If you experience bloating, have pain or discomfort in your belly or feel full after eating a small amount, you may assume you have heartburn, gas or another digestive problem.
That may indeed be the case. But if you’re a woman over 55, you should check in with your gynecologist, because those symptoms can also be warning signs of ovarian cancer, says Eli Serur, a gynecologic oncologist and chair of obstetrics and gynecology at Staten Island University Hospital in New York.
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Studies show that ovarian cancer is often misdiagnosed as another condition, at least initially.
“I can’t tell you how many times there are delays,” Serur says. “A patient goes to their internist, and they give you a proton pump inhibitor or antacid for indigestion. You can lose valuable time in terms of coming up with an ovarian cancer diagnosis.”
Ovarian cancer is rare, but it ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. The risk of a woman’s getting ovarian cancer is about 1 in 78 in her lifetime. It affects women of all ages, but it’s most common after menopause. More than two-thirds of those diagnosed are 55 or older.
Risk Factors for Ovarian Cancer
- Women who never had children
- Family history of breast or ovarian cancer
- Inherited genetic mutations of the BRCA1 or BRCA2 gene
- Early menstruation or late menopause
- Giving birth after age 35 or never having a full-term pregnancy
You’re at higher risk if you have a family history of ovarian or breast cancer, if you have inherited mutations in the BRCA1 or BRCA2 gene, if you have endometriosis or if you’re obese. Early menstruation (before age 12) and late menopause also bump up risk.
Symptoms may be subtle
Ovarian cancer has sometimes been called the silent killer, because it’s often not detected until it’s too late to be cured. Plus, there’s no good screening test for it, like a mammogram for breast cancer or a colonoscopy for colorectal cancer. About 70 percent of women diagnosed with ovarian cancer already have advanced-stage disease.
Despite its nickname, ovarian cancer does have some early warning signs, research indicates. One study of 1,725 women with ovarian cancer found that 95 percent had noticeable symptoms three to 12 months before diagnosis.
Part of the difficulty is that the symptoms tend to be subtle, common and unspecific — meaning they can indicate a variety of disorders, explains Jason Konner, a gynecologic medical oncologist at Memorial Sloan Kettering Cancer Center.
“My advice to a woman experiencing these symptoms,” Konner says: “Listen to your body, and trust your instinct about what you’re feeling. If you believe something is wrong, persist in advocating for yourself.”
Here are some symptoms that can indicate ovarian cancer.
Although bloating is a symptom of many conditions, it’s one of the most common signs of ovarian cancer, caused by a buildup of fluid in your belly. In one study, 72 percent of ovarian cancer patients said they experienced bloating.
“It’s a feeling of fullness or that you’re not able to pass gas, but you feel like you have to,” explains Laura Fortner, a board-certified obstetrician-gynecologist near Columbus, Ohio.
2. Abdominal or pelvic discomfort
Another symptom is pressure or pain in your abdomen or pelvis. The discomfort can be caused by fluid accumulating in the abdomen or pelvis, or by tumors that have spread to those areas. Some women describe it as feeling like period cramps, Konner says. Others experience back pain or a pain in their side.
3. Difficulty eating, or feeling full quickly
If your appetite changes or you feel unusually full after eating only a small amount, that’s another red flag. You may find that you can consume just a small meal, even if you’re hungry before you start eating. “The way patients describe it is, ‘I don’t have much of an appetite. I take two bites and can’t eat anymore,’ ” Serur says.
4. Change in your bathroom habits
Ovarian cancer can put pressure on your bladder or irritate it, causing you to have to pee more often. In one study, about 34 percent of women with ovarian cancer reported increased urination frequency, urgency or pain while urinating. As the disease progresses, it can also cause constipation and other changes in your bowel habits.
5. Abdominal swelling
A buildup of fluid in your abdomen from ovarian cancer can cause your waistline to expand, making it more difficult to button or zip your pants. “I had a patient come to me and tell me, ‘Doc, I’m developing a beer belly,’ ” Konner recalls. When researchers at the University of Washington compared patients with and without ovarian cancer who visited a primary care clinic, they found that the cancer patients were 7.4 times more likely to report increased abdominal size.
What to know if you have symptoms
If you develop any of the above symptoms, it’s important to remember that they can also signal other conditions and that ovarian cancer is rare. One study published in the journal Cancer found that women with ovarian cancer typically experience symptoms at least 12 times per month.
If ovarian cancer is suspected, your doctor will probably do a pelvic exam and order an ultrasound or another imaging test to look for signs of disease. In addition, your physician may test your blood for a tumor marker called CA-125. (High levels of CA-125 can also be caused by conditions such as endometriosis and pelvic inflammatory disease.)
Fortunately, the death rate from this type of cancer has been dropping in recent years. Surgery and chemotherapy, the most common treatments for ovarian cancer, can be effective even if the disease has spread, Konner says.“For ovarian cancer, you can have stage 3 and it’s essentially curable,” he says. “You can do surgical debulking and chemotherapy and potentially eradicate it.”
Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader’s Digest, Real Simple, Prevention, The Washington Post and The New York Times.