Ovarian Cancer Warning Signs Can be Subtle

One of the most difficult aspects of ovarian cancer is diagnosing it in the first place. That’s because the symptoms can often be vague, and may not correlate directly to cancer. “I think what’s really challenging about ovarian cancer is that, while it’s sometimes referred to as silent, I would say it’s more subtle than silent,” says Dr. Karen Zempolich, gynecologic oncologist at St. Mark’s Hospital in Salt Lake City. “Most women have some symptoms. It’s just that they overlap with so many other things.”

Here are some ovarian cancer symptoms to watch for, plus the tests that can lead to a diagnosis.

Common Symptoms of Ovarian Cancer

Most warning signs of ovarian cancer relate to pain or discomfort in the abdominal area. These can include:

• Feeling full more quickly
• Bloating
• Abdominal discomfort
• Nausea or upset stomach
• Changes in bowel movements
• Swelling in the pelvic area

“Most of the symptoms are focused on the abdomen,” says Dr. Zempolich. “There’s some sort of upset stomach feeling or getting full earlier, rather than eating a full meal without the sensation of having a full stomach.”

Keep in mind that this doesn’t mean every time you feel full or bloated it could be a sign of ovarian cancer. The difference when it is cancer is that these symptoms will happen without any triggers attached to them.

“Anybody who eats a really spicy meal will have some indigestion, bloating, or maybe changes in their bowel movements,” says Dr. Zempolich. But symptoms that last for two to three weeks and don’t have any obvious cause are worth telling your doctor about and “thinking about whether or not there is something going on in the abdomen or pelvis related to the ovaries.”

Steps to Diagnose Ovarian Cancer

If you’re having continuous pain in the pelvic area, you may not be sure which type of doctor to visit. Dr. Zempolich recommends starting with whichever doctor you see on a regular basis: a primary care physician, nurse practitioner, or your OB/GYN, which many younger women may visit more often than their internist.

After hearing your symptoms, the doctor will start with a pelvic exam. “As part of that exam they’ll feel through the vagina and the rectum for any masses inside the pelvis that might suggest ovarian cancer,” says Dr. Zempolich.

Once a pelvic exam has been completed, your doctor will likely do one or both of the following tests:

• A pelvic ultrasound to look at the ovaries more closely
• A CA-125 blood test, which looks for specific proteins in the blood that may be tumor markers

While these tools are useful in pinpointing the cause of your symptoms, there are no true screening methods when it comes to ovarian cancer. “[These tests] just aren’t specific enough,” says Dr. Zempolich. “They can be normal, and cancer can be present and [your CA 125] can be elevated from things that are not ovarian cancer.”

This is where a crucial part of diagnosing ovarian cancer comes in: you. It’s important to be your own health advocate if you sense something is wrong with your body, so you can get the proper care when you need it. Seek out medical expertise as soon as possible, and if you’re not satisfied with the results of your pelvic exam and subsequent screenings, don’t be afraid to get a second opinion.

According to the American Cancer Society, only about 20% of ovarian cancers are diagnosed at an early stage. The earlier you make an appointment with a doctor and start asking questions (and more questions, if needed), the quicker you can get the proper care and treatment you may need.

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