Ovarian cancer symptoms: Early and advanced

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The early signs of ovarian cancer can be subtle. In the early stages, the malignant growths have not spread far beyond the ovaries or fallopian tubes, which can mean it causes no symptoms.

People who do develop symptoms commonly experience:

• bloating
• pelvic or abdominal pain
• difficulty eating or feeling full quickly
• more frequent or urgent need to urinate

Less common symptoms in the early stages include changes in menstruation, pain during sex, tiredness, back pain, and upset stomach or constipation.

Many conditions can cause these symptoms. However, when the cause is cancer, they will typically be persistent and different from normal.

Advanced ovarian cancer means the cancerous cells have spread to other parts of the body, such as the abdomen, lymph nodes, intestines, or further areas. People are more likely to notice ovarian cancer symptoms at this stage.

In addition to the above symptoms, people with advanced ovarian cancer may develop:

Digestive symptoms

Ovarian cancer may grow large enough to disrupt a person’s digestion. In the later stages, it may also spread to the intestines. This may cause a swollen belly, constipation, nausea, or pain.

Ascites

This symptom occurs when cancer spreads to the abdomen and liver, causing large amounts of fluid to accumulate in the abdomen. This may cause:

• loss of appetite
• indigestion or heartburn
• nausea
• shortness of breath

Doctors can drain this fluid to reduce the discomfort.

Weight loss or gain

Someone with ovarian cancer may gain weight unintentionally if fluid accumulates in their abdomen. However, they can also lose weight if they have appetite loss. This is referred to as cancer cachexia, which involves loss of appetite, weight, and muscle mass.

Fatigue

As ovarian cancer progresses, the cancerous cells use up energy, leading to extreme tiredness.

If ovarian cancer spreads and metastasizes, it can disrupt how other parts of the body work, resulting in complications. Ovarian cancer treatments, such as chemotherapy or surgery, can also have long-term effects.

These include:

• Infections: During chemotherapy treatment, people can be more vulnerable to infections. Viruses, bacteria, and fungi that affect most people mildly may cause serious infections.
• Bowel obstruction: If a tumor develops in the intestines, it may partially or completely obstruct the bowel. This causes severe pain and vomiting, and may require surgical removal.
• Perforated colon: Targeted cancer treatments may damage the lining of the colon, or large intestine. An individual may require surgery to bypass the affected area of the bowel.
• Urinary blockage: If tumors spread to the urinary system, they may block the tubes that transport urine from the kidneys to the bladder. If left untreated, this can cause kidney damage. Surgeons may be able to place a thin tube known as a stent to bypass the blockage.
• Pleural effusion: When cancer spreads to the lungs, fluid can build up between the lining of the lungs and chest wall, which doctors call pleural effusion. A doctor may need to place a needle through the chest wall to drain away the fluid.

Treating ovarian cancer usually involves removing the ovaries, fallopian tubes, and uterus in order to remove as many cancerous cells as possible. This begins menopause, which can cause a range of symptoms. After this surgery, a person will no longer be able to get pregnant.

There are many conditions that can cause the symptoms of ovarian cancer. These include:

• Ovarian cysts: Ovarian cysts are fluid-filled sacs that can develop on the ovaries. While the symptoms of ovarian cysts are similar to ovarian cancer, most will come and go with each menstrual cycle, meaning that the symptoms fluctuate. Some types of cysts can become malignant, but most are harmless and go away on their own.
• Irritable bowel syndrome (IBS): This common digestive syndrome causes some of the same symptoms as ovarian cancer, including abdominal pain, changes in bowel habits, and bloating. However, IBS usually gets better or worse in response to certain foods, or other triggers, such as stress.
• Urinary tract infection (UTI): UTIs occur when bacteria get into the urinary tract, causing pain and changes in urination. This may include a feeling of urgency or a burning sensation when urinating.
• Uterine fibroids: Fibroids are growths that develop inside or on the walls of the uterus that can cause pain, constipation, trouble urinating, a bloating sensation, and longer menstrual periods.
• Endometriosis: Endometriosis is a condition that causes tissue that is similar to uterine lining to grow outside the uterus. The symptoms include pelvic pain, heavy or painful periods, pain during sex, and changes in bowel movements or urination.
• Pelvic inflammatory disease: This potentially serious condition causes inflammation of the reproductive organs, often as a result of a sexually transmitted infection.

Yes, a person can have ovarian cancer without knowing.

Doctors use four stages to classify the advancement of ovarian cancer. In stage 1 ovarian cancer, the cancerous cells are only present in one or both ovaries or fallopian tubes. This can cause symptoms, but not always.

It is possible to find ovarian cancer early, but there is no reliable screening test as there is for cervical cancer. Getting regular pelvic exams can help gynecologists notice any changes.

People at high risk for ovarian cancer may be able to get tests, such as a transvaginal ultrasound or a special blood test, that can detect early signs of the disease. This includes people with BRCA gene mutations, people with certain genetic syndromes, and people with a strong family history of ovarian cancer.

If someone has any of the symptoms of ovarian cancer, they should speak with a doctor. This is especially true if the symptoms:

• are persistent
• do not come and go
• develop after the age of 50
• are new or not typical

The American Cancer Society states that if symptoms occur more than 12 times a month, it is time to make an appointment.

It is also important to notify a doctor if symptoms of preexisting conditions change in a way that is out of the ordinary. For example, people with endometriosis are also more likely to develop a certain kind of ovarian cancer, so if their symptoms get worse or they notice new ones, a medical professional should perform tests to rule it out.

In addition to speaking with a doctor, someone who is noticing symptoms of ovarian cancer may want to request to speak with a gynecologic oncologist. This can help the person avoid a misdiagnosis.

The early symptoms of ovarian cancer are not always obvious. People may experience persistent bloating, urinary urgency, pelvic or abdominal pain, or feeling full quickly when eating. However, not everyone has symptoms initially.

Speak with a doctor if these symptoms develop. There are many other conditions that may explain them, but it is important for a doctor to investigate and confirm the cause as soon as possible.