Ask Dr. Pat

September is Ovarian Cancer Awareness
Are There Early Warning Signs?

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 has usually spread beyond the ovaries, a point at which 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 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.

This dogma began to change when patients were interviewed carefully about the symptoms that they had experienced before the diagnosis of ovarian cancer, demonstrating that 87% of women with early-stage disease do have symptoms.  In 2001, a case-control study from Memorial Sloan-Kettering Cancer Center was published. Women with ovarian cancer and controls were interviewed for symptoms experienced during the preceding six months. The authors found that ovarian cancer patients were significantly more likely to complain of bloating, lack of appetite, abdominal pain, fatigue, urinary frequency, and constipation than controls. In this study, 89% of women with early-stage disease also complained of symptoms before diagnosis, and there was no significant difference in the symptoms reported between those with early-stage versus late stage disease.  In addition to this growing awareness that patients with ovarian cancer often have symptoms in early stage, there is recognition that there are often 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.

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.

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 should, almost daily for more than a few weeks, see their doctor, preferably a gynecologist.

Other symptoms less strongly associated with early ovarian cancer include:

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

Ovarian Cancer Awareness should be every month for women and their health care providers.  Share this post with all the women in your life.

Dr. Pat




Jacobs IJ, Menon U, Ryan A, et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet. 2016;387(10022):945-956.

National Cancer Institute Surveillance, Epidemiology, and End Results Program. Cancer stat facts: ovarian cancer.