Ovarian cancer is often called a "silent" disease, but most women do report symptoms before diagnosis. The difficulty is that these symptoms are common and easily attributed to other conditions. Knowing which signs are persistent and new is the single most useful step towards an earlier diagnosis.
The most common symptoms
According to the American Cancer Society and the UK's National Health Service, the symptoms most frequently reported by women later diagnosed with ovarian cancer are:
- Bloating or a persistently swollen abdomen
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary symptoms, such as needing to urinate more urgently or more often
Research on symptom patterns found that this cluster is significantly more frequent, more severe and more recent in onset in women with ovarian cancer than in the general population (Goff BA et al., Cancer, 2007).
Other symptoms that may occur
- Fatigue
- Back pain
- Indigestion or an upset stomach
- Changes in bowel habits, such as constipation
- Pain during sex
- Changes to the menstrual cycle
- Unexplained weight loss
Most of these complaints are caused by benign conditions. What matters is the pattern, not any single symptom.
When should you see a doctor?
UK national guidance (NICE guideline NG12, Suspected cancer: recognition and referral) recommends contacting a doctor if any of these symptoms are new, persistent and occur roughly 12 or more times a month, particularly in women over 50. The same applies at any age when symptoms do not settle within a few weeks.
How ovarian cancer is investigated
Initial assessment usually includes a pelvic examination, a transvaginal ultrasound scan and a CA-125 blood test. Where findings are suspicious, a CT scan and referral to a gynaecological oncology team follow. European clinical practice guidelines from ESMO-ESGO stress that management in a specialised centre improves outcomes.
Who is at higher risk?
- Inherited variants in the BRCA1 or BRCA2 genes, or Lynch syndrome
- A family history of ovarian, breast or colorectal cancer
- Increasing age, especially after the menopause
- Endometriosis
- Never having been pregnant, and long-term hormone replacement therapy
Women with a strong family history should ask about genetic counselling and testing. The World Health Organization estimates more than 300,000 new cases of ovarian cancer worldwide each year, with survival strongly dependent on the stage at diagnosis.
What you can do
Keeping a simple symptom diary — what you feel, how often and since when — gives your doctor exactly the information needed to decide whether further tests are warranted. Esperity's tools are built to help patients record, organise and share this kind of information with their care team and their trusted circle.
Sources
- American Cancer Society. Signs and symptoms of ovarian cancer.
- NHS. Ovarian cancer — symptoms and diagnosis.
- NICE. NG12: Suspected cancer — recognition and referral.
- ESMO-ESGO. Clinical practice guidelines: ovarian cancer.
- World Health Organization / IARC. Global Cancer Observatory.
This article is for information only and does not replace advice from a qualified healthcare professional.