8 Early Symptoms of Ovarian Cancer, According to Women Who Experienced Them
The facts about ovarian cancer
More than 22,000 American women are expected to be diagnosed with ovarian cancer this year alone. But ovarian cancer's early symptoms are easy to miss, making it the deadliest female reproductive cancer.
One reason ovarian cancer isn’t typically detected until it has reached stages 3 or 4 has to do with the amount of space in the abdomen and pelvis, Nimesh Nagarsheth, MD, associate professor of obstetrics, gynecology, and reproductive science at Icahn School of Medicine at Mount Sinai, told Health in a prior interview. There’s enough room for organs to move as the cancer grows, which can mask ovarian cancer's signs and symptoms. Only when there's no more space left for a mass or tumor to hide do many patients start to notice ovarian cancer symptoms. Even then, the signs can be hard to decipher. After all, who doesn’t feel bloated every now and then?
“The symptoms are so normal that I just thought I didn’t feel well,” recalls Ashley Steinberg, a New Jersey-based legal assistant who was diagnosed with ovarian cancer at 24. “Plus, when you’re that age, you don’t think there’s something wrong with you. You figure it can’t be that bad.”
While about half of all ovarian cancers occur in women over the age of 63, younger women aren’t immune to the disease, especially if they possess a BRCA gene mutation, which significantly raises the risk of ovarian and breast cancer.
The good news is that 94% of women with ovarian cancer survive longer than five years if the disease is caught early, according to the American Cancer Society (ACS). But knowing how to recognize ovarian cancer symptoms is key.
We asked four real women associated with the National Ovarian Cancer Coalition to share the first symptoms they noticed before being diagnosed with the disease. (Many of these symptoms may also have less threatening causes, but if you experience any of these ovarian cancer signs more than 12 times a month, see your gynecologist.) Here, the survivors share the warning signs that led them to a diagnosis.
“In my case it was that my period was coming every two weeks,” says Sheryl Newman, who was diagnosed with stage 4 ovarian cancer at age 53. “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 women with ovarian stromal tumors (though Sheryl didn’t have them), which only account for 1% of all ovarian cancers. Stromal tumors often produce estrogen, which can cause period-like bleeding, even after menopause, according to the ACS.
“It all started when my stomach felt bloated and wouldn’t go down,” says Ashley, now 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 later, the tumor in her abdomen had grown to the size of a watermelon, covering her right ovary and kidney.
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Sheryl, now 55, also found herself “blowing up” in the months leading to her diagnosis: “I knew I was putting on weight because my pants wouldn’t zip,” she remembers. “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 says she looked like she was six months pregnant thanks to ascites, or fluid buildup that can gather in the abdomens of some people with liver disease or cancer.
“I remember feeling full quickly,” says 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, may also result in a loss of appetite.
“In the very beginning it felt like I was having menstrual cramps,” recalls 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 women assume the tummy troubles are benign. As Alicia Dellario, 54, tells us, “It’s very easy to ignore the symptoms of ovarian cancer.”
“I came home from work one day in excruciating back pain,” remembers 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,” she says. “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,” she says.
Women 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, says 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,” says Dr. Meyers, “especially if it is not related to physical activity that may have strained your back.”
“By the time I felt pressure in my lungs, I was already at stage 3 or 4,” says Sheryl. Though the discomfort would come and go, she remembers 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.
Ashley had heartburn, while Alicia says 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.
“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,” says Alicia.
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,” she says. “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.”
According to Dr. Meyers, an increased urge to urinate “occurs when ovarian cancer cells have studded the outside of the bladder wall or when ascites in the pelvis compresses the bladder, causing women to feel like urinating more frequently.”
It was Alicia’s need to pee that led her to a urologist, and ultimately a stage 3c ovarian cancer diagnosis: “None of my symptoms were slowing me down,” she says. “I was still running, working like a dog, and playing with my then 7-year-old daughter. My life hadn’t changed at all. If it wasn’t for the increased urination, I probably wouldn’t have gone to see anyone about it.”