Ovarian Cancer: Symptoms & Diagnosis
Symptoms of Ovarian Cancer
Ovarian cancer is commonly thought to be a silent killer or the cancer that whispers. This is because early stage ovarian cancers have almost none or very minimal symptoms.
Small ovarian tumours often have an absence of symptoms and are usually discovered incidentally during investigations for other conditions.
A larger ovarian tumour can cause genitourinary symptoms, including urinary frequency, and dyspareunia. Sometimes ovarian masses can cause bowel symptoms like constipation. These symptoms can occur in both benign disease and early ovarian cancer. It is impossible to differentiate a benign from a malignant ovarian mass by clinical examination alone.
An ovarian mass can sometimes cause sudden onset of abdominal pain and can become a surgical emergency. This can be due to rupture, torsion, and possible haemorrhage (bleeding) inside a cyst, which distends it, or by the rupture of a blood-filled cyst, causing hemoperitoneum.
Symptoms of advanced Ovarian Cancer are more varied. These can Include:
- Early satiety
- Loss of appetite
- Diffused/dull/constant abdominal pain.
Diagnosis of Ovarian Cancer
The most important factors to be considered are the patient’s age, menopausal status, family history of any malignancy, clinical examination, and the results of blood levels of tumour markers i.e. CA-125 and imaging studies like CT or MRI scan.
Because of the lethality of ovarian cancer, it is considered advisable to“err on the side of caution.”
American College of Obstetrics and Gynecology (ACOG) and SGO consensus guidelines recommend referral to a gynecologic oncologist for women with elevated blood level of CA-125, presence of fluid in abdomen, an ovarian mass and evidence of abdominal/distant metastasis.