10 Ovarian Cancer Warning Signs You Should Not Ignore

Ovarian cancer may account for only about 3% of the cancers affecting women, but it is one of the most deadly. It usually affects women over… Simi - October 31, 2017

Ovarian cancer may account for only about 3% of the cancers affecting women, but it is one of the most deadly. It usually affects women over the age of 50 and can spread to other organs surrounding the ovaries. Ovarian cancer starts when the cells in the ovaries start to grow in an uncontrolled way and interfere with the production of normal cells. When this happens, tumors start to form.

The cause of ovarian cancer is unknown but some researchers believe that there may be a link between ovulation and risk of developing ovarian cancer.  What is known is that several factors put some women at higher risk than others. Age, smoking, obesity, endometriosis, starting menstruation at a young age and stopping late, as well as never having given birth are some of these factors.

Ovarian cancer has been called the ‘silent killer’ because symptoms only become more specific in later stages, and the ones common in the earlier stages could be caused by many other less deadly conditions. Unlike breast and cervical cancers that can be screened for and found early, ovarian cancers often go undetected. Many women only discover they have ovarian cancer when it’s already quite advanced.

However, even in the early stages of ovarian cancer, there are signs that can be picked up such as bloating, pelvic pain, increased urination, finding it difficult to eat and feeling full. Dr. Tanner, assistant professor of gynecology at John Hopkins University believes that it should rather be called ‘the disease that whispers’ than the ‘silent killer’. He believes that symptoms may mimic those of other diseases and seem vague but most women do report certain symptoms consistently in the beginning stages.

The early symptoms of ovarian cancer also follow a pattern: they start suddenly, feel different from normal menstrual or digestive problems, happen almost daily and do not go away.

Abdominal and pelvic pain

Recent studies have shown that certain symptoms, such as abdominal pain, are commonly experienced by patients with ovarian cancer. Unfortunately, many women ascribe the pain to other less serious conditions.  Doctors too, are faced with many other common causes of abdominal pain when trying to make a diagnosis. Researchers have found that abdominal pain may be one of the earliest warning signs of ovarian cancer, and is often reported by many women a good six months before a diagnosis.

Women with late ovarian cancer are significantly more likely to report pain in the pelvic region, abdomen or both. The pain may have multiple causes due to cancer having spread. Sometimes in the later stages, a woman may even be able to feel the tumor in the abdomen. When the abdomen has been infiltrated, the pain can be severe. Abdominal pain may come together with other symptoms like indigestion, gas, nausea, cramps and bloating.

When a tumor puts pressure on other areas around the ovaries, it can cause persistent pain.     In the case of younger women, such pain might simply be an indication of the presence of an ovarian cyst. These benign cysts are more likely to be problematic during the childbearing years.  However, if you are over 50 and you have severe abdominal or pelvic pain, it could be a sign of ovarian cancer and you need to see a doctor.

Ovarian cancer patients often describe the pain in the later stages of the disease as severe and disabling.  One patient says her pain was severe enough to take her breath away and she could not speak while she was feeling it. It felt as though someone was squeezing her insides. She was eventually diagnosed with ovarian cancer and advised to have a total hysterectomy. Her womb, cervix, fallopian tubes and ovaries were removed.

Abdominal distension or bloating

Ovarian tumors are usually buried deep inside the abdomen which is why they may not be discovered until they are quite large. They can cause abdominal discomfort even in the early stages of the disease. Studies have found that women who suffer from ovarian cancer usually complain that their abdomens are extended or bloated, even in the early stages. Distension means that the size of the abdomen increases, while bloating may be intermittent, increasing and decreasing.

This bloating may be caused by an abnormal buildup of fluid in the pelvis or abdomen. This is thought to be caused by blockage of lymphatic drainage due to the cancer cells. Bloating is one of the symptoms of liver disease, but cancer can be the culprit too. The fluid buildup can make you look and feel as though you are a few months pregnant. As ovarian cancer spreads, a tumor can even start taking up space in the uterus and grow quite large.  As the uterus normally holds a fetus, the tumor has space to grow.

If you feel bloated before a period or after eating a big meal, there’s usually no cause for concern.  So, how do you know when to take bloating seriously? If you’re suddenly feeling bloated all the time, you do need to take notice. Persistent bloating is one of the major symptoms of ovarian cancer but only about 20% of the women suffering from this symptom seek medical help because of this. This figure was announced after a recent study of 324 women. They often attributed bloating to other factors such as gaining weight and the natural aging process.

If distension and bloating persist, a doctor should be asked to do further tests such as blood tests or ultrasounds. A transvaginal ultrasound will reveal masses on the surface of the ovaries and cysts inside the ovaries. Fluid buildup in the abdomen, called ascites, can also be seen on an ultrasound.  If you have symptoms of distension and bloating and you know you have a high risk of ovarian cancer or a family history of the disease, make sure that you tell your doctor about this.

