Ovarian cancer isn’t very common — a woman’s lifetime risk is only 2%. That’s the good news. The bad news? Ovarian cancer is the deadliest gynecologic cancer, in part because only 20% of cases are diagnosed in the early stages of the disease. It is often called the silent cancer, but really, it whispers.
If you’re wondering why the early detection rate is so low, it’s because the symptoms of ovarian cancer are subtle and often overlooked or dismissed as being related to other common health conditions.
But it doesn’t have to be this way.
Allison Wagreich, MD, a gynecologic oncologist with Atlantic Health System, explains the often-missed signs of ovarian cancer, which factors may increase your risk for developing the disease, and what steps you can take to prevent or lower your risk.
What is Ovarian Cancer?
Let’s start with a basic anatomy lesson. The female reproductive system includes two ovaries that sit on either side of the uterus. Your ovaries produce eggs (ova) and the female hormones, estrogen and progesterone. Your ovaries are connected to the uterus by the fallopian tubes, through which your eggs travel during your menstrual cycle.
Ovarian cancer forms when abnormal cells grow within the ovaries or fallopian tubes and multiply, forming a malignant tumor.
Ovarian Cancer Symptoms
Because the ovaries are deep within your body, you probably won’t feel a tumor growing. Symptoms of ovarian cancer are often subtle until the disease spreads. Signs are also often dismissed or mistaken for digestive issues such as irritable bowel syndrome (IBS) or normal changes related to aging and menopause.
Common warning signs to look for include:
- Bloating
- New pelvic or abdominal pain and discomfort
- Changes in appetite/feeling full quickly or experiencing indigestion
- Changes in bathroom habits, including constipation or diarrhea and/or more frequent urination
Menstrual changes such as spotting, heavier-than-usual bleeding, or bleeding after menopause may occur, but are less common.
The key is to pay attention to new, persistent symptoms. “If you’re experiencing any of these signs and they don’t resolve in a few days, talk to your doctor,” says Dr. Wagreich.
Risk Factors
Scientists don’t know exactly what causes ovarian cancer, but they have identified factors that may increase your risk for developing the disease. These include:
- Age (most cases occur after menopause; the average age for diagnosis is 63)
- Genetics (specifically having BRCA1 or BRCA2 gene changes and/or Lynch syndrome)
- Family history of ovarian, breast or colon cancer
- Personal history of breast cancer
- Infertility or no pregnancies
- Having endometriosis
- Not having used hormonal birth control
- Obesity
Prevention Advice
Unfortunately, most factors that increase your risk of developing ovarian cancer are out of your control. But that doesn’t mean you’re doomed. The most important thing you can do is educate yourself.
The first step is to talk with your doctor.
- Discuss your personal and family history to assess your risk level.
- Consider genetic testing and counseling — especially if you have a family history of ovarian, breast or colon cancer.
Other preventive measures may include:
- Taking birth control pills (just 5 years of oral contraception reduces your risk).
- Having gynecologic surgery such as oophorectomy (surgical removal of one or both ovaries), hysterectomy (surgical removal of the uterus) or tubal ligation (closing off your fallopian tubes, a.k.a., having your tying your tubes).
Early detection improves survival rates. Listen to your body. If something is different and it’s not going away, have it checked out.
“Ovarian cancer whispers,” says Dr. Wagreich. “There is no test for ovarian cancer, but there are symptoms. You know your body better than anyone else, and you know when something is off. Trust your instincts and talk to your doctor.”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.