Can Young Women Get Ovarian Cancer?

A Real Case, and What Every Young Woman Should Know

PATIENT DETAILS

Dr V Sreekanth Reddy

Senior Consultant Surgical Oncologist

I was in my chamber one afternoon when a colleague knocked on my door, visibly anxious. His daughter’s close friend — a 22-year-old working in an IT company — had just been told she had a mass in her pelvis. They were frightened. I asked them to come in.

When she walked into my clinic, she didn’t look like someone most people imagine when they hear the word cancer. She was fit, active, and led a healthy lifestyle — no smoking, no alcohol. She had simply developed abdominal pain one day, visited a general physician, and was sent for an ultrasound scan. The scan revealed a 12 x 15 cm mass in the pelvis, most likely arising from the ovary.

Not Every Ovarian Mass Is Cancer — But Every One Deserves Attention

The first thing I want every reader to understand is this: finding a mass in the ovary does not automatically mean cancer, particularly in a young woman. Ovarian cysts and benign tumours are far more common at this age. However, the possibility of malignancy must always be taken seriously and ruled out with the right investigations.
In this patient’s case, I ordered two key investigations:

Tumour markers — Blood tests that can indicate the likelihood of malignancy. Elevated markers raise concern; normal values are reassuring, though not conclusive.

Contrast MRI of the pelvis — A more detailed imaging tool than ultrasound that helps assess the character of the mass, its relationship to surrounding structures, and features that guide surgical planning.

Her tumour markers were normal — a positive sign. However, the MRI revealed certain high-risk features that could not be ignored. After a careful review of the imaging with my radiology colleagues, we decided that surgery was necessary.

The Conversation Before the Operation

Before the surgery, I sat down with the patient and her family. She was 22, unmarried, and her reproductive future mattered deeply — both to her and to me.

“Our goal was not just to remove the mass — it was to preserve her future.”

I explained the diagnosis, the uncertainty we would face in the operating room, and the plan: we would attempt a fertility-preserving surgery, with the aim of keeping her uterus and at least one ovary intact — if the findings allowed it. She understood. She consented. And she trusted us.

Inside the Operating Room

We chose open surgery over laparoscopy for a specific reason: ovarian masses of this size carry a risk of rupture during surgery. If a malignant cyst ruptures, tumour cells can spill into the abdominal cavity — an outcome we needed to avoid at all costs.
Once the mass was carefully excised and removed intact, we sent it immediately for a frozen section — a rapid pathological examination performed while the patient was still on the operating table. This tells us the nature of the lesion in real time and guides our next surgical step.
The result: Borderline mucinous ovarian cancer.
This is an important diagnosis to understand. Borderline ovarian tumours sit between benign cysts and frankly malignant cancers. They are far less
aggressive, do not invade surrounding tissue in the typical way, and — crucially — do not usually require chemotherapy. They are treated primarily with surgery.
With this information, we proceeded to complete the surgery: we performed an appendicectomy (the appendix is routinely assessed in mucinous ovarian tumours), preserved her uterus and the opposite ovary, and closed.
She woke up. She was whole. Her future — including the possibility of motherhood — remained intact.

What This Case Teaches Us

I share this story not to alarm young women, but to empower them. Here are the key lessons:

1. Ovarian Cancer Can and Does Occur in Young Women

While it is less common than in older women, ovarian cancer is not age-restricted. Any persistent pelvic pain, bloating, or abdominal swelling in a young woman deserves medical evaluation — not dismissal.

2. Proper Investigation Changes Everything

A good ultrasound is the starting point, but tumour markers and MRI often provide critical additional information. Importantly, the imaging should be reviewed in discussion with an experienced radiologist — this collaborative approach shapes better surgical decisions.

3. Fertility-Preserving Surgery Is Possible

For young women with ovarian cancer, losing the ability to have children is one of the greatest fears. Careful pre-operative planning — including assessment of tumour size, nature, and involvement of both ovaries — can allow surgeons to preserve reproductive organs in many cases. Where both ovaries are involved, egg preservation (cryopreservation) is a conversation worth having.

4. Not All Ovarian Cancers Are the Same

The type of ovarian tumour matters enormously. Borderline tumours behave very differently from high-grade epithelial cancers. Germ cell tumours, which also occur in young women, respond beautifully to chemotherapy. Treatment is never one-size-fits-all.

5. Small, Non-Suspicious Lesions Can Be Watched

Not every ovarian cyst needs surgery. Small lesions without worrying features can be monitored conservatively with regular imaging. The key is appropriate characterisation — and that requires the right specialist at the right time.

A Final Word

My patient returned for follow-up a few weeks after surgery. She was recovering well. She asked me, with characteristic directness, whether she could still have children one day.
“Yes,” I told her. “That was always part of the plan.”
Ovarian cancer in a young woman is not a death sentence. It is a diagnosis that demands urgency, expertise, and — above all — a surgical plan tailored to the whole person, not just the tumour.
If you or someone you know has been told there is an ovarian mass, seek a consultation with a qualified oncosurgeon. Early evaluation, expert imaging review, and thoughtful surgical planning can make all the difference.