder habits, bloating or belly distension, inability to eat, or rapid weight loss – or a constellation of these symptoms more than 10 to 12 times a month – talk with a doctor to evaluate your symptoms.
Advances in ovarian cancer treatment
In the UTSW Gynecologic Oncology Prevention Program, patients with a genetic risk for ovarian cancer or a family history of gynecologic cancers can get counseling and surveillance for their risk of cancer. Providers will customize care to each patient and help women understand their options, such as surveillance, surgery, hormone replacement therapy, management of menopausal symptoms, and fertility preservation.
New approach to hysterectomy
These findings have changed the way gynecologists approach hysterectomy. If a woman at average risk of ovarian cancer gets a hysterectomy, removal of the fallopian tubes is recommended to reduce the risk of ovarian cancer. The ovaries typically are not removed to continue producing female hormones and avoid early menopause.
As we learn more about the role of hrMSCs in the fallopian tubes in developing ovarian cancer, we may better understand how ovarian cancer begins in the absence of BRCA1 or BRCA2 mutations. This has the potential to lead to biomarker tests that would offer an opportunity for early detection.
Genetic testing for those at high risk
Women with certain risk factors, particularly those with a family history of breast or ovarian cancer, should talk with a doctor to learn about genetic testing and counseling. Risk factors include:
- Genetic mutations: About 39% to 58% of women who inherit BRCA1 mutation and 13% to 29% of those with a BRCA2 mutation will develop ovarian cancer
- Eastern European or Ashkenazi Jewish heritage
- Endometriosis
- Family history of breast or ovarian cancer
- History of breast, uterine, or colorectal cancer
- Difficulty conceiving or having never given birth
Advanced medications
There has been tremendous progress in medications that can improve survival and quality of life for patients with ovarian cancer. Some of the most exciting advancements include:
- PolyADP-ribose polymerase (PARP) inhibitors: These medications boost the effectiveness of chemotherapy by stopping cancer cells from repairing their DNA. They have been shown to be particularly helpful in patients with BRCA mutations.
- Antibody-drug conjugates: This targeted therapy combines a monoclonal antibody and a cytotoxic drug. Personalized for each patient, these treatments show promising results compared to conventional therapies.
Ongoing research
UT Southwestern is participating in two clinical trials of therapies to treat ovarian cancer. Women with ovarian cancer who are interested in enrolling can call 833-722-6237 for information. Search for a clinical trial.
Clearly, we need to find safer, more effective tactics to detect and prevent ovarian cancer. The recent findings regarding the origins of ovarian cancer might help us save more lives in the future with less radical surgery and fewer side effects.
Related reading: Increasing access to cancer clinical trials across Texas
To talk with an expert about ovarian cancer, make an appointment at our offices in Dallas, Richardson, or Fort Worth by calling 214-645-4673 or request an appointment online.
