Ovarian cancer symptoms & diagnosis
Find a cancer specialistOvarian cancer has been described as a “silent” disease since you may not have obvious symptoms when it first develops, making it harder to catch in its early stages when chances of successful treatment are higher. Regular checkups and clear communication with your doctor about potential ovarian cancer symptoms can help keep your risk to a minimum. And if you have ovarian cancer, our specialists offer you cutting-edge care at clinics in Milwaukee, Kenosha, Fond du Lac, and throughout eastern Wisconsin.
What causes ovarian cancer?
At this time, there are no definitive ovarian cancer causes. Cells in any part of the body can begin to grow rapidly and become cancer. Risk factors, including family history, can increase the chance of developing cancer.
Ovarian cancer symptoms
Symptoms of ovarian cancer can be vague and hard to detect. They might also mimic other, less serious conditions. Signs and symptoms of ovarian cancer can include:
- Pelvic pain, pressure, bloating or a feeling of fullness
- Nausea, indigestion, constipation or diarrhea
- Shortness of breath
- Urinary urgency
- Loss of appetite
- Back pain
- Fatigue
- Abnormal vaginal bleeding
- Unexplained weight loss or gain
Ovarian cancer back pain can feel like a dull backache that gets worse over time.
Pain with ovarian cancer
In the early stages you may not have ovarian cancer symptoms, including pain. If you do have pain, it may feel like it’s:
- Located in your pelvis – the area between your hips
- Constant – it doesn’t come and go
- Like acid reflux, a dull ache or a feeling of pressure
- On only one side or on both sides
Pain like this could be caused by something besides ovarian cancer. The best thing to do is check with your doctor as not getting checked may increase your risk. Ovarian cancer that is given more time to grow is harder to treat.
Risk factors for ovarian cancer
- Age over 55
- Starting periods before age 12
- Never being pregnant
- Use of estrogen replacement therapy after menopause
- Infertility
- Use of certain fertility drugs
- Family or personal history of breast, uterine or colorectal cancer
Ovarian cancer is more common in White women than in Black women.
Those who are of Ashkenazi Jewish descent are more likely to carry mutations in breast cancer genes BRCA1 and BRCA2. These mutations increase the risk of ovarian cancer.
Genetic testing can identify specific genes to determine if you are at risk. Ovarian cancer screening includes education and genetic counseling alongside the testing. Our board-certified genetic counselors will walk through the results with you, discuss next steps and refer you to a specialist, if you are at risk. Ovarian cancer has a higher treatment success rate if found early, before it grows in your ovaries or fallopian tubes.
Testing for ovarian cancer
If you have signs of ovarian cancer, your ovarian cancer specialist will first perform a pelvic exam to feel your ovaries and other organs as they check for abnormal sizes or shapes. They may also insert an ultrasound probe into your vagina (transvaginal ultrasound procedure) to look for a tumor. If a tumor is found, you’ll need further testing to determine if it’s ovarian cancer.
Tests for ovarian cancer may include:
- MRI: This test can be used to determine if a tumor is cancerous.
- CT scan: CT scans can detect a tumor and show its precise location, size and involvement with other nearby tissue.
- CA-125 test: This test checks your blood for elevated levels of a substance that could signal cancer (also called CA-125 serum testing).
- Laparoscopy: This allows your doctor to view suspicious growths or take a small tissue sample (biopsy).
- Biopsy: A biopsy removes a small tissue sample for evaluation. The tissue can be removed using laparoscopy, traditional surgery or with a needle inserted through your skin.
- Genetic testing: This testing checks for genes related to ovarian cancer such as BRCA1 and BRCA2 mutations. This is generally done for people whose risk factors indicate a need.
Ovarian cancer stages
After a cancer diagnosis, the next step will include ovarian cancer staging which determines the stage of your cancer. A pathologist will examine and evaluate a biopsied tissue sample.
During staging, they check to see if there is any spread from the original site to nearby lymph nodes outside of the ovaries, fallopian tubes, or any spread to the fluid around the lungs or distant organs (metastasis).
Your multidisciplinary care team will give you a staging result with a number that reflects more details on these evaluations. The lower the stage number, the less the cancer has grown or spread, and the higher your chances of successful cancer treatment.
In stage 1 ovarian cancer, the cancer is confined to the ovary or fallopian tubes and has not spread to other lymph nodes or organs.
Stage 1A: Cancer is in one ovary.
Stage 1B: Cancer is in both ovaries or the fallopian tubes.
Stage 1C: Cancer is in one or both ovaries and fallopian tubes and one of the below is also occurring:
- Stage 1C1: Cancer is present on the surface of one or both ovaries.
- Stage 1C2: The tissue surrounding the tumor has ruptured before surgery.
- Stage 1C3: Cancer has spread to the fluids of the pelvis or abdomen.
Treatment: Your ovarian cancer doctor will likely recommend surgery to remove any tumors. Additional treatment may not be needed for this stage of ovarian cancer, but chemotherapy or additional treatments may be recommended for those with stage 1B or 1C.
In stage 2 ovarian cancer, the cancer has spread from the ovaries to other nearby pelvic organs or the lining of your abdomen, but not to other lymph nodes or distant organs.
Stage 2A: Cancer is also in the uterus or fallopian tubes.
Stage 2B: Cancer is also in nearby pelvic organs like the bladder or rectum.
Treatment: Surgery to remove the tumor and reduce the size of the cancer is recommended in most cases, but it depends on the type of tumor. A total hysterectomy (removal of the whole uterus) or hysterectomy with salpingo-oophorectomy (removal of one or both ovaries, and the fallopian tubes, along with the uterus) might be suggested, along with chemotherapy.
In stage 3 ovarian cancer, the cancer has spread to nearby lymph nodes or organs, but not to distant sites beyond the pelvis and abdomen.
Stage 3A: Cancer cells are in the pelvis and have spread to lymph nodes outside or behind the peritoneum (membrane lining the cavity of the abdomen).
Stage 3B: Cancer smaller than 2cm has spread to the peritoneum and possibly the lymph nodes behind the peritoneum.
Stage 3C: Cancer larger than 2cm has spread to the peritoneum and possibly to the lymph nodes in the abdomen or the outside of the liver or spleen.
Treatment: Similar to the stage 2 ovarian cancer plan, surgery is recommended to remove as much of the tumor as possible, along with more intensive chemotherapy treatments to shrink and kill tumor cells. Ovarian cancer palliative care – a specialized care to relieve the symptoms, stress and pain of serious illnesses – will be required for follow-up treatment and recurrence.
Stage 4 ovarian cancer is the most advanced ovarian cancer stage. During stage 4, cancer has spread to distant organs and tissues, like the liver, bones and lungs.
Stage 4A: Cancer has spread to the fluid between the lungs and chest wall.
Stage 4B: Cancer has spread to the spleen, liver or groin-area lymph nodes.
Treatment: Stage 4 cancer can be cured, although it will be more difficult than other stages. It is treated like stage 3, with further monitoring and more robust treatments. Chemotherapy may be needed before and after surgery and a targeted treatment drug may also be prescribed.
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