You might assume a condition as serious as cancer would trigger symptoms of a similar magnitude—but that’s not always the case, particularly when it comes to the ovarian kind.
“Ovarian cancer has been known as the ‘silent killer’ because many women do not experience symptoms until after it is already widespread and considered advanced,” Eloise Chapman-Davis, MD, a gynecologic oncologist at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF. And when symptoms do crop up, they can be deceivingly vague.
It’s a big reason why only around 20% of ovarian cancers are diagnosed in early stages, which is when it’s confined to the ovaries or fallopian tubes (where most ovarian cancers actually start). The rest are detected later on, when the cancer cells may be less responsive to treatments like chemotherapy. Hence why ovarian cancer is the deadliest of all gynecologic cancers—though it’s relatively rare, affecting just about 20,000 women in the US each year, it’s also the fifth-leading cause of cancer-related deaths for this demo.
And yet, when ovarian cancer is detected early, about 94% of patients live longer than five years after diagnosis. Read on to learn the subtle symptoms of ovarian cancer to look out for, as well as the preventative steps you may be able to take to reduce your risk.
9 nebulous symptoms of ovarian cancer
It’s worth reiterating that plenty of people with ovarian cancer might not have symptoms, especially at the early stages, and that’s largely because of where it grows.
Upwards of 90% of ovarian cancers are the epithelial type, which means they occur in the tissue that coats the surface of the ovaries, or as scientists have recently discovered, start in a fallopian tube and then move to the top of the ovary. “You don’t have a sensory nervous system in either place, so you wouldn’t necessarily feel anything wrong, particularly if the tumor is small,” Christina Annunziata, MD, PhD, senior vice president of Extramural Discovery Science at the American Cancer Society (ACS), tells SELF. (The two other types of ovarian cancer—germ cell and stromal cell—are very rare and occur inside the ovaries, where they tend to cause much sharper abdominal pain, Dr. Annunziata points out.)
Generally, it takes time before the typical ovarian tumor grows big enough and takes up enough space in your pelvis to cause symptoms, Dr. Chapman-Davis says. And even then, the symptoms can be pretty nonspecific and easy to chalk up to other conditions, she notes. Some of the most common ones include:
Bloating
Your stomach or pelvis feels unusually puffed-out, or you feel like your pants aren’t fitting correctly, but you’re not putting on weight anywhere else, Dr. Annunziata explains. This can occur as the cancer starts to spread from your ovaries to other parts of your abdomen.
Feeling nauseated or getting full quickly when eating
You might feel like food doesn’t taste as it should or doesn’t sit well anymore, Dr. Annunziata says. That might lead you to eat less, so you could wind up losing weight, too—even as you experience bloating or stomach swelling at the same time, she points out.
Peeing frequently or feeling a constant urge to do so
Feeling like you have to go all the time but can never quite empty your bladder completely is another sign, typically caused by the way the body can hold onto fluid when fighting cancer, Dr. Annunziata says. This might show up as waking up constantly to pee, too.
Pelvic or stomach pain
As an ovarian tumor grows, it can start to press on other organs in your pelvis and potentially push up against a nerve, which can trigger an achy pain, Dr. Annunziata notes. (It’s typically nagging though not necessarily sharp.)