Ovarian cancer is a frightening diagnosis that often comes after the cancer has spread. As a result, it's the most deadly of the gynecological cancers.

But not all the news about ovarian cancer is grim. Incidence is declining. Doctors are learning more about early symptoms and more effective treatments. The September issue of Mayo Clinic Women's HealthSource looked at myths and facts about ovarian cancer.

Myth: There are no early symptoms.

Fact: Many women with ovarian cancer do have early warning signs. However, common symptoms—abdominal pressure, fullness, swelling or bloating, urinary urgency, and pelvic discomfort or pain—mimic those of many other conditions. It's not unusual for women with ovarian cancer to be diagnosed first with a digestive or bladder disorder. With these concerns, symptoms tend to come and go, occur in certain situations, or be related to certain foods. With ovarian cancer, symptoms are likely to occur daily for weeks or months on end. Symptomatic women who have been treated for other health conditions and haven't improved should schedule a follow-up visit with their doctor or seek a second opinion.

Myth: Pap tests can detect ovarian cancer.

Fact: Pap tests, also called Pap smears, are designed to detect cervical cancer, not ovarian cancer. Other exams and tests can help detect ovarian cancer, but none is helpful for routine screening.

When ovarian cancer is suspected, a doctor likely will perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include what's called a CA 125 blood test and a transvaginal ultrasound. The protein CA 125 often is elevated in women with ovarian cancer. A transvaginal ultrasound is used to produce detailed images of the ovaries and other reproductive organs.

Myth: Most women with ovarian cancer have a family history of the disease.

Fact: Only 10 to 15 percent of ovarian cancers are inherited. The most important risk factor for ovarian cancer is the presence of inherited mutations in breast cancer genes known as BRCA1 and BRCA2. Other risk factors are personal or family history of breast cancer, obesity, and a woman's age. Most patients with ovarian cancer are postmenopausal.

Myth: Women who have had a hysterectomy can't get ovarian cancer.

Fact: During a hysterectomy, a surgeon removes the uterus and usually the cervix. In some cases, the fallopian tubes and ovaries are removed. If one or both ovaries are left intact, ovarian cancer is possible. There's a very small chance of the disease, even when the ovaries are removed.

Myth: Ovarian cancer is always deadly.

Fact: Ovarian cancer is a serious illness, but it's not always deadly. An estimated 21,550 women will be diagnosed with ovarian cancer in 2009, and 14,600 will die from the disease. When ovarian cancer is diagnosed and treated early, five-year survival rates are nearly 93 percent.

Having a gynecologic oncologist perform the surgery increases survival rates. Combining certain chemotherapy drugs also may improve survival rates and help prevent recurrence, even in women with later stages of the disease.

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives.