Ovarian cancer symptoms are often unclear in the early stages. Warning signs to watch for include bloating, feeling full quickly, and pelvic pain that occur frequently and persist for more than 2 weeks.
If you are in a higher-risk group, such as having a family history or a BRCA gene mutation, you should have regular follow-up screening.
Pelvic examination, transvaginal ultrasound, and a CA-125 blood test can help assess abnormalities at an early stage.
Why is ovarian cancer known as a “silent killer”?
Ovarian cancer is often called a “silent killer” because it usually does not show clear symptoms in the early stages. As a result, most patients with ovarian cancer see a doctor only after the disease has already progressed significantly. Understanding the warning signs and symptoms of ovarian cancer is therefore extremely important and can help reduce loss of life.
Small changes that may seem harmless at first
but could actually be warning signs of ovarian cancer
Early warning signs you should not ignore
Warning signs of ovarian cancer often resemble symptoms of digestive disorders or premenstrual symptoms. However, the key difference is that these symptoms occur frequently and persist over time, such as:
- Bloating, abdominal fullness, frequent gas, or a persistent swollen sensation in the abdomen
- Feeling full unusually quickly, even when eating less than usual
- A dull ache or pressure in the lower abdomen or pelvic area
The difference between “common symptoms” and “ovarian cancer symptoms”
| Symptom Characteristics | Common Symptoms (e.g. bloating after eating) | Symptoms that may suggest ovarian cancer |
|---|---|---|
| Frequency | Occur occasionally, often after meals | Occur almost every day |
| Duration | Improve after taking digestive medicine | Persist continuously for more than 2 weeks |
| Severity | Usually do not affect daily life much | Gradually worsen and do not improve |
Common symptoms of ovarian cancer to watch for
When the tumor begins to grow larger or starts affecting nearby organs, more noticeable symptoms may appear, including:
- Changes in bowel or bladder habits, including urinary urgency or frequency — feeling the need to urinate more often than usual or needing to rush to the bathroom suddenly, due to the tumor pressing on the bladder. Chronic constipation may also occur.
- Abnormal menstrual cycles — such as irregular periods or unusual vaginal bleeding after menopause.
- Changes in body shape — the abdomen becomes enlarged, similar to weight gain, while the arms and legs appear thinner, or a lump may be felt in the lower abdomen.
If you have these symptoms for more than 2 weeks or they occur more than 12 times in 1 month
you should see a doctor for a thorough evaluation
Less noticeable internal symptoms and other signs of ovarian cancer
These symptoms may not be clearly visible physically, but they may be felt as overall changes in the body.
- Ascites — a buildup of fluid in the abdomen that causes abdominal swelling and tightness, which often occurs in advanced stages.
- Fatigue — feeling unusually tired or weak without a clear reason.
- Changes in body weight — such as rapid weight loss, or in some cases weight gain caused by the tumor and fluid buildup in the abdomen.
- Pain during intercourse — due to inflammation or pressure from a tumor in the pelvic area.
Ovarian cancer symptoms by stage
- Stage 1 – The cancer is still confined to one or both ovaries. Most patients have no symptoms, or only mild bloating that may resemble digestive problems or premenstrual symptoms. Stage 1 ovarian cancer is very difficult to diagnose because the body often gives “non-specific symptoms,” causing many women to mistake them for normal bodily changes.
- Stage 2 – The cancer has started to spread to organs in the pelvis, such as the uterus, fallopian tubes, or lower bowel. Lower abdominal or pelvic pain usually becomes more noticeable.
- Stage 3 – The cancer has spread to the lining of the abdominal cavity or the lymph nodes. Symptoms such as ascites, feeling full quickly, and a more noticeable abdominal mass may occur.
- Stage 4 – The cancer has spread to distant organs such as the liver or lungs. Symptoms may include difficulty breathing or abnormal liver function.
