Subtle signs of ovarian cancer you should never ignore

It is one of the deadliest gynaecological cancers yet there currently is no early diagnostic test. Here’s what you need to know about ovarian cancer.

A woman dies from ovarian cancer every eight hours in Australia.

But unlike screenings for breast or cervical cancer, there is currently no early diagnostic test for ovarian cancer, gynaecological oncologist Dr Nicole Krzys says.

Dr Krzys, who serves on the international scientific advisory committee for the Ovarian Cancer Research Foundation, says it is a “silent killer”, with many women often experiencing no symptoms.

“One in 80 people who have ovaries will get an ovarian cancer during their lifetime,” Dr Krzys says. “It’s the most lethal gynaecological cancer that we have.”

But what, exactly, is ovarian cancer? And what are the early signs to look out for?

Here’s what you need to know — and the subtle symptoms you should never ignore.

What is ovarian cancer?

While ovarian cancer mainly affects the ovaries, Dr Krzys explains it can also include cancer of the fallopian tubes and peritoneum, which is the membrane that lines the abdominal cavity.

“There are lots and lots of different kinds of ovarian cancer, but I like to group them into epithelial, stromal and germ cell tumours,” she says.

“If the ovary was a small fruit, imagine a tiny Mandarin the size of a plum, and you imagine that it’s covered in an orange skin, that’s what we would call the epithelium.

“And then you have the pulpy part inside the fruit, that’s called the stroma; and then there’s other cells in there that are the seeds or the eggs.

“You can develop a cancer of any of those three things.”

Dr Krzys says all of these cancers behave very differently, but the epithelial or the skin cancers are the most common, and they have the worst prognosis.

LISTEN BELOW: Gynaecological oncologist Dr Nicole Krzys joins The House of Wellness radio team to discuss ovarian cancer symptoms to look out for and why early detection is key:

Why is ovarian cancer hard to diagnose?

One of the key difficulties with ovarian cancer, Dr Krzys explains, is that often in the early stages, where there might be just a small tumour on the ovary, there are no symptoms.

“So by the time a woman experiences any symptoms, the cancer has often spread outside of the ovary,” she says.

Adding to the complexity is that, even when a woman does experience symptoms, they can be very vague.

“They’re common things that women experience every day,” Dr Krzys says.

“They’re often really minor so women don’t seek medical attention until they’re (the symptoms are) severe and, by that stage, the cancer has spread from the ovaries and often throughout the abdomen.”

Ovarian cancer signs and symptoms

Dr Krzys says symptoms of ovarian cancer can include abdominal bloating or pelvic pain, cramping and changes to bowel or bladder habits.

Fatigue and loss of appetite can also occur.

“Often a woman will have these symptoms for a few days and then they’ll disappear, and often they’ll have them at certain times of their menstrual cycle if they’re younger, or if you eat something funny when you’re older,” she says.

“But what I would say is that if they’re persistent, they don’t go away, and you’re worried about them, you need to see a doctor.”

While there are often no obvious signs, Cancer Council advises to see a doctor if you experience one or more of the following symptoms:

  • abdominal bloating
  • difficulty eating or feeling full quickly
  • frequent or urgent urination
  • back, abdominal or pelvic pain
  • constipation or diarrhoea
  • menstrual irregularities
  • tiredness
  • indigestion
  • pain during intercourse
  • unexplained weight loss or weight gain.

What are the risk factors?

While the cause of ovarian cancer is unknown, Cancer Council Australia says age (particularly being over 50); family history of ovarian, breast or bowel cancer; early onset of periods or late menopause; not having children, or having a first child after the age of 35; and using oestrogen-only hormone replacement therapy can increase your risk of developing it.

How important is early diagnosis?

Given both the prevalence of and the survival rates for ovarian cancer, The House of Wellness presenter Dr Isabelle Carr says early diagnosis could be “vital”.

“Over 70 per cent of cases of this cancer are diagnosed in quite late stages,” she tells The House of Wellness Radio program.

“We’ve got screening for breast cancer, we’ve got screening for cervical cancer, and a lot of my patients don’t understand that ovarian cancer is a very different kettle of fish.”

The problem, Dr Krzys adds, is that “we don’t have an early test for ovarian cancer”.

“The whole point of (mammograms and pap smears) is that they can detect early cancers or even pre-cancers when they’re at a stage that can be cured,” she says.

Is there an ovarian cancer vaccine?

Unlike the cervical cancer vaccine, there is no currently no preventive measure or vaccine for ovarian cancer.

Dr Krzys says more research is needed to help improve our understanding of ovarian cancer — and increase survival rates.

“The research into breast cancer has managed to increase the survival rate for women with breast cancer from something like 75 per cent 30 years ago to nearly 95 per cent now,” she says.

“I would love to see our survival rates for ovarian cancer increase from where they are currently — which is less than 50 per cent.

“Anything above that would be a great win for Australian women.”

When should you see a doctor?

Dr Krzys urges women to listen to their bodies and seek medical attention if they can sense something isn’t right.

“Women have a sixth sense about what’s normal for them and for their bodies, and I think doctors in general need to take women seriously if they say that they have a concern that’s been persistent.”

She says simple tools including ultrasounds and blood tests can be used to rule out ovarian cancer in many cases.

“And if you’re not taken seriously, you can always seek another opinion with another doctor,” Dr Krzys says.

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Written by Tianna Nadalin.