It is difficult to recognize ovarian cancer early. The symptoms can mimic other conditions, and chances are you don’t have one. In addition, doctors and gynecologists do not have reliable screening tests to detect early signs of the disease. Those are the main reasons why women are diagnosed with ovarian cancer in stage I or II, before the disease spreads widely, only in about 20% of cases.
But you can do things to take charge of your health. Find out which symptoms you should take into account so that you can have them checked by your doctor or gynecologist. And find out what things put women at high risk for the disease so you can get preventive treatments if necessary. Here’s what two doctors who treat gynecological cancers want you to know about how to spot ovarian cancer as early as possible.
Sometimes early-stage ovarian cancer causes no symptoms, especially during the first phase of the disease. That’s when the cancer is limited to one or both ovaries, which store eggs and make the female hormones estrogen and progesterone.
“There’s a lot of room in the abdomen for the ovaries to grow” when a cancerous tumor forms on them, says Leslie Boyd, MD, director of NYU Langone’s Division of Gynecologic Oncology. “So usually, stage I ovarian cancer is a fairly silent disease.”
Katherine Kurnit, MD, a gynecologic oncologist at the University of Chicago, agrees. Generally, she says, women experience symptoms when the cancer begins to spread, affecting other structures or invading other parts of the body.
However, it is possible to develop symptoms in the early stages of the disease. Some of them are:
- Bloated feeling
- Pain in your abdomen or pelvis
- You feel full quickly when you eat
- An urgent or frequent need to urinate
Talk to your doctor or your gynecologist if you have such symptoms, especially if they are new to you and don’t go away, says Kurnit. Because ovarian cancer can cause nonspecific problems such as gastrointestinal or intestinal problems, be aware that it is often misdiagnosed as gastrointestinal or intestinal problems, say Kurnit and Boyd.
If you are being treated for any of these conditions and your symptoms last for two or more weeks, contact another doctor or your gynecologist. A pelvic ultrasound is a quick test that can give your gynecologist a lot of information about what’s going on with you, Boyd says.
A number of things increase your chances of getting ovarian cancer, such as growing older. The disease is rare if you are under 40 years of age. The disease is much more common if you are 63 years or older. It usually starts after menopause.
However, Boyd and Kurnit say two main things put you at high risk for developing the disease: your immediate family’s medical history and certain gene changes, or “mutations.”
If you have a first-degree relative, such as a sister or mother, who has had ovarian cancer, your chances of getting the disease increase, Kurnit says. Having a close family member who has had breast cancer can also be a risk factor, she says.
Inherited mutations in genes called BRCA 1 and BRCA 2 are also linked to a higher risk of ovarian cancer and other cancers. The way to find out if you have either mutation is to have your genes tested. You can ask your doctor or gynecologist if genetic testing is right for you. If so, they may be able to refer you to a genetic counselor.
“The best way to identify someone at high risk, or with one of these genetic mutations that put him or her at higher risk for familial cancers, is to consult a genetic counselor,” says Boyd. “They can go over the risks and benefits of getting the genetic testing and then move forward with testing if it makes sense for that patient.”
If you decide to have genetic testing, a counselor can also help explain your results. “It’s sometimes very difficult to understand what having a gene mutation means for someone who isn’t in the medical field, or for someone who just isn’t very familiar with it,” Kurnit says.
If you are diagnosed with a mutation in one of your BRCA genes, your healthcare provider can explain how this affects your risk of ovarian cancer and other cancers. They can also tell you how best to share the information with any siblings you have, “both men and women, who are also at potentially higher risk for cancer syndromes,” says Kurnit.
Direct-to-consumer gene testing is also available. Boyd says it can be difficult to interpret the results yourself without the help of a counselor.
If you find out that you are at high risk for ovarian cancer, your doctor or gynecologist will monitor your health closely and explain which preventive treatments may be right for you, as well as explain the risks and benefits of each treatment.
Doctors would like to have an accurate screening test to detect ovarian cancer early before it causes symptoms, but it doesn’t exist. Tests such as the Pap smear for cervical cancer are not effective in finding signs of early ovarian cancer. For now, the U.S. Preventive Services Task Force recommends that doctors not routinely screen average-risk women who have no symptoms.
Still, Boyd says, “It’s always a good idea to maintain a relationship with your gynecologist throughout the stages of life. And especially in postmenopause you run the greatest risk of developing the most common gynecological cancers.”
Kurnit agrees. “Women often think that after menopause they no longer need to see a gynecologist.” She recommends that you continue to receive all your recommended gynecological care and routine checkups with your regular doctor.
It can give you some peace of mind to know that your overall risk of ovarian cancer is “pretty low,” Boyd says. The chance of you getting it during your lifetime is about 1 in 78, or 1.3%.
If you get ovarian cancer, treatments help people live better and longer than before, she says.