8 Early Symptoms of Ovarian Cancer

01-intro-ovarian-cancer — Photo: Klaus Vedfelt/Getty Images

Ovarian cancer is the fifth most-deadly type of cancer among people with ovaries, and roughly 20,000 people in the United States are diagnosed with it every year, per the American Cancer Society (ACS).

The ovaries, which are the female reproductive glands, are made up of three different types of cells, as outlined by the ACS: epithelial cells, germ cells, and stromal cells—all of which can develop into a cancerous tumor. However, in the earliest stages of ovarian cancer, the cells exist on a microscopic level, so it's very difficult to catch.

Recognizing the symptoms of ovarian cancer can lead to a diagnosis in an earlier, more curable stage. The most important thing, according to Rebecca Brightman, MD, assistant clinical professor of obstetrics, gynecology, and reproductive science at Mount Sinai, is listening to your body. "Women, in general, know what's normal for them," Dr. Brightman told Health. "And that, for me, is one of the more helpful things in my practice. If someone comes in saying, 'this is not normal, there is a change,' then that person needs to be evaluated."

It's important to listen to your body and go to your healthcare provider if you do notice something abnormal, because most ovarian cancer cases are diagnosed in the later stages. "About one in five women that have ovarian cancer, by rule of thumb, right now, will be diagnosed at an early stage," Mary Rosser, MD, assistant professor of obstetrics and gynecology at Columbia Medical School, told Health. "The benefit of being diagnosed early is that you have [a better chance at] survival, because you'll have earlier, better treatment."

Because early diagnosis is key to a successful treatment plan, we spoke to real people about the changes they noticed in their bodies ahead of their cancer diagnosis and to gynecologists about what these signs mean.

01 of 08

Bloating

Bloating is the main symptom that puts medical experts on high alert, said Dr. Rosser.

"It all started when my stomach felt bloated and wouldn't go down," said Ashley at age 29. "I ignored it, thinking it had to do with my period or my unhealthy diet. But the bloating wouldn't go away."

The little belly Ashley always had started to expand. By the time she visited her gynecologist for an annual checkup two months after noticing this symptom, the tumor in her abdomen had grown to the size of a watermelon, covering her right ovary and kidney.

Sheryl Newman, who was diagnosed with stage 4 ovarian cancer at age 53, also said she was "blowing up" in the months leading to her diagnosis. "I knew I was putting on weight because my pants wouldn't zip," remembered Sheryl at age 55. "But I just thought I was getting older and, since my period was suddenly coming often, I figured that was bloating me too."

Within a few months, Sheryl said she looked like she was six months pregnant thanks to ascites, or fluid buildup that can gather in the abdomen of some people with liver disease or cancer.

If a person comes into her office with bloating, Dr. Rosser checks to make sure there's an up-to-date colonoscopy if the patient is over 45 and does a transabdominal and transvaginal ultrasound to examine the reproductive organs.

02 of 08

Increased Satiety

"I remember feeling full quickly," said Kimberly Singleton, who was diagnosed with ovarian cancer at age 32. "I always used to order this one salad out and could easily finish it, but suddenly I was only eating half of it."

Ascites, the same fluid buildup that causes some ovarian cancer patients to feel bloated, can cause troubles eating and make you feel full quickly. This increased satiety from belly swelling is also accompanied by weight loss, according to the ACS.

"There's fluid in their abdomen; there are frequently lesions, you know, implant lesions all over their bowel, and something potentially pressing against their bladder," said Dr. Brightman. As a result, you feel full sooner and eat less over time.

03 of 08

Indigestion

In addition to increased satiety, the fluid buildup in the abdomen can also lead to indigestion.

Ashley had heartburn, while Alicia Dellario, at age 54, said she experienced gas for six months straight leading up to her ovarian cancer diagnosis. This is common among ovarian cancer patients, who tend to experience general discomfort in the abdomen, including bloating and constipation due to the placement of their tumors. "I was nearing my 50th birthday and I was feeling a lot of gas, but I chalked it up to eating a high-fiber diet or maybe just getting older," said Alicia.

04 of 08

Cramps

"In the very beginning it felt like I was having menstrual cramps," recalled Sheryl. Since her cycle had always been accompanied by uncomfortable cramps, she didn't think much of the discomfort at first.

It's not uncommon for tumors growing in the pelvis to cause pain in the lower abdomen. And since the discomfort can feel similar to period cramps, many people assume the tummy troubles are benign (or harmless). As Alicia told Health, "It's very easy to ignore the symptoms of ovarian cancer."

Since half of people diagnosed with ovarian cancer are over the age of 63, and likely post-menopausal, cramping is another sign that medical experts flag. "Especially in a post-menopausal woman, if there are menstrual signs like cramps or bleeding, though I've never really seen [bleeding], then we want to evaluate ASAP," said Dr. Brightman.

05 of 08

Back Pain

"I came home from work one day in excruciating back pain," remembered Sheryl. "I couldn't sit, I couldn't stand. It was constant." The discomfort interfered with her sleep too: "The pain was so bad that it would wake me up in the night."

Kimberly also experienced back pain: "Right before my diagnosis, I was having very bad lower back pain," said Kimberly. "It was so severe that it was interrupting my day." The ache was more intense than the back pain she typically experienced from sitting at her desk all day. "I had to take ibuprofen for it daily," added Kimberly.

People with ovarian cancer can experience back pain when fluid accumulates in the pelvis or when the tumor spreads in the abdomen or pelvis, directly irritating tissue in the lower back, said Marleen Meyers, MD, an oncologist at New York University's Langone Medical Center.

"Because many of us get back pain at one time or another, the key is to report new pain that doesn't go away," said Dr. Meyers, "especially if it is not related to physical activity that may have strained your back."

06 of 08

The Urge To Go

In the weeks leading up to her diagnosis, Kimberly felt like she had to urinate—constantly. "I would say every 30 minutes I would get the urge to go, but when I tried, nothing would come out or it would just be a trickle."

Alicia also experienced an increased urge to urinate. She thought she had a UTI and even took two rounds of antibiotics to treat her symptoms. "I always had to go to the bathroom," said Alicia. "I tend to drink a lot of water, so I'm always going to the bathroom anyway, but this was escalated. I couldn't even sit through meetings at work. It was embarrassing."

Dr. Brightman said this symptom comes from "the cancer pressing near the ureters that bring the fluid from the kidneys into the bladder."

07 of 08

Bleeding

"In my case it was that my period was coming every two weeks," said Sheryl. "I'd already been through menopause and stopped getting my period for about nine months. So when it started up again, I knew something wasn't right."

Irregular bleeding is most common among people with ovarian stromal tumors (though Sheryl didn't have them), which only account for 1% of all ovarian cancers, so the ACS statistics. Stromal tumors often produce estrogen, which can cause period-like bleeding, even after menopause, according to the ACS.

Since the bleeding is only a symptom of 1% of ovarian cancer cases, said Dr. Brightman, it's not high up on the list of symptoms to look out for.

08 of 08

Difficulty Breathing

"By the time I felt pressure in my lungs, I was already at stage 3 or 4," said Sheryl. Though the discomfort would come and go, she remembered having difficulty breathing especially when she would lie down.

Late-stage ovarian cancer can bring on breathing troubles. As tumors grow large, they may begin to press against the lungs and obstruct a patient's ability to inhale and exhale.

Updated by Anthea Levi

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