Ovarian cancer is sometimes referred to as a “silent” disease, because early symptoms can be mild and easy to dismiss. These symptoms can also be caused by a variety of other problems that have nothing to do with cancer.
In early-stage ovarian cancer, there is generally no visual evidence of the disease.
Early symptoms may include general abdominal discomfort, bloating, and swelling. You may have difficulty eating or you may feel full after eating only a small amount. Ovarian cancer may also cause upset stomach and pelvic or abdominal pain. You may experience bouts of constipation, which is sometimes mistaken for irritable bowel syndrome.
Increased pressure from a tumor can cause an urgent need to urinate or frequent urination. Some women with ovarian cancer experience painful intercourse. It can also cause changes to your menstrual cycle.
As ovarian cancer progresses, symptoms become more persistent. Fatigue, weight loss, and unexplained back pain can be symptoms of ovarian cancer. You should see your doctor as soon as possible if symptoms are severe or continue to occur for more than a month.
Your doctor will start by taking your medical history and performing a general physical examination. The next step will likely be a pelvic exam. Your family doctor can do this, but you may be referred to a gynecologist.
During the pelvic exam, your doctor will insert a speculum into your vagina to visually inspect for abnormalities. With two gloved fingers in your vagina, the doctor will press on your abdomen to feel your ovaries and uterus. A pelvic exam can offer clues to your condition. However, enlarged ovaries can’t always be felt, due to their location within your pelvis.
Your doctor will probably order a blood test. There’s a protein called CA-125 that’s found on ovarian cancer cells and can be detected in the blood. A high level of CA-125 could be indicative of ovarian cancer, but not always. Your blood tests may also reveal problems with kidney or liver function.
Imaging tests are more helpful in discovering abnormalities. They can give doctors information about the structure, size, and shape of your ovaries. While imaging tests can reveal a tumor or other mass, they can’t determine if it’s cancerous. After diagnosis, imaging tests are quite helpful in checking to see if cancer has spread (metastasized) to other areas of your body.
If you’re having an ultrasound, a small probe will be placed on your abdomen or in your vagina. Sound waves help to form an image. A good ultrasound image can identify a mass and determine if it’s a tumor (solid) or a cyst (fluid-filled). It can even see inside the ovaries.
Computed tomography (CT) scans use X-rays to create cross-sectional pictures. For a CT scan, you’ll lay still on a narrow table while the scanner moves around you. You may need an intravenous (IV) line for the contrast dye.
A CT scan can’t always detect smaller ovarian tumors. It can find larger tumors, evidence of enlarged lymph nodes, and cancer that has spread outside the ovaries.
MRI uses magnetic fields, radio waves to create very precise and accurate images and is often used to better visualize the ovaries and characterize any masses seen on CT or ultrasound.
Chest X-rays can be used to see if the cancer has metastasized to the lungs. A positron emission tomography (PET) scan isn’t usually used to check for ovarian cancer. It’s more useful in finding out whether ovarian cancer has spread. PET uses radioactive glucose to spot cancer cells.
In a procedure called laparoscopy, your doctor inserts a lighted tube into your lower abdomen. This allows them a closer look at the ovaries and nearby organs and tissues.
If there is any hint of ovarian cancer, there is only one way to know for sure: biopsy. For ovarian cancer, that usually means surgical removal of the mass and one or both ovaries. A small sample is sent to a laboratory, where a pathologist examines it under a microscope. A pathologist is a doctor who is trained to diagnose and classify diseases by microscopic examination. If you have a buildup of fluid in your abdomen, the fluid can be analyzed to see if it contains cancer cells.
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Other risk factors include:
- having a close family member who had it, such as your mother, grandmother, sister, or aunt
- carrying the BRCA1 or BRCA2 gene mutation
- having had breast, cervical, uterine, or colorectal cancer
- a previous diagnosis of melanoma or endometriosis
- having an Eastern European or Ashkenazi Jewish background
- never giving birth or having fertility problems
- hormonal therapy — specifically, taking estrogen without progesterone for 10 years or more
See your doctor right away if you have some of these risk factors and experience any symptoms of ovarian cancer. Treatment may involve surgery, chemotherapy, radiation, or a combination of therapies. The earlier ovarian cancer is diagnosed and treated, the better your prognosis.