With this article, WVFC’s Dr. Elizabeth Poynor kicks off an in-depth series on ovarian cancer: early signs and symptoms, risk assessment, and other factors in ovarian health after menopause.

For many years, it was widely accepted that ovarian cancer had no early warning signs or symptoms and women had to accept their fate: if they developed ovarian cancer, it would most likely be well advanced by the time it was found by their physicians. It was referred to as a “silent killer.”

Ovarian cancer accounts for only 4% of cancer in women, but due to its lethal nature, it is the fifth leading cause of cancer death in women. Each year approximately 24,000 women will be diagnosed with ovarian cancer and 15,000 women will die. The high mortality rate from this disease is due to the fact that at the time of diagnosis it is usually spread beyond the ovaries, when the disease can only be cured up to 20% of the time. But if the disease is found at its earliest stages, when it is confined to the ovary, it can be cured up to 90% of the time. Until recently, we were taught by our mentors in gynecologic oncology that there were no early symptoms of the disease. This was because there was no data or study to suggest that there could be early symptoms associated with ovarian cancer.

All that changed in a radical fashion a few years ago, when Dr. Barbara Goff presented her findings from a study of ovarian cancer survivors, demonstrating that 87% of women with early-stage disease do have symptoms.

The story of how this study evolved is itself an interesting one. Dr Goff listened to a group of ovarian cancer survivors who urged her to research the issue. She conducted a small study in 2000, in which she discovered that indeed there are early warning signs. She also found that there were long delays in diagnosis, and that women’s early ovarian cancer symptoms were being attributed to other, more common illnesses such as irritable bowel syndrome, constipation, stress, and depression.

Ovarian cancer is now referred to as a disease that whispers. Currently, we do not have good screening technologies for ovarian cancer, so it is important that all women be aware of the signs and symptoms of ovarian cancer and listen to their bodies. This led the first National Statement of Ovarian Cancer Symptoms in 2007.

Symptoms of ovarian cancer include:

  • Bloating
  • Pelvic or abdominal pain
  • Difficulty eating or feeling full
  • Urinary symptoms (urgency or frequency)

Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Further evaluation should include a physical examination, a trans vaginal ultrasound, and a blood test called CA125, which is a protein associated with ovarian cancer.

Other symptoms less strongly associated with early ovarian cancer include:

  • Fatigue
  • Indigestion
  • Back pain
  • Pain with intercourse
  • Constipation
  • Menstrual  irregularities

The bottom line: if you have any of these symptoms, review them with your health care provider. If you have a personal history of breast cancer, or a family history of breast or ovarian cancer, you may be at elevated risk for ovarian cancer and additional interventions to protect yourself may be warranted.

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