A Guide to Ovarian Cancer Symptoms
Ovarian cancer is a malignant disease arising from the ovaries or fallopian tubes. Numbers of patients diagnosed with ovarian cancer are increasing, with Cancer Australia reporting about 1,530 cases per year.
There is no screening test for ovarian cancer, so women should be aware of symptoms. If you have recently had a Cervical Screening Test and received a normal result, you should still have any abnormal symptoms checked by a doctor because a Cervical Screening Test screens for cervical cancer only, and does not detect ovarian or any other cancer.
Ovarian cancer symptoms are unspecific, may present at later stages and can be mistaken for less serious conditions, such as irritable bowel syndrome, an upset stomach or bladder infections.
Common symptoms of ovarian cancer include
- Increase in abdominal size or bloating
- Difficulty eating or feeling full quickly after eating a small amount
- Frequent or urgent urination
- Back, abdominal or pelvic pain.
Other ovarian cancer symptoms can include
- Change in bowel habits such as constipation or diarrhoea
- Menstrual irregularities
- Excessive tiredness
- Indigestion or nausea
- Pain during intercourse or bleeding after
- Unexplained weight loss or weight gain.
If you have one or more of these symptoms and they are persistent on most days over 2-4 weeks, then you should speak to a doctor as soon as possible. In hindsight, almost all ovarian cancer patients display some of the above signs, but these signs may also be indications of benign conditions.
The diagnosis of ovarian cancer is established in a stepwise fashion. First, your doctor will rule out other causes of your symptoms, perform a pelvic examination, arrange for medical imaging scans such as an internal ultrasound and tumour marker blood tests (CA125, CA19.9, CEA, HE4).
Some women may even have a colonoscopy to rule out any bowel conditions that may present with similar symptoms. If there is still concern for ovarian cancer, surgery will be initiated, where the surgeon takes a tissue sample (biopsy). This procedure is ideally performed by a gynaecological oncologist.
The key to successful ovarian cancer treatment is the combination of surgery plus chemotherapy. Surgery for ovarian cancer will typically remove the uterus, fallopian tubes and both the ovaries. Commonly the omentum and lymph nodes will need to be removed also. Sometimes, patients will require a bowel resection. Almost all patients will require chemotherapy after surgery.
Ovarian cancer risk factors
We don’t know exactly what causes ovarian cancer, but a number of factors can increase ovarian cancer risk:
- Being over 50 years of age—the average age of women when they are diagnosed with ovarian cancer is age 64.
- Family history of ovarian, breast or bowel cancer
- Being overweight or obese
- Changes in the genes BRCA1 or BRCA2
- Being of Ashkenazi Jewish descent due to a higher BRCA incidence
- Early onset of periods (before 12 years)
- Late menopause
- Women who have not had children
- Women who have their first full-term pregnancy after the age of 35
- Smoking, which may slightly increase mucinous ovarian cancer
- Using oestrogen-only hormone replacement therapy
- Fertility treatment.
It has been suggested that the use of talc powder may cause ovarian cancer if the talc used on the external genitals would travel through the reproductive tract, through the fallopian tubes to the ovaries; the inflammation caused by the talc particles could lead to female genital cancer.
However, Cancer Council reports the ‘current evidence is insufficient to conclude that the use of talcum powder on the external genitals is linked to ovarian cancer’. Research in this area continues and women who are concerned about talc can use other products, such as cornstarch based powders, or avoid using the products altogether.
On the other hand, the use of the oral contraceptive pill has been linked to a lower risk of ovarian cancer. Keeping a healthy lifestyle such as maintaining a healthy body weight and diet can also reduce the risk of ovarian cancer.
Salpingectomy (removal of the fallopian tubes) for contraception reduces the risk of developing ovarian cancer by 50% to 60%.
If you have any signs or symptoms of ovarian cancer, they are persistent and unusual, you should speak to your GP in the first instance. Ovarian Cancer Australia have a symptom diary, this can be downloaded and completed prior to your appointment for a record of how long and how often you have been experiencing the above symptoms. Many benign and treatable problems can also be a cause of these symptoms, not just ovarian cancer. Most of the time these symptoms will have a less serious reason, however it is important to know the cause so you can receive early treatment. Putting up with abnormal symptoms is never a good idea because it can mask serious conditions that cannot be detected otherwise.
If you are concerned about any of these symptoms and wish to discuss them with a Gynaecological Oncologist, please enquire about an appointment.