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Subtle signs of ovarian cancer that might be easy to miss

INSIDER logoINSIDER 3/9/2018 cpraderio@businessinsider.com (Caroline Praderio)
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  • Symptoms of ovarian cancer might be missed by patients and doctors because they seem non-specific, oncologist Dr. Julian Schink told INSIDER.
  • The most common symptoms include an increase in belly size, abdominal pain, urinary changes, and feeling full very quickly when you eat.
  • Other possible signs are fatigue, constipation, upset stomach, back pain, pain during sex, and changes in your period.
  • If you have symptoms that last two weeks, see a doctor. 

Ovarian cancer has a reputation as a silent killer — a disease that grows imperceptibly, never showing any symptoms until it reaches an advanced and deadly stage. 

But Dr. Julian Schink says that reputation isn't entirely accurate. 

"That 'silent killer' terminology is really unfair because the vast majority of women with ovarian cancer have had symptoms," Schink, chief of the division of gynecologic oncology at Cancer Treatment Centers of America, told INSIDER. "And many of those women have complained to somebody about their symptoms and people didn’t listen or they weren't heard."

The problem, he explained, is that the common symptoms are non-specific, meaning doctors or patients often attribute them to other problems.

That's why it's important for people with ovaries — especially those with risk factors for ovarian cancer — to learn and stay alert for warning signs of the disease.

Here are potential symptoms to look out for — and when to see a doctor if you notice them.

The most common signs can seem non-specific

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The most common ovarian cancer symptoms are an increase in belly size, pain, urinary changes, and feeling full quickly, according to the American Cancer Society (ACS). 

"One of the most important [symptoms] is an increase in abdominal size that is happening quickly," Schink said. "Not like, 'OK, in the last 10 years I gained three inches.' It's like, 'I gained three inches this month.'" Some people also describe bloating as a symptom, he added. 

Persistent, unexplained pain can be a symptom of many cancers. Ovarian cancer can cause pain in the abdomen, Schink said. 

Urinary frequency (having to pee more often than normal) or urgency (always feeling like you need to pee) can also signal the disease. 

And finally, feeling very full after eating only a small amount of food — also called early satiety — can be a symptom, though Schink said this is "often a sign of fairly advanced ovarian cancer."

It's easy to see why Schink described these common symptoms as non-specific. They can all be caused by other, non-cancerous conditions. In fact, it's more likely that they're caused by non-cancerous conditions, according to the ACS.

Other possible signs include fatigue, constipation, and changes in your period

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The ACS also lists fatigue, constipation, upset stomach, back pain, and pain during sex other potential symptoms of ovarian cancer. 

It's also possible ovarian cancer could cause changes in periods. But Schink said it's not common sign because the majority of people who get ovarian cancer are peri- or post-menopausal, and have already stopped menstruating regularly. Even in pre-menopausal women, ovarian cancer may not stop periods, he added. 

"The ovaries are a remarkable organ and in some women, they keep cycling even if one of them is really filled with cancer," Schink said. 

Ovarian cancer symptoms are both new and persistent

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Schink said true ovarian cancer symptoms have two key characteristics: They're new and they don't go away.

"I see patients all the time who have 12 hours of abdominal pain [say], 'Is this ovarian cancer?' And my comment to them is cancer symptoms generally come and while you wish they would go away, they don't. And that's the difference."

It's likely that ovarian cancer will cause more than one symptom, too. Schink said earlier research on ovarian cancer symptoms found that most patients had two or more signs of the disease. 

"It wasn't just one thing suddenly wrong," Schink said. "You've got two or more symptoms of these rather nonspecific symptoms, but they're new to you, they don't go away, and they persist over the course of several weeks. That's kind of the key."

See a doctor if your symptoms last any longer than two weeks

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Schink said if you experience any of the above symptoms for more than two weeks, see your doctor.

"Most abdominal issues that are related to viral illness come and go in less than a week. So when things persist for two weeks, it's time to see your physician," he said.

And don't be afraid to tell your doctor that you're concerned about ovarian cancer specifically, he added.

The outlook for ovarian cancer is improving

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About 22,240 women in the US will be diagnosed with ovarian cancer in 2018, according to estimates from the ACS. An estimated 14,070 of those patients will die from the disease, making ovarian cancer the fifth deadliest cancer among women.

But Schink stressed that the outlook for the disease is improving.

"People need to be aware that new treatments are emerging rapidly and survival continues to improve," he said. "Every year it gets better and we have new treatment options ... It's not a death sentence. It is becoming a more and more manageable cancer."

Watch: The Ovarian Cancer Signs You Should Know (Health.com)

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