Proactive screening to detect ovarian cancer
as early as Stage 1 (Early Detection)
To detect ovarian cancer as early as Stage 1 (Early Detection) — the stage with the highest chance of complete cure (more than 90%) yet with almost no symptoms — proactive screening is essential. This is because a routine physical examination often cannot detect a tumor in its early stage. However, an annual pelvic examination can help the doctor initially assess abnormalities of the uterus and adnexa, and it is recommended that the following 2 methods be used together by a gynecologic oncologist for a more accurate diagnosis.
1. Transvaginal Ultrasound (TVS)
This method can detect abnormal masses or cysts even when they are only a few centimeters in size. The doctor will assess the shape of the mass, whether it contains any solid components, suspicious cloudy fluid, or abnormal blood supply. Because the ovaries are located deep within the pelvic cavity, using a transvaginal probe allows the examination to get as close to the ovaries as possible. As a result, the images are more detailed than those from an abdominal ultrasound, making it easier to identify small ovarian abnormalities clearly.
2. CA-125 Blood Test
This test measures the level of a protein in the blood that is often elevated in patients with ovarian cancer. However, CA-125 levels can also be increased by non-cancerous conditions, such as endometriosis (chocolate cyst) or pelvic inflammation. Therefore, the results should always be interpreted together with the ultrasound findings.
Those with a family history or BRCA gene mutations (BRCA1, BRCA2) should be especially cautious!
Who Is at the Highest Risk for Ovarian Cancer and Should Be Screened Most Closely?
These groups of people should not wait until symptoms appear, but should consult a doctor for regular screening.
- Those with a family history (very important) – such as having a mother, older sister, or younger sister with ovarian cancer, breast cancer, or colon cancer
- Those who have tested positive for BRCA gene mutations (BRCA1, BRCA2) – if you know that you carry these inherited mutations, your risk is several times higher than that of the general population
- Postmenopausal women (age 50 and older) – ovarian cancer is more commonly found in this age group
- Those with the following reproductive health history – women who have never been pregnant or had children – women with endometriosis or chronic chocolate cysts – women who started menstruating early (before age 12) or reached menopause late (after age 55)
Screening is the best protection against ovarian cancer
Because ovarian cancer does not have specific symptoms in its early stages, and there is still no 100% effective screening test like there is for cervical cancer, “an annual pelvic examination and lower abdominal ultrasound at least once a year” is essential, especially for those in high-risk groups.
Do not wait until the symptoms become obvious, because detecting ovarian cancer at an early stage can increase the chance of a complete cure to as high as 90%. Love yourself by starting with a health check today.
FAQ
Q: What are the early symptoms of ovarian cancer?
A: Bloating, feeling full quickly, and lower abdominal pain that occur frequently and persist over time.
Q: When should you see a doctor right away?
A: When the symptoms occur almost every day, last longer than 2 weeks, or happen more than 12 times in 1 month.
Q: What tests can help screen for ovarian cancer?
A: Pelvic examination, transvaginal ultrasound, and a CA-125 blood test.
Q: Who should be screened more frequently than usual?
A: Those with a family history, BRCA gene mutations, or women aged 50 and older.
Article by
Kunthida Rithirangsriroj, M.D.
Women Health Centre
Specialty
Obstetrics and Gynaecology , Gynaecological Oncology
Language
Thai, English
– 2012 Thai Board of Obstetrics and Gynaecology, Chulalongkorn University
– 2014 Thai Subboard of Gynaecological Oncology
– Obstetrics and Gynaecology
– Gynecologic Oncology
– General OB/Gyne
– Colposcopy
– Minimally invasive surgery
– Women health screening : cervical cancer screening, transvaginal ultrasound, breast cancer screening
– 2006 Doctor of Medicine, Chulalongkorn University
– 2012 Thai Board of Obstetrics and Gynaecology, Chulalongkorn University
– 2014 Thai Subboard of Gynaecological Oncology
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