Science- Symptoms of
ovarian cancer might be missed by patients and doctors because they seem non-specific, oncologist Dr. Julian Schink told Insider. - Common symptoms include an increase in belly size, abdominal pain, urinary changes, and feeling full quckly during meals, but also fatigue, constipation, pain during sex or change in your period.
- If you experience symptoms for longer than two weeks, or more than 12 times in a month, see a doctor.
Ovarian
But Dr. Julian Schink says that reputation isn't entirely accurate.
"That 'silent killer' terminology is really unfair because the vast majority of women with ovarian cancer have had symptoms," Schink, chief of the division of gynecologic oncology at Cancer Treatment Centers of America, told Insider. "And many of those women have complained to somebody about their symptoms and people didn't listen or they weren't heard."
The problem, he explained, is that the common symptoms are non-specific, meaning doctors or patients often attribute them to other problems.
That's why it's important for people with ovaries — especially those with risk factors for ovarian cancer — to learn and stay alert for warning signs of the disease.
Here are potential symptoms to look out for — and when to see a doctor if you notice them.
The most common signs can be subtle
The most common ovarian cancer symptoms are an increase in belly size, pain, urinary changes (such as feeling the need to pee often or more urgently), and trouble eating or feeling full quickly, according to the American Cancer Society (ACS).
"One of the most important [symptoms] is an increase in abdominal size that is happening quickly," Schink said. "Not like, 'OK, in the last 10 years I gained three inches.' It's like, 'I gained three inches this month.'" Some people also describe bloating as a symptom, he added.
Persistent, unexplained pain can be a symptom of many cancers. Ovarian cancer can cause pain in the abdomen, Schink said.
Urinary frequency (having to pee more often than normal) or urgency (always feeling like you need to pee) can also signal the disease.
And finally, loss of appetite or feeling very full after eating only a small amount of food — also called early satiety — can be a symptom, though Schink said this is "often a sign of fairly advanced ovarian cancer."
It's easy to see why Schink described these common symptoms as non-specific. They can all be caused by other, non-cancerous conditions, and those are a more likely explanation than cancer, according to the ACS.
There can be cause for concern, though, if the symptoms occur persistently or are severe and markedly different from a person's normal state of being, according to the ACS.
Other possible signs include fatigue, constipation, changes in your period, or pain during sex
The ACS also lists fatigue, constipation, upset stomach, back pain, and pain during sex other potential symptoms of ovarian cancer. Unexplained weight loss, particularly with the other symptoms, is another clue.
It's also possible ovarian cancer could cause changes in periods. But Schink said it's not common sign because the majority of people who get ovarian cancer are peri- or post-menopausal, and have already stopped menstruating regularly. Even in pre-menopausal women, ovarian cancer may not stop periods, he added.
"The ovaries are a remarkable organ and in some women, they keep cycling even if one of them is really filled with cancer," Schink said.
Vaginal bleeding not during your period, though, is cause for concern, as is any other abnormal vaginal discharge.
Ovarian cancer symptoms are both new and persistent
Schink said true ovarian cancer symptoms have two key characteristics: They're new and they don't go away.
"I see patients all the time who have 12 hours of abdominal pain [say], 'Is this ovarian cancer?' And my comment to them is cancer symptoms generally come and while you wish they would go away, they don't. And that's the difference."
It's likely that ovarian cancer will cause more than one symptom, too. Schink said earlier research on ovarian cancer symptoms found that most patients had two or more signs of the disease.
"It wasn't just one thing suddenly wrong," Schink said. "You've got two or more symptoms of these rather nonspecific symptoms, but they're new to you, they don't go away, and they persist over the course of several weeks. That's kind of the key."
See a doctor if your symptoms last any longer than two weeks
Schink said if you experience any of the above symptoms for more than two weeks, see your doctor.
"Most abdominal issues that are related to viral illness come and go in less than a week. So when things persist for two weeks, it's time to see your physician," he said.
And don't be afraid to tell your doctor that you're concerned about ovarian cancer specifically, he added.
The ACS also recommends seeing a doctor if you have symptoms more than 12 times within a month.
This is even more important for older women, as half of all cases of ovarian cancer occur in women 63 and older, according to the ACS. You may also be at higher risk if you've had breast cancer, had children later in life and/or had fertility treatments or hormone therapy for menopause.
The outlook for ovarian cancer is improving
About 21,750 women in the US will be diagnosed with ovarian cancer in 2020, according to the ACS, down slightly from the previous two years.
But it's still one of the a concern, as an estimated 13,940 women will die from the disease this year, making ovarian cancer the fifth deadliest cancer among women.
But the death rate from ovarian cancer has been steadily declining in the past decades, according to available data, and the survival rate for early stages is more than 90%.
Schink stressed that the outlook for the disease is improving.
"People need to be aware that new treatments are emerging rapidly and survival continues to improve," he said. "Every year it gets better and we have new treatment options ... It's not a death sentence. It is becoming a more and more manageable cancer."
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