Science Made Simple: Ovarian Cysts and Ovarian Cancer

Ovarian cysts are fairly common, but that doesn’t make having them any less nerve-wracking. If you’ve been diagnosed with an ovarian cyst, it’s natural to wonder if that means you have, or are at risk of developing, ovarian cancer. 

While it’s important to be vigilant when it comes to any abnormality, you should also know that having an ovarian cyst does not mean you have ovarian cancer

There are significant differences between ovarian cysts and ovarian tumors: 

  • Ovarian cysts are sacs or pockets of regular tissues or cells, and are usually filled with fluid, while ovarian tumors are solid masses of cancer cells.
  • Most ovarian cysts come and go with menstrual cycles, while ovarian tumors will not go away on their own, and will require treatment.
  • Most ovarian cysts are not harmful, don’t cause symptoms and are not indicative of risk for future ovarian cancer, though some complex ovarian cysts may raise the risk.   

Though diagnosis of an ovarian cyst does not necessarily indicate ovarian cancer, it’s important to understand what they are, how they’re formed, and when – and how – to work with your doctor to look into them further.

As always, you should ask questions and be sure they’re answered satisfactorily. If you don’t feel heard, or suspect that your concerns are not being taken seriously, seek a second opinion.

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac or pocket that forms in the ovary or on its surface. Ovarian cysts are most common in women who have not gone through menopause because they’re often formed as part of the regular menstrual cycle. 

Each month during menstruation, the ovary grows a cyst-like structure, called a follicle. The follicle contains the hormones progesterone and estrogen, which help to release an egg and promote conception. When the follicle bursts and the egg is released down the fallopian tube, this is called ovulation. 

Functional cysts

Ovarian cysts that form as a result of the menstrual process are called functional cysts. These types of cysts are usually benign (not cancerous), do not produce noticeable symptoms, and usually go away on their own within 2-3 months. Read more about functional cysts.

Pathological cysts

Pathological cysts are caused by abnormal cell growth. These types are less common and are often benign, but they can carry a higher likelihood of malignancy. Read more about pathological cysts.

What makes some people more prone to ovarian cysts?

Different factors can predispose some people to certain types of cysts. For instance, a hormonal imbalance, often caused by drugs that promote conception, can lead to functional cysts. Endometriosis, severe pelvic infections, complications in early pregnancy, and Polycystic Ovary Syndrome can all lead to formation of cysts. Learn more about risk factors for ovarian cysts.

How are ovarian cysts first identified?

Because ovarian cysts don’t always produce symptoms, and often resolve on their own, many people have them and never know it. In many cases, cysts are first found through pelvic exams performed by a gynecologist or primary care physician.

When ovarian cysts do produce symptoms, they can be similar to symptoms of ovarian cancer.

Common symptoms of both ovarian cysts and ovarian cancer can include abdominal pain, bloating, pain with intercourse, menstrual irregularities and, more rarely, frequent urination. Unusual growth of facial and body hair is a symptom more common to ovarian cysts than ovarian cancer. 

Sudden sharp abdominal pain, fever and nausea can be a sign that an ovarian cyst has ruptured or twisted, and requires quick medical attention often followed by emergency surgery.

How can doctors tell the difference between an ovarian cyst and a tumor?

Once a mass is identified and a cyst is suspected, doctors may perform additional tests to determine what type of cyst it is, or if the mass appears to be a tumor – and in either case, if treatment is necessary. 

  • Pregnancy test: If a pregnancy test comes back positive, and the patient isn’t pregnant, it may mean presence of a corpus luteum cyst. 
  • Transvaginal ultrasound: This will let a doctor see the size, shape, location, and type of mass.

If a doctor suspects a benign cyst after performing these tests, the next course of action is often to keep an eye on the cyst through more ultrasounds over the next several months to make sure it resolves and does not continue to grow. 

If an ultrasound indicates the mass looks solid and complex (as opposed to fluid-filled and simple), and if there is increased blood supply flowing to it, a doctor may suspect an ovarian tumor, and perform additional testing. 

  • A CA125 blood test measures a protein that is often elevated in people with ovarian cancer. A doctor may perform a CA125 if a patient is considered high risk for ovarian cancer, or if the ultrasound shows characteristics of a tumor. (It’s important to note that CA125 levels can also be elevated in noncancerous conditions, like endometriosis, uterine fibroids, and pelvic inflammatory disease.)

If a doctor suspects a tumor, the patient should then be referred to a gynecologic oncologist for further follow-up. The gynecologic oncologist may or may not recommend surgery to determine if the mass is cancerous.  And if it is determined to be a cyst, and not a tumor, you will likely be referred back to your gynecologist.

A final note on ovarian cysts: 

In short, presence of an ovarian cyst is not cause for alarm, but it is cause for vigilance. Know the facts, and make sure you’re clear on the process that should be used to investigate suspected cysts to rule out ovarian cancer. If you feel your questions are not being answered, be your own advocate and seek another medical opinion.

Learn more about ovarian cysts

You can find additional information on treatment, surgery, questions to ask your doctor and more in the Ovarian Cysts section of our website

Posted on in OCRA News and News

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