PCOS, Endometriosis, and Ovarian Cysts: Understanding Ovarian Cancer Risk

If you’ve ever been told you have PCOS, endometriosis, or ovarian cysts, chances are the first thought that ran through your mind was: Does this mean I’m at risk for ovarian cancer?

You’re not alone. It’s one of the most common questions we hear at the National Ovarian Cancer Coalition. And in this episode of Teal Talk – An Ovarian Cancer Podcast, Dr. Natalie Godbee, a gynecologic oncologist at City of Hope, joined us to clear up confusion, calm fears, and share what everyone should know.

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What are PCOS, endometriosis, and ovarian cysts–really?

Medical terms like “polycystic ovarian syndrome” or “borderline ovarian cysts” can sound intimidating, but Dr. Godbee explained them in a way that makes sense:

• PCOS isn’t just about having cysts on your ovaries. It’s actually a metabolic condition connected to hormone imbalance and insulin resistance. Some women with PCOS may notice symptoms like irregular cycles, facial hair growth, or trouble managing blood sugar. Others may not even have visible ovarian cysts at all.
• Endometriosis is when tissue similar to the uterine lining grows outside the uterus, sometimes on the ovaries or even beyond. It often comes with painful periods or chronic pelvic pain, and while it isn’t cancer, it can cause real challenges.
• Ovarian cysts themselves are often completely normal. In fact, your body naturally makes a cyst every month during ovulation. The difference comes when cysts don’t go away, get larger, or look unusual on an ultrasound. That’s when doctors keep a closer eye.

Do these conditions increase ovarian cancer risk?

Here’s the short answer: sometimes yes, sometimes no.

• PCOS doesn’t usually raise your ovarian cancer risk. But because it’s tied to hormone imbalances, it can increase your risk of endometrial cancer (cancer of the uterine lining).
• Endometriosis is the one most connected to ovarian cancer. Research shows a tenfold increase in risk for certain types of ovarian cancer in women with endometriosis.
• Ovarian cysts are usually harmless. Most are just part of the natural cycle. But complex or persistent cysts, especially those with unusual features, are worth following up with your doctor.

As Dr. Godbee put it:

“An ovarian cyst won’t always lead to ovarian cancer . . . If you happen to be diagnosed with a cyst, it’s definitely something that you want to follow up on to make sure there are no complex components and that it’s not continuously growing.”

What you can do: Taking charge of your health

The best thing you can do? Stay engaged with your own health.

• Keep up with your annual gynecologist visits.
• Pay attention to changes in your pain, cycles, or overall health.
• Speak up if something feels different or “off”.
• Know the symptoms of ovarian cancer like bloating, changes in bowel or bladder habits, fatigue, or unexplained weight changes.

Dr. Godbee reminds us:

“Continue to advocate for yourself. You know your body. If what we are treating you with is not working . . . continue to say, ‘Okay, but something is wrong.'”

The emotional side: You’re not alone

Hearing words like PCOS, endometriosis, or cysts can be scary. Add in the worry about cancer, and it’s easy to feel overwhelmed. But knowledge is power and community is comfort.

Endometriosis and PCOS may bring daily challenges. Ovarian cysts can mean frustrating follow-up appointments. But none of this means you’re facing it by yourself. Support groups, mental health resources, and conversations with your care team can help lighten the emotional weight.

Key takeaways

• PCOS does not increase ovarian cancer risk, but it can raise risk for endometrial cancer.
• Endometriosis does increase ovarian cancer risk and should be followed closely.
• Most ovarian cysts are normal but complex or recurring ones need monitoring.
• The best protection is knowing your body, reporting changes, and advocating for your health.