Paying Attention to Symptoms
- A 37-year-old mom of three says years of bloating, pain, and a lump dismissed as a hernia were ultimately diagnosed as stage 4 ovarian cancer. She underwent major surgery and chemotherapy and now advocates for earlier recognition of symptoms.
- Ovarian cancer is frequently diagnosed in advanced stages because early symptoms are often unclear or easy to overlook.
- Warning signs can be subtle and may include bloating, nausea, and pain in the abdomen or pelvis. If these symptoms last longer than a week, it’s important to consult a healthcare provider.
- For women at average risk, there is no effective routine screening test available.
Now, the U.K. resident, who received her stage 4 low-grade serious ovarian cancer (LGSOC) diagnosis in the summer of 2023, is determined to share her store to encourage other women not to ignore symptoms.
Read MoreSoutham admitted that she had a history of heavy periods that intensified, but both before and during pregnancy when symptoms escalated, she says her concerns were brushed aside.
It’s important to note that ovarian cancer is often diagnosed at an advanced stage. In fact, it has been called “the sleeping lion,” says Dr. Kimberly Resnick, gynecologic oncologist at MetroHealth in Cleveland, Ohio. “It’s hard, because 75% of women who walk into our office with ovarian cancer, unfortunately, are going to walk in with advanced stage disease.”
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The diagnosis of ovarian cancer is often delayed because its symptoms can be subtle and nonspecific. In fact, many of the symptoms mimic those that women often experience in everyday life, and that can be attributed to any number of other conditions or health problems. That’s why it’s so important for women to be on the lookout for common symptoms like these:
- Bloating
- Abdominal pain
- Nausea
- Quickly feeling full when eating
Other symptoms of advanced disease may include weight gain in just the abdomen and changes in bowel habits.
“When I was pregnant there was a lump on my tummy and they said it was due to the pregnancy. I’d gone in with a lot of pain and I felt like the baby had no space. I was saying it doesn’t feel like she has any room to move,” said Southam.
“After that I had symptoms, like frequent urination, pain, and bloating. I had those symptoms but didn’t go in for those symptoms straight away.”
Southam noted that approximately six months later, she discovered some spots on the right sight of her abdomen and a lump, which was determined as a hernia.
Recounting how she continued to push for answers, Southam said, “They said ovarian cancer happens to older ladies and that I was too young and fit for that, but I pushed for further investigation.
“I saw a doctor who did a further biopsy of those lumps. It transpired that it was stage 4b low grade, so it was very advanced. She did a full hysterectomy, my spleen, part of my bowel, part of my tummy button, part of diaphragm, it was a very extreme operation.
Following surgery, she underwent chemotherapy until reaching remission.
The inspirational mom recently posted on Instagram to share how she’s continuing to work on her strength, captioning a video of her in the gym, “Strong people are harder to kill… that’s a fact.
“I’ve neglected my strength work a bit recently so I’m back and making it a priority.”
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In another recent post, Southam shared how she was featured on a billboard in Piccadilly Circus, London, on World Ovarian Cancer Day.
“This means so much to me, firstly, knowing that it will impact and influence people to go get checked. Especially with younger women, women’s issues get so easily dismissed for menstrual pain etc. and we’ve been conditioned to just live with it and carry on,” she wrote alongside a photo of herself standing by the billboard.
“So to advocate that bloating, pain and other symptoms aren’t right and to give people that ‘permission’ to go get checked is so important. No one can live in the past but mine was obviously diagnosed at late stages so this is something I’m really passionate about.”
She concluded, “Secondly, as a representation of what I’ve been through and my body has been through.
“My scars show my super powers, strength and resilience and today I feel proud to think of what I’ve overcome so far.”
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Understanding Ovarian Cancer
Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.
“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.
The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
WATCH: Treating ovarian cancer.
Meanwhile, a hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix, according to the National Cancer Institute. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy.
The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.
RELATED: New Treatments for Ovarian Cancer Are Changing the Game And Doctors Are Moving Fast
Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal.
Expert Ovarian Cancer Resources
- “You Are Your Own Best Advocate” – Recognizing the Subtle Symptoms of Ovarian Cancer
- Ovarian Cancer: Symptoms, Diagnosis & Making a Treatment Plan
- ‘Faith, Family, and Friends’ Helped Beverly Reeves Get Through Ovarian Cancer Treatment
- Advances in Ovarian Cancer Treatment
- An Extraordinary New Treatment Option for Ovarian Cancer: PARP Inhibitors
- Chemo or Surgery: Deciding The Order For Ovarian Cancer Treatment
- Custom-Fitting An Ovarian Cancer Treatment Plan to You
- Coping with Hair Loss During Ovarian Cancer Treatment
With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.
Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer.
Genetic testing helps doctors determine the best maintenance therapy.
WATCH: How your ovarian cancer responds to certain types of chemotherapies guides your future treatments.
Staging Ovarian Cancer
While medical professionals use the staging of ovarian cancer to analyze how serious the illness is, how best to treat it and to provide a discussion about survival statistics, Dr. Beth Karlan previously told SurvivorNet that, “The staging of cancers is really to help us with a dialogue, and the honesty of our outcome.”
