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Ovarian cysts and cancer: Is there a connection?

Benign — or non-cancerous — ovarian cysts are common among women of childbearing age. And most premenopausal women who have one at any given time probably won’t even realize it.

But what are ovarian cysts? How are they treated? And, do they ever increase your chances of developing ovarian cancer?

We went to gynecologic oncologist Travis Sims, M.D., for answers. 

What are ovarian cysts and how many different types are there?

Simple ovarian cysts, also called functional cysts, are fluid-filled sacs that develop on or in the ovaries as a normal part of a menstrual cycle. They come and go based on hormonal fluctuations. 

There are several different types, including:

  • follicular: so-named because of their location in the follicles, where eggs develop
  • corpus luteal: this name also stems from their location — in the temporary structure that develops in an empty follicle after a mature egg has been released
  • “chocolate”: so-called based on their appearance because they’re filled with a dark substance, for example, blood; these include hemorrhagic cysts and sometimes ovarian endometriomas

Regardless of their name or location, simple ovarian cysts look hollow on a scan; they have nice clean borders and a black interior on an ultrasound.

Do ovarian cysts have any symptoms?

Most women who have a simple ovarian cyst feel nothing because they aren’t that big, and they aren’t affecting anything around them.

If they get really large, though, even simple ovarian cysts can become painful, or start causing other problems, like constipation, because they’re pushing against other organs and structures in the pelvis. 

Large, heavy cysts can also cause ovarian torsion, which is when the ovary or fallopian tube twists on itself and cuts off its blood supply.

How are ovarian cysts typically diagnosed?

Most simple ovarian cysts are found by chance because someone has an abdominal scan for appendicitis or some other reason.

Are ovarian cysts ever cancerous?

Simple ovarian cysts are not cancerous. But ovarian masses that appear more complex on imaging scans fall into another category. 

Ovarian masses that have nodules or septations (little membranes subdividing the interiors) for instance, may not be benign cysts, so we’ll examine those much more closely. We may order a tumor marker test for CA-125, for example, or obtain a CT scan to look for things like ascites, or fluid pockets in the belly, to determine if a mass is suspicious for ovarian cancer.

How are ovarian cysts treated?

Unless they are causing pain or other symptoms, we normally leave simple ovarian cysts alone. If a cyst gets really big or super uncomfortable, your gynecologist might suggest removing it surgically. But most go away on their own.

If they are not complex and concerning for cancer, we don’t typically treat them here at MD Anderson, but sometimes we do if they are large and a patient has a complex surgical history.

Are certain people more likely to get ovarian cysts?

Simple ovarian cysts are extremely common among premenopausal women of all ages but uncommon in post-menopausal women.

The development of ovarian cysts is tied to the menstrual cycle. So, finding a cyst in a 70-year-old would be very unusual.

What is polycystic ovary syndrome?

Polycystic ovary syndrome is a hormonal imbalance that can cause lots of little cysts to develop on the ovaries, as well as other symptoms like acne, obesity, excess hair growth, irregular menstrual periods and infertility. It’s not the same thing as a simple ovarian cyst.

Does having an ovarian cyst increase your chances of developing ovarian cancer? 

No. There is no data supporting a connection between simple ovarian cysts and ovarian cancer. Ovarian cancer is rare. Only about 20,000 people will be diagnosed with it each year.

Ovarian cysts, on the other hand, are very common. And most ovarian cysts come and go.  But if you start to have symptoms, see your doctor.

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