Symptoms of Ovarian Cancer and When to Seek Help

According to the American Cancer Society, one out of every 78 women will develop ovarian cancer at some point in their life. Of those diagnosed, one out of every 108 will die from the condition. In 2018 alone, it’s estimated that doctors will diagnose more than 22,000 women with ovarian cancer while more than 14,000 deaths will occur. ¹

In a report published in CA: A Cancer Journal for Clinicians in May 2018, it was determined that preventative measures and early diagnosis are key to lowering the incidence rate of ovarian cancer in years to come.² When diagnosed at an early stage, the five-year survival rate is between 80 and 90 percent. For women diagnosed at a later stage, the survival rate drops below 40 percent.³

The best way to increase the rate of early detection is to educate women on the symptoms of ovarian cancer and signs that they need to seek medical attention. The following information is designed to provide that education for all women.

What are the Symptoms of Ovarian Cancer

Less than 20 percent of women with ovarian cancer are diagnosed in the early stages.⁴ It’s during these stages that women have the highest chance of survival, but it’s difficult to diagnose early because most women don’t have recognizable symptoms. They may experience some subtle signs that something is wrong, but those signs are easily attributed to the menstrual cycle, weight gain, or other issues that don’t require prompt medical attention.

Many women are referred to gastroenterologists and other specialists before they see a gynecologist capable of detecting the symptoms and testing for ovarian cancer. This is because the earliest symptoms of ovarian cancer often mimic the symptoms of gastrointestinal conditions like irritable bowel syndrome.⁵ For instance, chronic constipation and diarrhea are among the earliest warning signs of ovarian cancer.

There are four key symptoms that most women experience as ovarian cancer develops:

1. Bloating or abdominal swelling
2. Pelvic pain
3. Sensation of abdominal fullness
4. Frequent urination

The sensation of fullness in the stomach may also present as appetite loss or trouble eating due to the stomach feeling full too quickly. In some cases, women feel the urge to urinate frequently but might not produce urine each time.

All four of these signs typically start out subtle, so many women don’t realize that they need to mention it to their doctors. This is why ovarian cancer is considered a “silent killer” that is typically diagnosed in the advanced stages.

Other Signs

In addition to those four basic symptoms of ovarian cancer, many women will experience one or more of the following signs:

1. Fatigue
2. Back pain
3. Changes in bowel habits
4. Menstrual changes
5. Weight loss
6. Pain with sexual intercourse⁶

Women who suddenly experience changes in their bathroom habits or menstrual cycles are strongly encouraged to see their doctors. Change in bowel habits can include chronic constipation or diarrhea as well as frequent urination. Changes to the menstrual cycle can include the length of periods, heaviness of bleeding, and amount of cramping.

When to Talk to A Doctor

All the symptoms listed above aren’t required for an ovarian cancer diagnosis. These are just some of the symptoms that many women report experiencing prior to their diagnosis. It’s always better for a woman to see her doctor and discover that she doesn’t have cancer than to blow off these early signs and receive a late-stage diagnosis.

Most symptoms of ovarian cancer are also experienced by many women who don’t have cancer, but it’s still important to seek medical attention if those symptoms occur with any of the following criteria:

1. Change from Normal: These symptoms were never experienced before, so they are out of the ordinary for the individual.
2. Increased Severity: The individual has a history of these symptoms, but the symptoms are now more severe and thus out of the ordinary.
3. Frequent Occurrence: The individual experiences the symptom 12 or more times over the course of a month.
4. Persistent: The symptoms continue to occur and aren’t one-time experiences. For instance, changes in the menstrual cycle are considered persistent if they start to occur every month.

Even if a woman experiences just one symptom of ovarian cancer and it presents with one or more of these criteria, she should seek medical attention. Women should directly ask for ovarian cancer screening to ensure doctors don’t underestimate the importance of early detection.

It is now believed that about 15 percent of ovarian cancer cases are hereditary.⁷ Women may know that they’re at higher risk for the disease if multiple females in their family have suffered. Genetic tests are also available to detect BRCA gene mutations. These mutations are strong indicators that a woman may later develop ovarian or breast cancer.⁸ Women with known mutations should seek medical attention immediately if they experience any signs of ovarian cancer.

There is no single test that can verify ovarian cancer immediately. Most doctors will use one or all the following diagnostics to determine if this is the appropriate diagnosis:

1. Pelvic examination
2. Bloodwork
3. Gastrointestinal testing (colonoscopy, endoscopy)
4. Ultrasound
5. CT scan
6. MRI scan

Treatments Available

Once a diagnosis of ovarian cancer is delivered, the treatment plan may depend on the stage of the cancer, the type of ovarian cancer detected and the overall health of the woman. In most cases, women are referred to a local gynecologic oncologist, medical oncologist, or surgeon.⁹ The following list identifies the most common treatments for ovarian cancer, but each woman will receive an individualized treatment plan.

1. Surgery: In addition to removing the cancer tumors, surgeons will remove the uterus, ovaries, fallopian tubes, and omentum while collecting fluid and biopsies for further study.¹⁰ In some cases, the surgeon will remove parts of other organs if the cancer has spread throughout the abdominal cavity. The prognosis is best when all cancerous tissues are successfully removed.
2. Chemotherapy: Chemo medication is pumped through the bloodstream. This approach is often used to eliminate remaining cancer cells after surgery or to shrink large tumors that aren’t entirely removed during surgery.¹¹
3. Radiation Therapy: Most women won’t receive radiation treatment for ovarian cancer, but it is sometimes used to treat cancer cells that have spread beyond the reproductive system.¹²
4. Hormone Therapy: Some doctors may use hormones or hormone-blocking treatments to fight ovarian stromal tumors.¹³
5. Targeted Therapy: This is a more sophisticated cancer treatment that targets individual cells. The goal is to change the behavior of cancer cells without impacting surrounding healthy cells.¹⁴ There are different types of targeted therapies that may prove useful for select ovarian cancer patients.

For most women, surgery followed by chemotherapy is the best approach to treating ovarian cancer. Once all cancerous cells are removed, patients should go into remission with no symptoms of cancer. They will still require ongoing checks to ensure that the cancer doesn’t return.

It’s estimated that approximately 70 percent of patients will experience ovarian cancer recurrence, but the risk is much lower for patients diagnosed in stage I or II.¹⁵ The cancer can return to the same spot it was originally detected or it may appear elsewhere in the body. Women have the best chance of eliminating all cancer cells the first time around if they’re diagnosed early.