UNC Health Care
ovarian cancer symptoms

Early Signs of Ovarian Cancer, and How to Help Reduce Your Risk

You often hear how important it is to be screened for cancer, whether it’s getting a mammogram or colonoscopy. But when it comes to ovarian cancer, there’s no screening available—and that can be a scary realization for women.

In the United States, ovarian cancer is the deadliest gynecologic cancer and the fifth-leading cause of cancer-related death in women. The reasons? It can’t be detected early through screening, and symptoms of ovarian cancer are vague. This means that by the time of diagnosis, ovarian cancer is in advanced stages.

“It’s almost like going zero to 100; there’s not really an in between when you can say, ‘I can capture this early,’” says Linda Van Le, MD, a gynecologic oncologist with UNC Gynecologic Oncology.

Knowing Family History Might Help You Prevent Ovarian Cancer

Here’s what you can do: Know your family history, especially if you have family members who have or had cancer. Although most cases of ovarian cancer are sporadic, meaning there’s no family history of ovarian cancer, heredity can play a role.

“Do you have a history of breast or ovarian cancer in your family? If you do, then have a discussion with your physician about whether you need genetic counseling,” Dr. Van Le says.

If genetic testing reveals a mutation in a woman’s BRCA1 or BRCA2 genes, which indicates a heightened risk of ovarian cancer, she should probably undergo surgery, Dr. Van Le says. In the case of ovarian cancer, risk-reducing surgery includes the removal of both ovaries and the fallopian tubes. Talk to your doctor to create an action plan that’s right for you.

“Probably the only way to prevent ovarian cancer is undergoing risk-reducing surgery when the mutation is identified,” Dr. Van Le says. “These are the patients we can really help.”

Understanding the Signs and Symptoms of Ovarian Cancer

The early warning signs of ovarian cancer can be subtle and might mimic other illnesses, including those related to gastrointestinal issues and menstruation.

“As ovarian cancer develops, not much is detectable because the ovary is so small,” Dr. Van Le says. “But as the cancer grows exponentially and more organs become involved, then symptoms become really apparent.”

The most common warning signs of ovarian cancer are:

  • Bloating
  • Pelvic and abdominal pain
  • Difficulty eating or feeling full quickly

However, the following could also be symptoms of ovarian cancer:

  • Urinary incontinence such as urgency (always feeling like you have to go) or frequency (having to go often)
  • Fatigue
  • Back pain
  • Gastrointestinal issues such as heartburn and constipation
  • Menstrual changes
  • Pain during sex

Because ovarian cancer symptoms can be vague, it can be hard to know when to go to the doctor. A key indication that something more serious is happening is that the symptoms are persistent and abnormal, meaning they’re more painful or occur more often.

“When you get to the point where you have a big tummy and bloating and can’t eat … there is not much to be confused about,” Dr. Van Le says. “What I typically see is that a patient is fine and then—boom. All of the sudden, they feel awful. That’s when the cancer has already gotten to a critical mass.”

Treatment of Ovarian Cancer May Vary Depending on Age

So what happens once ovarian cancer is diagnosed?

“There is usually surgery,” Dr. Van Le says. “We can operate right away, or we can operate after giving some chemotherapy.”

Because ovarian cancer tends to be a postmenopausal disease, a hysterectomy is usually performed to take out the uterus. Cancerous ovaries and fallopian tubes are also removed. “Any piece of cancer we find, we should take out,” Dr. Van Le says.

If you’re experiencing symptoms that you think could be related to ovarian cancer, remember there are a host of other conditions that could be to blame. Talk to your doctor about the best next steps for you.

Ovarian Symptoms infographic

If you need a doctor, find one near you. You can also learn more about treatment available at UNC Gynecologic Oncology, with clinic locations in Chapel Hill, Raleigh, Cary and Greensboro.