Urinary symptoms: Urgency or frequency

Ovarian cancer means that tumors can grow in all directions. The reproductive system is near the urethra and the bladder. This means that tumors can cause very similar symptoms to urinary tract infections when a mass starts to push on other organs such as the bladder.

When changes occur in your urinary habits, such as urinating more often, or an increased urge to pee, it’s easy to put it down to a simple urinary tract infection.  This is likely to be the case for the majority of women who are finding they need to go to the loo more often.  It could simply just be a result of stress incontinence. However, an investigation is necessary if it persists because it could also be an indication of ovarian cancer.

Experts warn that not enough women know that needing to pee more often can be a warning sign of ovarian cancer. Linda was one of these women, thinking that her need to pee a few times every hour was a sign that she had a bladder infection. Her doctor thought so too and gave her some antibiotics. She now knows why the pills did not help at all – she was suffering from ovarian cancer.

Linda continued wanting to pee more and more often. Eventually, she also started feeling bloated and very ill. When she was diagnosed, she already had late-stage cancer and it had spread. More than five liters of fluid were drained from her abdomen and she needed to have intensive chemotherapy, followed by surgery.

In 2004, the Mayo Clinic, together with the Olmsted Medical Center, studied 107 ovarian cancer patients. When their symptoms were analyzed, researchers discovered that an urgency to urinate was one of the most common symptoms of those who had stage one or two ovarian cancer. When you need to urinate more often, lose control of your bladder or see blood in your urine, don’t hesitate to make a doctor’s appointment.  

Loss of appetite and feeling full quickly

Cancer cells shed by the tumor float in fluid and the volume of fluid may put pressure on the abdomen, creating an impression of being full. Some women may have as much as 10 or more liters of fluid drained once they are diagnosed with ovarian cancer.

If you’re a healthy eater, it’s normal to feel satisfied after eating a good meal. However, if you feel full even when you haven’t eaten much at all, it could be because of a tumor taking up space and fluid is building up. The women who experience this feeling may simply get used to it, and be happy that they are losing weight, not realizing that they may have a deadly disease.

Patients also experience a loss of appetite, as is often the case when suffering from serious cancers. If you’ve recently begun to eat more healthily and are doing more exercise, it’s common to lose weight. But if you start losing weight for no reason, it’s a sign to sit up and take notice. Feeling a lack of appetite together with feeling full after eating small amounts is definitely a reason for concern.

One patient says that she only thought about visiting her doctor when eating half a sandwich at a time was too much for her because she felt so full. She never put this feeling of being full down to anything being really wrong. Her message to others is to know your own body, be aware of symptoms, don’t ever just ignore them and to visit your doctor to have them checked out as soon as possible.

Finding it hard to breathe

Breathing difficulties may be caused by any number of medical problems, including asthma, bronchitis, panic attacks and heart disease. Some conditions affect the lungs directly, such as asthma while other conditions may cause bloating which presses on the diaphragm, causing discomfort when breathing.

There are some medical conditions that impact the ovaries and breathing is affected as a result. One of these conditions is an ovarian cyst. Another is called ovarian hyperstimulation syndrome which may be developed during fertility treatments. The ovaries may fill up with fluid which can spill over into the abdomen, causing cramping and shortness of breath.

When ovarian cancer spreads, it causes fluid to build up in the abdomen and irritates the lining. The collected fluid may then put pressure on the diaphragm. Symptoms such as chest pain and shortness of breath may be experienced as a result of pressing on the diaphragm… A visit to the doctor and undergoing some tests is the only way of determining whether a condition in the ovaries such as ovarian cancer is causing a shortness of breath.

One patient with ovarian cancer says that she couldn’t walk from her car to the front door of her office building without breathing heavily. She had great difficulty climbing a flight of stairs, having to stop and catch her breath constantly. It wasn’t long before she found herself in an emergency room because her breathing was so labored and she was eventually diagnosed with ovarian cancer.    

Lower back pain

As a tumor grows, it’s possible for it to push backwards into the sacrum and cause lower back pain. This pain in the back may spread to the whole pelvic area, increase over time and may be severe enough to make it difficult to focus on normal daily activities. The pain may even extend down into the leg in some cases.

Lower back pain is a very common problem, experienced by countless people. You may experience it simply because you are having a heavy period or because you have strained some muscles while exercising. It could also be indicative of something more serious such as degenerative disc disease or osteoporosis. However, when lower back pain is accompanied by the other symptoms mentioned in this article, you need to consider the possibility that it may be due to ovarian cancer.

