Ovarian cancer is, put simply, when abnormal cells grow and multiply in the ovaries, destroying healthy body tissue. These cells can also originate in the fallopian tubes or peritoneum, the membrane that lines the inside of your abdomen and pelvis. The American Cancer Society predicts that nearly 20,000 women will receive an ovarian cancer diagnosis in 2023. Sometimes known as the “silent killer,” ovarian cancer ranks fifth in cancer deaths among women.
One of the reasons this particular disease carries the unceremonious title of “silent killer” is because ovarian cancer isn’t always easy to detect.
As Rescripted has already reported, getting that essential ovarian cancer diagnosis can be a challenge for patients. Some experience medical gaslighting, and, especially if the patient is young, their symptoms may be dismissed as little more than ovulation pain. Another obstacle is the fact that “early-stage ovarian cancer very often does not have symptoms,” explains Eleonora Teplinsky, MD, an oncologist specializing in breast and gynecologic cancer at Valley Medical Group in Paramus, New Jersey. Dr. Teplinsky says the lack of visible symptoms makes ovarian cancer difficult to detect in its earliest stages.
For all of these reasons, it’s important to know what steps to take if you think you might have ovarian cancer — and how to be your own advocate, if necessary.
What are the symptoms of ovarian cancer?
Recognizing potential symptoms is critical to early detection. Per Dr. Teplinsky, symptoms of ovarian cancer can include the following:
abdominal bloating or fullness
early satiety (which is feeling full early while eating)
changes in bowel habits or bowel movements
If you are experiencing any or all of these symptoms, the typical first step is to make an appointment with either your OB/GYN or primary care physician. “They will order the necessary workup and typically will refer you to a gynecologic oncologist if needed,” says Dr. Teplinsky. While it’s important not to panic before you have a diagnosis, she also stresses the urgency of seeking medical attention if you suspect something is wrong. “If cancer is diagnosed,” says Dr. Teplinsky, who also hosts Interlude Podcast: Women’s Cancer Stories, “it is best to diagnose as early as possible, which will lead to better outcomes.”
Once there is a diagnosis, you will likely be referred to a gynecologic oncologist for a surgery discussion. Although surgery to remove the tumor is usually the next step, Dr. Teplinsky says that “in certain cases, we will do chemotherapy before surgery.”
How to screen for ovarian cancer
An additional reason why so much symptom awareness and early detection falls on the shoulders of the patients is that there aren’t great screening modalities for ovarian cancer when someone is asymptomatic. This is an issue Dr. Teplinsky has been speaking out about for a while now, creating an Instagram reel on this very subject back in September 2021. Unfortunately, Dr. Teplinsky says not much has changed since she made that reel nearly two years ago.
“For patients at high risk of ovarian cancer who still have their ovaries and fallopian tubes, we will sometimes recommend a pelvic ultrasound and a CA-125 blood test (tumor marker) every 6 months but that has many limitations as well,” she says. “Screening using these modalities has not been shown to improve mortality in those at average risk.” Dr. Teplinsky also warns that these particular screenings can cause false positives.
Suffice it to say, it’s imperative that patients know their own ovarian cancer risks (family history, etc.) and make their doctors aware of these risks.
New developments in ovarian cancer detection
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Dr. Teplinsky does highlight some more recent changes, however, in ovarian cancer detection. Specifically, the recommendation of an opportunistic salpingectomy, or the removal of the fallopian tubes, in some patients: “We recommend this for someone who is of average risk, is done having children, and is undergoing pelvic surgery for another reason (such as removal of a cyst or tubal ligation), to reduce ovarian cancer risk. This is because much of ovarian cancer initiates in fallopian tubes.”
Even though ovarian cancer still carries the “silent killer” stigma and lacks a reliable screening protocol for patients without symptoms, Dr. Teplinsky offers up plenty of optimism: “There have been a number of advances in the last few years,” she says, “and new drug approvals for ovarian cancer leading to improved outcomes! We are making progress!”
That being said, the onus does remain on the patients to be their own champions when it comes to ovarian cancer. Even though only 20% of ovarian cancers are found at an early stage, 94% of those patients live longer than five years after diagnosis. Therefore, it’s worth taking charge of your medical future: Know your family history, listen to your body, pay attention to your symptoms, and don’t wait to get something checked, even if it seems minor.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.