As with any cancer, early diagnosis and treatment of ovarian cancer can save lives. Over 200,000 women are diagnosed with ovarian cancer every year and it causes approximately 15,000 deaths annually. In fact, ovarian cancer is the fifth most common cause of cancer death in American women.
What happens in ovarian cancer?
Cancer is a serious disease that can affect any tissue or organ. Normally cells multiply in an orderly manner and only when necessary. This growth is a carefully controlled process. However, in cancer the cell multiplication occurs rapidly and in an uncontrolled manner.
In ovarian cancer this abnormal and excessive growth occurs in the ovaries. It may start in the ovaries (primary tumor) or start elsewhere in the body and then spread to the ovaries (metastatic spread). Cancer that starts in the ovaries can also spread to other parts of the body.
Damage or mutation of genes is the reason why cancers arise. These genes control growth and determine the structure of new cells. When these genes are a problem then these new cells (cancer cells) can become abnormal and grow uncontrollably thereby invading healthy tissue.
The reason why genes become damaged or mutated is unclear. Ovarian cancer may be associated with a family history meaning that defective genes are inherited. The defects may also arise during the course of life and ovarian cancer is associated with other risk factors like smoking and using hormone medication.
Where is the cancer in the ovaries?
The ovaries produce egg cells (ova). During ovulation, an egg cell (ovum) is released from the ovary. Sometimes more than one ovum is released. The ova travel from the ovary, down the fallopian tubes and enter the uterus (womb).
The ovaries are located on either side of the uterus, connected to it by the fallopian tubes. It sits in the pelvic cavity. The cancer may arise from the tissue around the ovary and fallopian tube or from deep within the ovarian tissue. Most ovaian cancers arise from the outer lining (epithelium).
Read more on ovarian cancer.
How To Spot Ovarian Cancer
There may be little to no symptoms in the very early stages of ovarian cancer. As the condition progresses, the signs and symptoms that do become apparent are largely non-specific. This means that the symptoms do not conclusively indicate that it is due to ovarian cancer.
It is similar to many other non-cancerous conditions and a diagnosis of ovarian cancer can sometimes be missed without proper diagnostic investigations. It is therefore important that high risk individuals undergo regular screening and seek medical advice when symptoms arise.
Abdominal Bloating and Distension
A common complaint in ovarian cancer is a sensation of fullness in the lower abdomen. This bloating may or may not be related to eating and may at times vary in intensity for no clearly identifiable reason. Eventually an enlargement of the abdomen (distension) may be observed. The distension is largely due to fluid accumulation in the abdomen (ascites) and becomes more pronounced in advanced cases of ovarian cancer.
Abdominal Discomfort and Ovarian Pain
Abdominal discomfort may arise from the early stages with symptoms like bloating. It is diffuse rather than being localized to the side of the affected ovary. The discomfort is often described as a pressure sensation or dull ache initially. However, as the cancer progresses this discomfort may become pain. This ovarian pain can get progressively worse over time and is localized to the affected side of the pelvis.
Read more on ovarian pain.
Altered Bowel and Bladder Habit
Alteration of bowel habit is another common symptom of ovarian cancer. This can be initially misleading but it is important to understand that the ovaries lie close to the colon. Constipation is the more common alteration but diarrhea can sometimes occur.
As the cancer progresses, alterations in bladder habit may also arise along with a host of bladder symptoms. The more common urinary symptoms observed in ovarian cancer is a frequent and urgent need to urinate which may does not correlate with fluid intake.
Vaginal Bleeding and Pain During Intercourse
Abnormal vaginal bleeding may occur in ovarian cancer but usually not in the early stages. This is one of the conclusive indicators of a gynecological cause of symptoms. There may also be pain during intercourse. It is important to note that vaginal bleeding and pain during intercourse may be due to other gynecological cancers, namely cervical or uterine cancer. It can also arise for other non-cancerous gynecological reasons.
Loss of Appetite and Nausea
Loss of appetite is another non-specific symptom in ovarian cancer. It accompanies other food-related symptoms like early satiety when eating. The loss of appetite may arise even before later symptoms like nausea become apparent. Along with other digestive symptoms like indigestion and acid reflux, most people do not associate these symptoms with ovarian cancer.
In addition, many of these symptoms are seen with cancer treatments like chemotherapy and radiation therapy. Nause and loss of appetite in particular are common side effects of these cancer treatments. It is often indistinguishable from nausea and loss of appetite due to the cancer.
Fatigue and Unintentional Weight Loss
These are two common non-specific symptoms that occurs in most cancer, and not just ovarian cancer. Fatigue becomes more apparent as the cancer advances. It does not correlate with the level of physical activity or quantity and quality of sleep.
Weight loss may in part be due to the loss of appetite and other digestive symptoms that can affect normal eating habits. However, as the cancer progresses the weight loss is unintentional and continues despite eating.
Other Symptoms with Cancer Spread
A host of other symptoms may also occur if the ovarian cancer spreads. The neighboring organs are at greatest risk, including the fallopian tubes and ovaries, large intestine and bladder. Therefore there may be symptoms associated with cancer of these organs, or of distant organs if the cancer has spread extensively. Similarly if the cancer begins elsewhere on the body and then spreads to the ovaria, there may also be symptoms of cancer in the organ of origin (primary tumor).