Living with advanced ovarian cancer
While earlier stages of ovarian cancer are easier to treat than advanced stages, early stages cause very few noticeable symptoms. This isn’t the case for advanced, or late-stage, ovarian cancer.
Advanced ovarian cancer causes significant symptoms. It’s important to work with your doctor to address these symptoms as each may require specific treatment.
In many cases, treatment will begin to ease your symptoms, but it’s important you’re aware of potential side effects. You, your doctor, and your cancer care team can create a plan for when your symptoms become problematic or painful.
Here, we explain the most common symptoms of advanced ovarian cancer and how to manage them.
In the early stages of ovarian cancer, pain in this area may be easily ignored, hard to identify, or attributed to another condition. But, advanced ovarian cancer often causes a lot of pain and discomfort in the pelvic and abdominal regions of your body.
The most common treatment for pain symptoms is medication. A doctor can help guide you on the proper dosages of over-the-counter (OTC) pain medications, such as acetaminophen (Tylenol) or anti-inflammatory pain relievers like aspirin or ibuprofen (Motrin, Advil).
If your pain isn’t manageable by OTC medications, your doctor may prescribe an opioid, which can help relieve stronger pain. Most often, morphine taken as a pill, is prescribed for individuals with cancer.
Other pain-relieving opioid options include:
Some people with ovarian cancer may also find alternative therapies helpful in managing their pain. For example, those who are experiencing abdominal pain could try:
- massage therapy
- relaxation techniques, such as meditation
- guided imagery
- chiropractic treatment
Constipation may be the most obvious sign of a bowel obstruction.
Large ovarian cancer tumors may block your intestines and prevent your body from working as it should. This can lead to significant pain and discomfort, especially as the blockage worsens.
The blockage may also lead to other symptoms, including:
If the constipation is caused by a blockage from a tumor, treatment can vary based on your surgical options or option to reduce the tumor in order to relieve the obstruction.
Your doctor may be able to perform surgery to remove the blockage or may place a temporary opening in order to go around the blockage.
Some individuals may find that their bowels are still able to function even through an obstruction, so treatment includes helping to facilitate bowel movements through:
- drinking adequate fluids
- soft, easy-to-digest foods
- gentle exercise
Some medications might also help manage the symptoms of constipation including:
- laxatives, such as Miralax
- steroids to reduce inflammation
- anti-nausea medication, such as ondansetron (Zofran)
- octreotide, a prescription hormone therapy
In some cases, constipation may also be caused or worsened by opioid medication, so your doctor will work with you to alter your dosage as needed.
Sometimes, ovarian cancer can spread and affect the urinary system. The cancerous tumor can block one or both of the ureters.
Ureters are responsible for moving liquid waste (urine) between the kidneys and the bladder. If one or both of these tubes become blocked, your urine won’t reach the bladder. You’re likely to experience swelling and pain as a result.
Eventually the kidney will become damaged if you don’t treat the blockage and relieve the pressure.
If both ureters are blocked, a special tube may need to be placed to drain the urine during cancer treatment. The tube may either be placed inside the body to drain urine from the kidney into the bladder, or outside of the body to pull urine directly from the kidney.
In the late stages of ovarian cancer, however, bloating and swelling may become more uncomfortable. OTC remedies may not ease this discomfort, but your doctor can work with you to reduce secondary bloating.
Secondary bloating is bloating caused by other factors, like the foods or beverages you ingest.
The prescription medication octreotide may help relieve symptoms of discomfort from abdominal bloating. Additionally, addressing secondary bloating can help reduce your overall discomfort.
You can decrease secondary bloating by avoiding:
- carbonated beverages
- processed foods
- gas-producing foods such as broccoli, cabbage, and beans
You can also do gentle movements as you’re able.
Unexpected weight loss, or losing a large amount of weight without trying, is another symptom of advanced ovarian cancer.
It’s important you work with your doctor and a registered dietitian or medical nutritionist to ensure you’re getting the proper nutrition.
Getting the right kind of calories from a healthy diet is better than eating calories just for the sake of trying to maintain your weight.
Your doctor may prescribe an appetite stimulant if you’ve lost interest in food. A nutritional supplement, such as a shake, may help you get in the calories you need more easily.
As cancer cells grow, they can expand and begin to push on neighboring organs like the bladder. Pressure on the bladder and urinary system may make you feel the need to urinate more frequently.
If you’re able to urinate on your own, using the bathroom more often may help relieve some of the discomfort that comes with increased urgency.
Your doctor may also recommend lifestyle modifications such as wearing incontinence underwear. If there’s a blockage in your urine caused by the cancer cells growing, you may need the urine drained through a procedure.
Women with advanced ovarian cancer may experience ascites, also known as the buildup of fluid in the abdomen. This fluid buildup can begin for several reasons.
In some cases, cancer cells that travel into the abdomen aggravate the surrounding tissue. That causes fluid to build up.
Cancer cells can also block the lymphatic system and prevent the excess fluid from draining out of the abdomen. That compounds the swelling and bloating, which may make the condition very uncomfortable.
In some cases, the treatment for ascites is the same as the treatment for the cancer because reducing the cancer cells can help reduce the swelling and fluid from building up.
In some instances, a paracentesis procedure will drain the excess abdominal fluid to help relieve the swelling and bloating.
It’s always important to pay attention to your body and any symptoms you’re experiencing.
Talk to your doctor if you begin noticing any of the described symptoms, especially if you’ve been diagnosed with ovarian cancer or have a higher risk.