She explained that if you detect any symptoms of ovarian cancer, and a visit to your doctor confirms the diagnosis, then the next step would be discussing the stage of your illness.
- Stage I – Confined to the ovary
- Stage II – Spread to pelvic structures
- Stage III – Spread to abdominal structures
- Stage IV – Spread outside the abdomen or inside the liver or spleen
As a general rule, the lower the stage ovarian cancer, the less the cancer has spread.
How Serious is My Illness? ‘Staging’ Ovarian Cancer
Stage one refers to the earliest stage. At this point, it is limited to one or both ovaries, and is considered a confined form of the cancer; it has not spread to distant sites in the body. Stage two is when the cancer has spread from one or both ovaries to other organs in the pelvis, which can include the side walls of the pelvis, one or both fallopian tubes, the back of the uterus and the rectum or sigmoid colon.
With stage three, the cancer is in one or both ovaries, and has spread beyond the pelvis area to the upper abdomen, either to the omentum (a fatty apron that stretches over the abdomen), or other surfaces within the abdomen, such as along the diaphragm, the surface of the liver or the spleen, or possibly, nearby lymph nodes. At this stage, it has still not spread to distant sites. Finally, with stage four, the cancer cells have spread beyond the abdominal cavity to other organs: tumors inside your liver (not just on the surface), inside the spleen, in and around the lungs or other organs outside the abdomen and pelvic region, and possibly to the bones.
Several factors go into deciding on what kind of treatment is best, depending on the type and stage of ovarian cancer, the age of the woman and whether she is planning to have children in the future. But surgery is usually the first treatment recommended, with chemotherapy for use after treatment.
For all four stages of ovarian cancer, two specific chemotherapy drugs are usually suggested. Chemotherapy is usually injected into a vein with an IV, given orally, or, in some cases, may be administered through a catheter directly into the abdominal cavity. There are currently two chemotherapies currently considered the backbone for the initial treatment of ovarian cancer.
“We do know that two medicines together are better than one,” says Dr. Karlan.
Understanding The Stages and Grades of Ovarian Cancer
Usually, a platinum compound (carboplatin), which kills ovarian cancer cells, and a taxane like paclitaxel (a chemical compound originally derived from plants, which interferes with the growth of cancer cells) are the therapies used. These two drugs are usually given as an IV into the vein, every three to four weeks.
Although, as with any chemotherapy, side effects can occur, Dr. Karlan tells us that even during this treatment, most women should be able to go about most of their daily routines, whether it is working or running a carpool, with the caveat that they will most likely feel more fatigue than normal.
“I say most, because they are going to be more tired. Nobody’s typical activity includes coming to a hospital for chemotherapy,” notes Dr. Karlan. After treatment, most women should be able to resume just about all their normal activities.
Taking Control of Your Ovarian Cancer Risk
Avoiding Provider Bias – Is Your Doctor Understanding You?
While your doctor has undergone years of training and practice, they are still human, and may come with their own set of biases that can impact how they treat patients.
To combat these biases and really get the most out of your interactions with your doctor, you should provide her or him with plenty of information about your life and ask plenty of questions when things aren’t clear. To better understand how you should approach conversations with your doctor, we previously spoke with Dr. Dana Chase, gynecologic oncologist at Arizona Oncology.
According to Dr. Chase, physicians, like many of us, can be a bit biased when seeing patients. She made it clear that these biases are rarely sinister, but rather unconscious and more subtle.
She explained, “We have certain beliefs that we don’t know about. We might look, for example, at an older woman, and just by the way she looks we might make certain assumptions, and we might not even know that we’re making these assumptions.”
Let’s Talk About Provider Bias
Clearing up misconceptions is important, but so is understanding what your doctor is telling you, Dr. Chase noted. Overall, she advises women to speak up and ask questions when they don’t understand something.
“It’s never a bad thing to ask for something to be repeated, or to ask the doctors to explain it in different terms.”
So next time you go to your physician, speak up if you need clarity, so your doctor can understand you and you can understand them.
Dr. Steven Rosenberg is the National Cancer Institute Chief of Surgery, and he previously told SurvivorNet about the advantages of getting input from multiple doctors.
Cancer research legend urges patients to get multiple opinions.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care. Because finding a doctor who is up to the latest of information is important,” Dr. Rosenberg said.
Questions for Your Doctor
If you’ve been diagnosed with ovarian cancer and are looking for ways to better understand your disease and treatment options, here are some key questions to bring to your doctor.
You can also turn to SurvivorNet’s proprietary AI tool, “My Health Questions,” which helps patients and caregivers navigate a new diagnosis and prepare thoughtful, personalized questions for their care team.
- What type of ovarian cancer do I have?
- What stage is my cancer in?
- Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
- What initial treatment options do you recommend?
- What are the possible side effects of the recommended treatment, and how can they be coped with?
- Will insurance help cover my recommended treatment?
WATCH: A New Wave of Cancer Patients Using SurvivorNet’s My Health AI Tools For Support
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