When Jillian, 57, experienced unbearable pain in her back while having dinner with friends, she knew something was seriously wrong with her. This pain was unlike any other lower back pain she had ever experienced before. She went to the doctor but he didn’t consider it to be a serious problem and gave her some medication.

Jillian’s intuition kept telling her that all was not well and this made her keep pushing for answers when the medication did not help.  Her doctor eventually sent her for a CAT scan which showed a tumor on her ovary and further tests confirmed it. The doctor diagnosed her with stage three ovarian cancer and she had to undergo a radical hysterectomy as well as chemotherapy.

Changes in bowel habits

Changes in bowel habits may be due to many conditions and diseases such as irritable bowel syndrome and diverticulitis. However, they could also indicate the presence of ovarian cancer. When a tumor grows and can start putting pressure on the bowel. This leads to a change in bowel habit with patients experiencing both constipation and diarrhea.

Constipation or diarrhea usually go away in a day or two if they are due to something temporary like food poisoning. Some people even tend to ignore such symptoms when they persist for longer, thinking that they have IBS (irritable bowel syndrome). Doctors are often likely to diagnose IBS when they hear about these symptoms. Patients over 50 who have been diagnosed for over a year with IBS, need to ask their doctors to consider cancer testing as IBS does not usually present itself for the first time at this age.

Cynthia was one patient who was diagnosed with IBS after experienced bloating and an upset stomach. She cut out wheat, dairy and tried many other things but nothing seemed to help. She would find that certain foods just went straight through her and her bloating became permanent. She went back to her doctor many times but he did not change his diagnosis. It was only when she developed severe pain and was referred for an ultrasound that a large tumor was discovered. 

Painful intercourse

When cysts are present on the ovaries, this can cause pain during intercourse. It’s not unusual to have cysts on the ovaries and intercourse can cause them to leak due to the pressure placed on them. These cysts are usually benign.

The larger the cysts, the more likely they are to leak and if a woman is past her child-bearing years, these ovarian cysts are more worrying because they are more likely to indicate the presence of ovarian cancer.

Women who have advanced ovarian cancer often experience pain during intercourse, usually felt in the pelvis or on the left or right side of the pelvis. This symptom is usually only reported by women in the late stages of the disease.

Vaginal abnormalities

As cancer spreads to other tissues, new capillaries are formed. These capillaries often break easily and bleeding results. If you ever notice postmenopausal vaginal bleeding or spotting, it’s a red flag and you need to take action.

Many times infections are to blame for a thick, foul-smelling vaginal discharge. However, a heavy discharge may be an indication of something more serious.

Thickening, areas of color change, and lumps, bumps or sores may also be noticed in the vaginal area when a patient is suffering from ovarian cancer.  

Constant tiredness

Fatigue is often one of the most commonly reported symptoms of all types of cancer. Of course, fatigue is not just due to cancer and may be experienced with many less serious conditions too. Ordinarily, when you feel tired, all you may need is a little rest to recover.  However, fatigue that stops you from going about your normal activities every day or from working may point to ovarian cancer.

Ovarian cancer affects your whole body, including your digestive and excretory system. It’s no wonder that it causes constant tiredness. If you feel like sleeping constantly without having changed your daily activities, it may indicate an underlying problem such as some type of cancer.

Cancer results in a reduction in the number of red blood cells. This causes anemia, which in turn leads to fatigue because your whole body is receiving less oxygen.

Some additional tips

  • If ovarian cancer is caught in the early stages, there is a higher survival rate because the disease responds better to treatment. If it is diagnosed later, the survival rate is much lower.
  • To address the issue of late or missed diagnoses, Target Ovarian Cancer and Macmillan Cancer Support brought women suffering from the disease and GPs together to get some ideas on how this could be addressed. Some of the following tips may help women who are worried about ovarian cancer.
  • The symptoms that are particularly significant are bloating, pain in the abdomen, feeling full quickly, having difficulty eating and needing to urinate frequently or urgently. Take note of these symptoms especially if they are new, don’t go away and happen more than 12 times a month.
  • You know your own body. If you feel that something is wrong, make an appointment and talk to your GP about your symptoms. Don’t put it off.
  • Book a double appointment if necessary so you can fully address your problems.
  • Help your GP as much as possible by writing down what you want to discuss. If you are worried about ovarian cancer, mention it to your GP.
  • Keep a symptom diary which can be useful for you to see any patterns but also helps when you see your GP.
  • If family or friends notice your symptoms or pick up that you are feeling unwell, don’t just dismiss their concerns.
  • If all the investigations and tests are negative but the symptoms continue to persist, you need to persist too and go back to your GP.  If  GPs ask you to come back if your symptoms don’t improve, they usually mean it.

A normal pap smear test will not pick up ovarian cancer. It only tests for cervical cancer. If you are worried about ovarian cancer, your doctor will need to perform other tests.