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Why a Diagnosis Often Comes Late

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It’s hard to spot ovarian cancer early. The symptoms can mimic other conditions, and there’s a chance you might not have any. What’s more, doctors and gynecologists don’t have reliable screening tests to find early signs of the disease. Those are the main reasons why women get diagnosed with ovarian cancer when in it’s stage I or II, before it spreads much, only about 20% of the time.

But you can do things to take charge of your health. Learn which symptoms to be aware of, so you can have your doctor or gynecologist check them. And find out what things put women at high risk for the disease, so you can get preventive treatments if necessary. Here’s what two doctors who treat gynecologic cancers want you to know about spotting ovarian cancer as early as possible.

Speak Up if You Have Symptoms

Sometimes ovarian cancer doesn’t cause any symptoms early on, especially during the first stage of the disease. That’s when the cancer is limited to one or both of your ovaries, which store eggs and make the female hormones estrogen and progesterone.

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“There’s a lot of room in the abdomen for the ovary to grow” when a cancerous tumor forms on it, says Leslie Boyd, MD, director of NYU Langone’s Division of Gynecologic Oncology. “So usually stage I ovarian cancer is a fairly silent disease.”

Katherine Kurnit, MD, a gynecologic oncologist at the University of Chicago, agrees. In general, she says, women start getting symptoms when the cancer begins to spread, pushing on other structures or invading other parts of the body.

It’s possible to get symptoms in the early stages of the disease, though. Some of them are:

  • Bloating
  • Pain in your belly or pelvis
  • Feeling full quickly when you eat
  • An urgent or frequent need to pee

Talk to your primary care doctor or your gynecologist if you have symptoms like these, especially if they’re new for you and they don’t go away, Kurnit says. Since ovarian cancer can bring on non-specific problems like gastrointestinal or bowel problems, be aware that it commonly gets misdiagnosed as a gastrointestinal or bowel problems, Kurnit and Boyd say.

If you get treatment for one of those conditions and your symptoms stick around for 2 or more weeks, follow up with another doctor or your gynecologist. A pelvic ultrasound is a fast test that can give your gynecologist a lot of information about what’s going on with you, Boyd says.

Learn What Could Put You at High Risk

A number of things increase your odds of getting ovarian cancer, like growing older. The disease is rare when you’re younger than 40. It’s much more common when you’re 63 or older. Most of the time it starts after menopause.

Boyd and Kurnit say two key things put you at high risk of getting the disease, though: your close family’s medical history and certain gene changes, or “mutations.”

If you have a first-degree relative like a sister or mother who’s had ovarian cancer, your chances of getting the disease go up, Kurnit says. Having a close relative who’s had breast cancer can also be a risk factor, she says.

Inherited mutations in genes called BRCA 1 and BRCA 2 are tied to a higher risk for ovarian and other cancers, too. The way to find out if you have either mutation is to get your genes tested. You can ask your doctor or gynecologist if genetic testing might be right for you. If so, they may be able to refer you to a genetic counselor.

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“The preferred way to identify someone at high risk, or with one of these genetic mutations that puts them at higher risk for familial cancers, is to have a consultation with a genetic counselor,” Boyd says. “They can go through the risks and benefits of obtaining the genetic testing, and then proceed with testing if it makes sense for that patient.”

If you decide to get genetic testing, a counselor can also help explain your results. “It’s sometimes very difficult to understand what having a gene mutation means for a person who’s not in the medical field or for someone who’s just not as familiar with that,” Kurnit says.

If you get diagnosed with a mutation to one of your BRCA genes, the counselor can walk you through how it affects your risk for ovarian and other cancers. They can also tell you how best to share the information with any siblings you have, “both male and female, who would also be at potentially higher risk for cancer syndromes as well,” Kurnit says.

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Direct-to-consumer gene tests are available, too. Boyd says that trying to interpret the results on your own without a counselor’s help could be daunting, though.

If you learn you have a high risk for ovarian cancer, your doctor or gynecologist will keep a close eye on your health and explain what preventive treatments might be right for you, as well as explain the risks and benefits of each.

What to Do if You’re at Average Risk

Doctors would love to have an accurate screening test to spot ovarian cancer early before it brings on symptoms, but it doesn’t exist. Tests like the Pap test for cervical cancer aren’t effective at finding signs of early ovarian cancer. For now, the U.S. Preventive Services Task Force recommends that doctors don’t routinely screen women at average risk who don’t have symptoms.

Still, Boyd says, “it’s always a good idea to maintain a relationship with your gynecologist throughout life stages. And certainly in the post-menopause, you’re at highest risk of developing the most common gynecologic cancers.”

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Kurnit agrees. “A lot of times women think that after they go through menopause they no longer need to see a gynecologist.” She recommends that you keep getting all your recommended gynecologic care and routine checkups with your regular doctor.

It may give you some piece of mind to know that your overall risk for ovarian cancer is “quite low,” Boyd says. The odds that you’ll get it in your lifetime are about 1 in 78, or 1.3%.

If you do get ovarian cancer, treatments are helping people live better and longer than before, she says.

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