Brenda Spriggs, MD, MPH, MBA
Ovarian cancer accounts for only about 3 percent of cancers in women but remains a major health concern due to its high mortality rate. The American Cancer Society estimates that in 2013, about 22,240 women in the U.S. will be diagnosed with ovarian cancer, and an estimated 14,230 women will die of the disease. There is no reliable screening test for ovarian cancer. Early detection is vital to successful treatment of ovarian cancer, but diagnosis is hampered by the lack of distinctive signs and symptoms.
Bloating, or a feeling of fullness, is one of the most common symptoms of ovarian cancer. However, bloating can be caused by many other conditions, ranging from mild gastric disturbance to irritable bowel syndrome, or IBS, to severe abdominal infection. Women with abdominal symptoms may self-treat or even receive medical assistance without a thorough workup to determine the cause. The pattern of bloating is significant. For instance, IBS is associated with bloating or fullness that comes and goes, while the bloating of ovarian cancer tends to persist. Many women with bloating from ovarian cancer also report difficulty eating due to a feeling of fullness.
Pain in the abdomen or pelvis may be a symptom of ovarian cancer. The pain may recede and recur, and it may be more severe on some days than others. As with bloating and fullness, transient pain may be misdiagnosed, often as a reaction to food or a side effect of stress. Any new abdominal or pelvic pain that recurs more than 12 times in a month should be investigated by a health-care practitioner.
Increased urination can also be a symptom of ovarian cancer. Most women associate urinary urgency and frequency with a urinary tract infection, and antibiotics may be prescribed without testing for infection. Urinary urgency may be written off as a sign of menopause or aging. Any increase in urinary frequency or urgency -- especially if accompanied by abdominal bloating or pain -- is cause for a visit to your doctor.
Watch for the Signs
In medical terminology, symptoms are changes that the patient feels, while signs are changes that can be observed and measured. Common signs of ovarian cancer include a measurable increase in abdominal size, unexplained weight gain or weight loss and a change in the size or shape of the ovaries. This last sign is often discovered during a routine gynecological checkup. Unexplained fever and night sweats can also indicate cancer and should be investigated.
Clues in the Pattern
Though ovarian cancer has no distinctive symptoms, it is possible to reach an early diagnosis based on the frequency and duration of symptoms. In a 2007 article published in the journal "Cancer," Dr. Barbara Goff and colleagues proposed the Goff symptom index to help detect ovarian cancer. According to Dr. Goff, a workup for ovarian cancer should be conducted if a woman experiences pain, urinary symptoms, bloating or difficulty eating due to fullness more than 12 times per month -- especially if the symptom is new in the past year and particularly if she is older than 50.