Why Ovarian Cancer Symptoms Can Be Hard To Miss

There are lots of stories on the internet about people who discovered that they had ovarian cancer because a sneaky or ordinary symptom gave them pause. These stories can be immensely helpful in spreading awareness about the lesser-known signs of ovarian cancer, but they can also cause unnecessary worry that a late period or a random cramp is way more serious than it actually is. So what's the deal?

It can be tough to weed out what you actually need to know about your ovarian health — or what you need to worry about. "Many people end up with a lot of guilt thinking they didn't pay enough attention to their bodies," says Roisin O'Cearbhaill, MD, a medical oncologist who specializes in gynecological cancers at Memorial Sloan Kettering Cancer Center in New York City. "That's unfair, because they're often very vague symptoms."

The ovaries (those reproductive organs responsible for producing eggs and hormones) are made up of three types of cells, all of which can develop into tumors, according to the American Cancer Society. Most ovarian tumors develop on the outer surface of the ovary, which can then metastasize and spread to other parts of the body — and that's typically when symptoms like bloating and abdominal discomfort would kick in.

Understanding a few key facts about your ovarian health can inform the questions you ask your gynecologist or primary care doctor at your annual checkups (which, BTW, you should be having). Ahead, Dr. O'Cearbhaill explains the four things young people should know about ovarian cancer.

Symptoms are typically very persistent.

The symptoms of ovarian cancer sound like ones you may have experienced before: abdominal bloating, feeling full after eating, pressure in the lower back, changes in urination, constipation, increased abdominal swelling, feeling tired, and changes in your menstrual cycle, Dr. O'Cearbhaill says. But unlike feeling bloated after eating or simply having an irregular period, symptoms of ovarian cancer are constant.

Often with younger people, there can be other explanations for the symptoms, like endometriosis, gastroenteritis, or even pregnancy, she says. "It can be tricky to figure out: Are the symptoms related to something serious like ovarian cancer or are they related to something more benign, like IBS?" If you're unsure if your symptoms are normal, ask your doctor or gynecologist, and be sure to mention how frequently they're occurring.
Ovarian cancer is uncommon in young women — but not impossible.

Normally, ovarian cancer presents in women in their 60s, Dr. O'Cearbhaill says. About half of the women diagnosed with ovarian cancer are age 63 and older, according to the American Cancer Society. That said, there are some ovarian cancers that occur in young women in their 20s, although they tend to be very rare. So, what should you worry about if you're younger than 60? Just know your family history, have regular pelvic exams, and be aware of the symptoms, Dr. O'Cearbhaill says.
Genetics matter a lot.

About 25% of ovarian cancers are familial or hereditary in nature, according to Bright Pink, a breast cancer organization that focuses on education and prevention. And according to a 2015 study, 15% of patients with ovarian cancer have a genetic predisposition.

"Not everyone with the [BRCA] gene will get it, but a high proportion will," she says. Given that, if you're someone with a family history of ovarian cancer (meaning, you have a first or second degree family member who has had ovarian cancer), or you've inherited the BRCA gene, then it's particularly important to understand your risk and the symptoms, Dr. O'Cearbhaill says.

People who are considered high-risk are strongly encouraged to have a screening (usually an ultrasound and/or blood test) and follow up with a specialist, O'Cearbhaill says. For those without a family history, regular pelvic exams (during which a doctor feels your ovaries) can help detect ovarian cancer early, according to the American Cancer Society. When the ovarian cancer has progressed, occasionally a Pap smear will be able to detect ovarian cancer. Otherwise, it's important to speak up if you notice any symptoms or changes in how you usually feel, according to the American Cancer Society.
Ovarian cancer is treatable.

Today, there are "loads of new treatments" available for ovarian cancer, Dr. O'Cearbhaill says. The main treatment for ovarian cancer is surgery, to see how far the tumors have spread and to "debulk" them, according to the American Cancer Society. Depending on how far the tumors have spread, patients also typically require a hysterectomy. In addition to surgery, most people with ovarian cancer will undergo chemotherapy, hormone therapy, and/or radiation.

If ovarian cancer is detected early, the relative survival rate of five years after a diagnosis is around 94%, according to the American Cancer Society. But the reality is that ovarian cancer is rarely detected early (only about 20% of cases are). An estimated three of four women with ovarian cancer survive one year after diagnosis, and nearly half live longer than five years after being diagnosed, according to MedlinePlus. Given how important early detection is in treating this and other cancers, it's crucial to be on top of your health — ovaries and all.
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