What Are Signs and Symptoms of Ovarian Cancer?
Early signs are easy to miss; learn what to watch for
Early signs are easy to miss; learn what to watch for
Ovarian cancer is a silent threat that often goes unnoticed until it’s too late. Its signs and symptoms are subtle, making it difficult to diagnose in the early stages.
“In the early stages of ovarian cancer, women may have few or no symptoms,” says Teresa Longoria, MD, a gynecologic oncologist at Scripps Clinic Anderson Medical Pavilion in La Jolla and Prebys Cancer Center in San Diego. “If there are symptoms, they are usually mild and can be mistaken for other common conditions.”
Most ovarian cancer cases are found late after the cancer has spread. It is the fifth most common cause of cancer deaths in women, according to the American Cancer Society. Only about 20% of cases are detected early.
When ovarian cancer is found early, the five-year survival rate is over 90%. Survival rates decrease when cancer is detected at a later stage after spreading beyond the ovaries.
What is ovarian cancer?
Ovarian cancer is a type of cancer that begins in the ovaries, the female reproductive glands that produce eggs and the hormones estrogen and progesterone.
Ninety percent of ovarian cancer starts in the lining of the ovaries, but it can begin in other parts of the ovary like the egg-producing cells or hormone-producing connective tissue.
Ovarian tumors can be benign (non-cancerous), borderline (low malignant potential), or malignant (cancerous and able to spread).
There are three main types of ovarian cancer:
- Epithelial tumors: Begin in the tissue covering the ovaries; they account for about 90 percent of ovarian cancers.
- Stromal tumors: Start in the hormone-producing ovarian cells; they are usually diagnosed earlier than other tumors.
- Germ cell tumors: Start in egg-producing cells; they are rare and usually affect younger women.
How common is ovarian cancer?
More than 20,000 women will be diagnosed with ovarian cancer in 2025, according to the American Cancer Society. About 13,000 women will die from ovarian cancer.
What are the symptoms of ovarian cancer?
Early-stage ovarian cancer rarely causes any symptoms. However, as cancer grows and spreads, it can produce a variety of signs and symptoms. These symptoms are often vague and can be easily confused with other common illnesses.
Common symptoms include:
- Persistent bloating
- Pelvic or abdominal discomfort
- Unexplained weight loss or weight gain
- Nausea, diarrhea, constipation, frequent urination
- Loss of appetite or feeling full quickly
- Abnormal vaginal bleeding
- Menstrual changes
- Fatigue
- Pain during sex
- Back pain
Having any of these symptoms does not mean you have ovarian cancer. These symptoms can be caused by common non-cancerous conditions. The key difference is persistence. If these symptoms are new, persist for several weeks, and don’t respond to normal interventions, such as diet changes or over-the-counter medications, talk to your doctor.
“It is always better to err on the side of caution,” says Dr. Longoria. “We want to find out what is causing your symptoms. If you do have ovarian cancer, we can start treatment right away.”
Ovarian cancer risk factors
Ovarian cancer can affect any woman, but some factors increase risk:
Age: Most cases are diagnosed at age 63 or older.
Family history: Women with a family history of ovarian or breast cancer are at higher risk.
Inherited genetic mutations: BRCA1 or BRCA2 gene mutations and Lynch syndrome increase the risk. Genetic testing can identify gene mutations that might raise your risk of cancer risk. Talk to your doctor or genetic counselor to see if testing is right for you, especially if you are at high risk.
Menstruation and menopause age: Women who began their periods at an early age, or began menopause at a later age, may have a greater risk.
Endometriosis: This condition is linked to some types of ovarian cancer. Endometriosis happens when tissue from the uterus grows outside of it.
Lowering your risk
Ovarian cancer cannot be prevented but certain risk factors may be reduced including:
Pregnancy and breastfeeding: Having children before age 26 reduces the risk of ovarian cancer. The risk decreases with each full-term pregnancy. Breastfeeding can also decrease the risk.
Birth control: Women who take birth control pills have a reduced risk of ovarian cancer. The longer they use the pills, the lower their risk becomes. The risk stays low for years after stopping the pill. Tubal ligation and IUDs can also lower the risk of ovarian cancer.
Weight: Body mass index (BMI) of 30 or more may increase risk.
Hormone therapy: Long-term estrogen use after menopause can raise the risk.
How is ovarian cancer diagnosed?
Currently there is no standard screening test for ovarian cancer. Diagnosis often begins when symptoms appear, or a pelvic exam shows something unusual.
Doctors use diagnostic tests to check for ovarian cancer when a patient shows symptoms. These tests include physical exams, blood tests, imaging tests and biopsies.
Ovarian cancer treatment options
Treatment usually depends on the stage and your health.
“We develop personalized treatment plans depending on the stage of the cancer, the patient’s overall health and other factors,” says Dr. Longoria. “Treatment usually involves a combination of surgery to remove the tumor and chemotherapy.”
If you have ovarian cancer, your doctor will check how far it has spread to decide the best treatment. Ovarian cancer has four stages:
- Stage 1: Cancer is only in the ovary or ovaries.
- Stage 2: Cancer is in one or both ovaries and has spread to other parts of the pelvis.
- Stage 3: Cancer in ovaries has spread to nearby lymph nodes or other abdominal organs, not including the liver.
- Stage 4: Cancer has spread to the lungs, liver or other distant organs.
Surgery
The main treatment for ovarian cancer is surgery. An oophorectomy removes one or both ovaries and can be performed using less invasive methods.
“Surgeries that once required large incisions and long recovery times can now be done through minimally invasive techniques, using smaller incisions, which can result in shorter hospital stays, quicker healing and less scarring,” Dr. Longoria says.
The goals of surgery are to remove as much of the tumor as possible and determine how far the cancer has spread.
If cancer has spread, surgeons may remove the uterus, fallopian tubes, omentum, lymph nodes, or parts of nearby organs.
Standard care usually includes chemotherapy. This treatment aims to target any remaining cancer cells, especially in later stages of ovarian cancer.