Ovarian cancer is often called a 'silent cancer' because its early symptoms are not clear-cut. This column looks at the early symptoms and at survival rates by stage. When it is found at stage 1 the survival rate is 89%, but at stage 3 it falls to 36%.
That gap depends on how quickly unusual signs are noticed and checked. Below, the early symptoms, survival rates by stage and the tests that are needed are set out in turn.
Why is ovarian cancer so hard to find early?
Ovarian cancer is a malignant tumour that develops in the ovaries, which release eggs and produce hormones, and among gynaecological cancers it is the most common after cervical cancer. Its early symptoms, such as heaviness in the lower abdomen or indigestion, resemble ordinary discomforts, so it is hard for women to read them as a clear warning sign.
About 2500 patients are newly diagnosed with ovarian cancer each year, and many of them only see a doctor once symptoms have become obvious, by which point the disease has already progressed. The figure that 60 to 70% of all patients are found at stage 3 or beyond reflects this.
What exactly are the early symptoms of ovarian cancer?
The signals the body sends while ovarian cancer progresses mostly look like digestive or urinary discomfort, which makes them easy to brush aside. If the lower abdomen feels heavy, or there seems to be a lump or cyst inside the abdomen, it is safer to have the cause checked by a gynaecologist than to assume it is simple indigestion.
As this is a cancer affecting women, changes related to periods or abnormal bleeding also deserve attention. If period pain has become worse than usual, or bleeding unrelated to the menstrual cycle keeps recurring, a check-up is warranted. When several symptoms overlap or last a long time, it is better not to put off testing.
- Heaviness in the lower abdomen — the lower belly feels heavy for no particular reason
- Frequent urination — you pass urine more often, with a feeling of pressure on the bladder
- A lump or cyst in the abdomen — a lump or cyst can be felt or is found on examination
- Digestive trouble — bloating or indigestion continues without an obvious cause
- Irregular periods or abnormal bleeding — period pain worsens or bleeding unrelated to the cycle keeps recurring
How much does the survival rate change depending on when ovarian cancer is found?
The survival rate of ovarian cancer differs enormously depending on when it is found. Diagnosed at stage 1, the survival rate is 89%, and found at stage 2 it still holds at 70%, but once the disease moves into stage 3 it drops to 36%. Compared with stage 2, that means only about 4 in 10 patients survive.
The fact that it is not unusual for the disease to be found only at stage 4 shows how many patients are diagnosed after it has progressed considerably. Since only a minority of patients are known to be diagnosed early, it is important not to dismiss early symptoms.
Which tests are needed if symptoms keep recurring?
If symptoms such as abdominal bloating, a frequent urge to urinate or pelvic pain recur almost every day for 2 weeks or longer, it is better to see a gynaecologist than to put it down to feeling run-down. A common approach is to check the shape and size of the ovaries and look for cysts or lumps on ultrasound, together with a CA-125 blood test.
Where the risk is higher because of a family history or an existing medical history, regular gynaecological check-ups are safer even without symptoms. Because the survival rate changes greatly the earlier the disease is found and treated, getting into the habit of having recurring changes checked with tests is helpful.
- Gynaecological ultrasound — checks the size and shape of the ovaries and whether there are cysts or lumps
- Blood test (CA — 125) — measures a tumour marker level to complement the ultrasound findings
- Regular check — ups — with a family history or existing medical history, have them periodically even without symptoms