In most cases, ovarian cancer symptoms typically do not present until the condition reaches an advanced stage. Even then, the signs are usually vague and can be easily mistaken for other conditions unrelated to cancer, like irritable bowel syndrome and constipation. Adding to the complexity is the fact that there is no reliable screening modality for ovarian cancer. All of these factors underscore the importance of a woman being aware of changes in her body and promptly seeing a physician when she notices anything different.
Common symptoms of ovarian cancer
Early-stage ovarian cancer may produce no symptoms at all, or only mild or nondescript symptoms. That’s mainly because the ovaries are very small and located deep within the abdominal cavity, and small cellular changes usually don’t have a noticeable effect on the surrounding tissues or structures. However, as ovarian cancer spreads and begins pressing on the pelvis and distant lymph nodes and organs, a variety of symptoms can emerge. These symptoms range in severity, although the symptoms can become more painful as the cancer progresses further.
The most common ovarian cancer symptoms include:
- Bloating or swelling
- Pelvic pain
- Back pain
- A quick feeling of fullness after eating
- Frequent urination
- Constipation or other changes in bowel habits
- Menstrual cycle changes
- Unexplained weight loss
What does ovarian cancer feel like?
Because every woman and every cancer is different, the symptoms of ovarian cancer can vary widely, and some symptoms are less common than others. Some women report feeling "off" for several months prior to receiving a diagnosis. In general, any sudden health change should raise a red flag, even if it would otherwise not cause concern. Since an early diagnosis is critical to achieving the best possible outcome, all women are urged to tell their physician about possible early signs of ovarian cancer that they are experiencing.
Bloating is one of the most common and noticeable signs of advanced ovarian cancer. Due to a buildup of fluid, a woman’s belly can become swollen and distended. The bloating may be painful or accompanied by an uncomfortable feeling of tightness around the abdomen, as well as indigestion and an increased need to pass gas. Additionally, this extra pressure on the stomach can cause a loss of appetite, while extra pressure on the lungs can cause shortness of breath.
What are the stages of ovarian cancer?
There are four main stages of ovarian cancer:
- Stage 1 – The cancer is confined to one or both ovaries.
- Stage 2 – The cancer has spread beyond the ovaries to other locations in the pelvis, such as the uterus or fallopian tubes.
- Stage 3 – The cancer has spread beyond the pelvis to the lining of the stomach or nearby lymph nodes.
- Stage 4 – The cancer has spread to distant lymph nodes and organs.
Does ovarian cancer always affect your menstrual cycle?
Ovarian cancer will not necessarily affect your menstrual cycle, especially when the cancer is in its earliest stages. However, ovarian cancer symptoms are often vague and may be ignored because they mimic the effects of the cyclic hormonal changes that occur naturally within your body due to menstruation.
When to see a gynecologic oncologist
Although many of these ovarian cancer symptoms are commonly experienced by women during menstruation and other non-cancerous situations, it’s best to see an expert gynecologist oncologist if any symptoms begin suddenly, feel different than normal digestive or menstrual problems or persist for more than two weeks. In general, the presence of symptoms may not indicate cancer, but it is always advisable to seek help from your primary care physician or OB/GYN when concerned. The number of symptoms that occur and their frequency often play a key role in diagnosis.
How is ovarian cancer diagnosed?
Typically, a physician will begin the diagnostic process with a pelvic examination. Then, he or she may order an imaging test, such as a transvaginal ultrasound, which can show the size, shape and structure of the ovaries in detail. If a physician suspects cancer based on the results of preliminary testing, he or she may then order further imaging tests and also obtain a small sample of blood, tissue or stomach fluid for evaluation under a microscope. For instance, a physician may order a blood test that can detect the CA-125 protein, which occurs on the surfaces of ovarian cancer cells.
Moffitt Cancer Center’s approach to ovarian cancer
Our dual board-certified and experienced gynecologist oncologists at Moffitt Cancer Center are available to all women for consultation. Whether you are facing new symptoms, are looking for a second opinion or are in need of symptom relief in conjunction with your current treatment plan, our multispecialty ovarian cancer team is here to assist you. Virtual appointments are also available.
Medically reviewed by Mian Shahzad, MD, PhD, gynecologic oncologist