Ovarian Cancer Signs and Symptoms

Source: National Ovarian Cancer Coalition

Source: National Ovarian Cancer Coalition

Every so often it’s important to offer a PSA (public service announcement) to remind women about their health risks and offer education on prevention and detection of disease. While more women get breast and cervical cancer, ovarian cancer is one of the deadliest forms of female cancers. According to the American Cancer Society, women have a 1 in 100 chance of dying from this disease in their lifetime. Here’s what you, and all the women in your life, need to know about the signs and symptoms of ovarian cancer.

What is Ovarian Cancer?

Cancer is a state in which your normal body cells start to become abnormal. This often results in cells multiplying out of control and forming into a cancerous, or malignant, tumor.

Ovarian cancer is when these abnormal cells and cancerous tumors occur in your ovaries, where your female eggs and the hormones estrogen and progesterone are produced.

Ovarian cancer frequently spreads to other places in the body, in which case it’s called metastatic ovarian cancer. It’s when the cancer has spread, usually to areas like the pelvis or abdomen, that it is first diagnosed. Unfortunately, this is often when the disease has already reached a later stage.

Why Ovarian Cancer Is So Hard to Diagnose

One of the most frustrating things about ovarian cancer is that it often goes undetected. Women may not know what signs to look for and may dismiss certain symptoms as being related to more mild issues that will resolve on their own.  

In fact, a survey done by the World Ovarian Cancer Coalition found that most women waited at least 13 weeks to see their doctor regarding symptoms, and another 24 weeks to receive their diagnosis, with a total of nearly nine months between first symptoms and diagnosis.

Unfortunately, there has also been a lack of good medical detection and testing methods in ovarian cancer for a long time. The ovaries are buried deep in your body, which makes it difficult to see what’s going on in there. Plus, transvaginal ultrasounds can detect ovarian masses but are unable to determine whether they’re cancerous - meaning, surgical procedures are frequently needed for a diagnosis.

As a result of all of these factors, only 20% of ovarian cancer cases are caught early. However, when diagnosed and treated at the earliest stages, the five-year survival rate is over 90%.

 
Source: National Ovarian Cancer Coalition

Source: National Ovarian Cancer Coalition

 

15 Early Signs and Symptoms of Ovarian Cancer

As you age, it becomes even more important to recognize potential symptoms of serious conditions. Although a woman can get ovarian cancer at any age, rates are highest in women aged 55-64 years. Symptoms of ovarian cancer can often feel like other conditions. These are quite common symptoms and most often DO NOT mean one has ovarian cancer if they are "intermittent or resolve," but if they "persist and get worse" talk to your doctor. Here are 15 of the most unsuspecting symptoms of what could be ovarian cancer.

  1. Bloating and abdominal pressure

  2. Difficulty eating or feeling full earlier than usual

  3. Indigestion

  4. Upset stomach

  5. Abnormal fluid buildup in your belly

  6. Heartburn or acid reflux

  7. Weight loss

  8. An increase in urination

  9. Feeling the urge to have to pee more often

  10. Constipation

  11. Fatigue or extreme tiredness

  12. Back, pelvic, or abdominal pain that is persistent

  13. Painful intercourse

  14. Irregularities in your menstrual period, if you still have it

  15. Dermatomyositis, an uncommon inflammatory disease that can cause a skin rash and weak muscles

Risk Factors for Ovarian Cancer 

Although the exact cause of ovarian cancer is not known, you may have a higher risk for ovarian cancer if you have the following risk factors. However, some women do develop ovarian cancer without having any of these risk factors.

  • A family history of the disease

  • Obesity

  • Never been pregnant or pregnant after age 35

  • Infertility

  • Used estrogen alone as hormone therapy or used a combination of estrogen and progestin for longer than five years

  • Genetic mutations associated with ovarian cancer like BRCA1 or BRCA2 and HNPCC or Lynch Syndrome

  • A history of breast, colon, or uterine cancer

  • A history of endometriosis

  • Older age, as most instances of ovarian cancer occur after reaching menopause

 
Source: National Ovarian Cancer Coalition

Source: National Ovarian Cancer Coalition

 

How is Ovarian Cancer diagnosed?

Advances in medical diagnostics are always being made, which is great news for diseases that can be difficult to detect, like ovarian cancer.

In fact, earlier this year researchers at the University of Kansas announced that they could find cancer markers called exosomes in a drop of blood, that could be used to help diagnose the disease. This type of research is still ongoing but has the potential for future early detection.

Still, one of the reasons that it’s so important to be aware of the potential signs and symptoms of ovarian cancer is because it’s not an obvious disease. Furthermore, there’s no routine test available to screen women for it.

A pelvic exam will often be the first step, in order to detect abnormalities. However, tumors are not commonly able to be felt through a pelvic exam unless they have grown.

Other diagnostic tests for ovarian cancer include transvaginal ultrasounds, an abdominal and pelvic CT scan, a blood test to measure levels of the cancer antigen 125 (CA-125) biomarker, and an ovarian biopsy to determine if you have abnormal, cancerous cells. Colonoscopy, chest X-rays, and laparoscopies may also be used to determine if the cancer has spread to other parts of your body.

Treatment for Ovarian Cancer 

Like other diseases, the best outcomes for ovarian cancer occur when it is detected and treated as early as possible. If diagnosed early, about 94 percent of women have a good prognosis following treatment.

The main treatment for ovarian cancer is surgery, which often includes the removal of the tumor or the entire uterus and ovaries. Ask to be referred to a gynecologic oncologist, a doctor who was trained to treat cancers of a woman’s reproductive system.

However, other common treatments may include chemotherapy and radiation, as well as hormone therapy. Targeted therapy is often used in an attempt to attack the cancer cells without harming other cells in your body. The appropriate treatment depends on the individual disease progression.

What You Can Do

If you have a family history of ovarian cancer or are otherwise concerned about your personal risk for this disease, it’s a good idea to speak with your healthcare provider about what else you can do to protect your health and detect the disease as early as possible.

For more resources on ovarian cancer, check out the National Ovarian Cancer Coalition’s website. To help spread the word, tag your friends on social media with the hashtag #KnowOvarian.

For more information about non-hormonal management of menopause symptoms and women’s health during midlife, head over to Lisa Health.  

Dr. Risa Kagan, MD, FACOG, CCD, NCMP is a leading clinician and researcher in Gynecology and Menopause. She is a board-certified obstetrician-gynecologist at Sutter Health and has been a Clinical Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco for over 35 years. She is a North American Menopause Society (NAMS) Certified Menopause Practitioner (NCMP) and is certified by the International Society of Clinical Densitometry (CCD). She was previously co-medical director and principal investigator (PI) for multiple clinical trials at the Foundation for Osteoporosis Research and Education (FORE) in Oakland, CA, and now serves on the Medical and Scientific Advisory Board of American Bone Health (ABH). She is also a PI on numerous women’s health clinical research trials with the Jordan Research and Education Institute (REDI) of the Alta Bates Summit Medical Center, Sutter Health Research Institute. Dr. Kagan is the author or co-author of numerous publications in peer-reviewed journals and is on the editorial board of Menopause. She is often an ad hoc reviewer for many other journals including The Journal of Women’s Health and The Journal of Sexual Medicine. She specializes in gynecology with particular focus on gynecologic surgery and women's health issues including menopause, bone health, female sexuality, and female cancer survivorship. Dr. Kagan is regarded as one of the leading physicians in her field and has been nationally listed in US Best Doctors for many years. Dr. Kagan graduated from New York University and the Albany Medical College of Union University.  She completed her internship-residency at the University of California San Francisco.

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