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4 Early Signs of Ovarian Cancer

December 07, 2007
From the WebMD Archives

Off the “Heart” Track, But Important to Me

I’ve been meaning to write about ovarian cancer warning signs for some time, because too many people think that the symptoms are too vague to recognize, leading too many women to overlook symptoms that could signal this frequently deadly cancer.

Recently I came across references to a set of common symptoms that may suggest that ovarian cancer is present. These symptoms should be promptly discussed with a woman’s health care provider. An expert panel, including individuals from the American Cancer Society, the Gynecologic Cancer Foundation, and the Society of Gynecologic Oncologists have published the following list of concerning symptoms:

  • Bloating of the abdomen (anywhere between the bottom of the ribs and the area between the hip bones {pelvis}, from side to side).
  • Pelvic or abdominal pain.
  • Trouble eating or feeling full quickly (also known as early satiety).
  • Urinary symptoms as might also be experienced with bladder infection, such as urinating more frequently, having to go urgently, or having pain with urination.

I actually make the point about the urinary symptoms because it highlights one of the potential problem with this list; they actually describe symptoms that could be attributed to many things, some of which are of no consequence.

Last year a patient in my primary care practice developed vaginal bleeding, even though it had been several years since her last menstrual period and we considered her to be post menopausal. She neglected to mention this bleeding for a while because a member of her family had told her that sometimes this “just happens.” When she did tell me she also mentioned feeling full quickly while eating and some abdominal pain. My first thought was that she might have endometrial cancer, a cancer of the lining of the uterus, which commonly causes bleeding after menopause. Fortunately the uterine biopsy that we did was negative, but the nearly simultaneous ultrasound showed an ill-defined mass in her abdomen that prevented us from seeing her right ovary. We had accidentally found ovarian cancer together. She had surgery to remove her ovaries, uterus, and the grapefruit-sized tumor, and more than a year later she remains free of cancer.

Many women aren’t so lucky. The abdomen is a fairly large open area (called a “potential space” because of its capacity) with the ability to stretch to accommodate a fairly large growth before it is noticed. This is because there are few nerve endings to pick up pain signals until a tumor is pressing against other organs that have these pain sensors. Once a tumor is this large, it will often have already spread to other organs, such as the stomach, liver and intestines.

The American Cancer Society estimates there will be 22,430 new cases of ovarian cancer in 2007 in the United States. While 93% of women diagnosed with early stage ovarian cancer will survive more than 5 years and many of them will be cured, only 19% of ovarian cancers are found at the early stage before they have spread to other organs. This results in ovarian cancer being the 5th leading cause of cancer death among women and it accounts for more deaths than any other cancer of the female reproduction system.

The important thing for women to know is that they can really help their health care providers to detect ovarian cancer at an early stage, if they are suspicious about a certain pattern of symptoms. If you develop any of the symptoms described above, pay careful attention to their persistence, especially beyond an episode of treatment. Take those urinary symptoms for example. If you see your health care provider for symptoms that might be associated with a bladder infection and it is either not that, or it seems to be but you don’t get better despite the right treatment, this warrants further investigation. Now think about bloating and abdominal pain. Many women have these symptoms with their menstrual cycles, but if your period comes and goes, and by the third week you are still feeling bloated or having pain, it needs to be evaluated further. Feeling full early into eating a meal is a big trigger for me. If I hear this complaint from a woman I consider ovarian cancer at the top of my list of potential diagnoses; you should too. If you have any family history of ovarian cancer you should really be on the lookout, and question early on if you have symptoms of concern.

Because ovarian cancer symptoms can be vague or mimic so many other things, it pays to be persistent if you are concerned. If you are not taken seriously seek a second opinion, preferably with an OB-GYN surgeon who is familiar with female cancers. Let your local medical community members think you are little nuts because you keep complaining about your symptoms until someone listens. If you are wrong – so what! If you are right, the life you save will be yours.

Take care,


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