Signs & Symptoms
Awareness: Listen to your Body
There is no one specific symptom for ovarian cancer. The symptoms are generally vague, non-specific and can be mistakenly attributed to other causes. Just because you have the symptoms, does not mean you have ovarian cancer.
Symptoms that are more severe or frequent than expected and of recent onset warrant further diagnostic investigation because they are more likely to be associated with both benign and malignant ovarian masses.
- University of Washington School of Medicine, 2004
Common Warning Symptoms
- Swelling or bloating of the abdomen
- Pelvic discomfort or heaviness
- Back or abdominal pain
- Fatigue
- Gas, nausea, indigestion
- Change in bowel habits
- Emptying your bladder frequently
- Menstrual irregularities
- Weight loss or weight gain
Other symptoms...
- Mass or "lump" in your pelvis that you can feel
- Inability to eat normally
- Pain with intercourse
- Vaginal bleeding
If you have one or more of these symptoms and these symptoms persist for 3 weeks or longer, see your health practitioner immediately.
Screening for Ovarian Cancer
To date, no single test can reliably detect ovarian cancer at a presymptomatic (before the symptoms begin or are very noticeable) stage. Screening involves using tests to detect early curable disease in healthy, asymptomatic (without symptoms) women.
- Having several tests which are all required for a clear picture may help detect ovarian cancer at an early stage
If you have experienced one or more symptoms, for 3 or more weeks, see your family doctor and ask for the following tests.
1. Pelvic Exam
A full pelvic exam is a very important step in diagnosing ovarian cancer. Remember, a Pap smear does not detect or rule out ovarian cancer.
- Your doctor will ask questions about your medical history to help to diagnose ovarian cancer and to rule out other gynecological/medical conditions
- Be sure to review all your symptoms with your doctor
- Your doctor will perform a pelvic exam
- Ask questions, write down the responses and ask for clarification if necessary
For more information, please visit:
2. Transvaginal Ultrasound
A transvaginal ultrasound is also recommended. In this test, a narrow probe is inserted into the vagina and sends out high-frequency sound waves which bounce off the ovaries and produce echoes that are used to create a picture called a sonogram. Doctors examine the sonogram for echoes that might represent abnormal areas. The patient usually receives the ultrasound results from the clinician or referring physician who ordered the test.
As in all phases of the diagnosis process and treatment one receives, the patient is encouraged to discuss the results with her doctor. Asking for a second opinion is an option.
For more information, visit:
3. CA 125 Test
CA 125 is not effective as a screening tool to catch ovarian cancer at an earlier and more curable stage. A proper diagnosis of ovarian cancer involves interpreting the results of the CA 125 blood test in conjunction with the above mentioned examinations.
Surgery is the only definitive way to rule out ovarian cancer.
4. Other Tests
If any of the tests suggest the presence of ovarian cancer, surgery may be advised to examine the cells and check for malignancy.
Since there is no effective screening test for ovarian cancer at this time, women need to be attentive to their bodies and aware of the signs and symptoms of ovarian cancer.
Talk with your doctor
If you have symptoms which might be ovarian cancer
Prepare for your doctor’s visit.
- The clearer the information you can provide about what you are experiencing, the more helpful it is to your doctor.
Your main concern & what you want to know by the end of your appointment:
- Write down your main concern before the doctor’s visit in a summary statement such as: “I have been having some symptoms for several weeks that make me uncomfortable (or are painful, or are new and unusual for me). I am concerned.”
- Write down what you would like to be accomplished by the end. For instance, you want an idea of what the doctor thinks may be a possible cause of your problem, and/or tests to investigate your problem.
Tell the doctor your symptoms in a clear and concise way:
- What the symptoms are (for example, bloating, diarrhea, pain in your abdomen)
- When the symptoms started
- How often you experience them
- What makes them better, if anything
- What makes them worse, if anything
- How mild or severe are they?
- Has anyone else on either side of your family has had breast, ovarian cancer or bowel cancer (ovarian cancer can sometimes run in families).
Keep in mind, that if you are not satisfied with the care that you receive from the doctor, you may seek a second opinion.
As your appointment draws to a close, it is a good idea to summarize and tell your doctor what you think you heard her/him say. Repeat in your own words what you heard and ask for confirmation. This will help ensure there aren’t any misunderstandings.
Some tips:
- Rehearse what you are going to say with someone in advance of your appointment.
- Be polite in your interaction. And you can also be firm.
- Make your conversation I-oriented: “I am concerned about these symptoms.” “I understand the symptoms may be something serious like ovarian cancer.”
- Listen to what is being said.
- If there is anything that you do not understand, ask the doctor to repeat it slowly or to use different words if you are unfamiliar with the medical terms.
- Consider bringing someone with you – having another person along may convey how important your symptoms are to you and may provide you with moral support. He or she can take notes or ask questions. You will need to make clear in advance of your appointment what you would like this person’s role to be.
- Take a fact sheet with you
- Bring a paper and pencil and jot down what you hear.
- Your symptoms merit being investigated regardless of their cause.
- You know your own body and what is normal or unusual for you.
- Keep in mind that ovarian cancer is not a common disease, so the odds are in your favour.
Genetics and Their Role
About 10 per cent of ovarian cancers are hereditary, or run in the family.
The BRCA1 and BRCA2 (or Breast Cancer 1 and 2) genes are involved in most cases of familial ovarian cancer.
- A woman who is a carrier of a BRCA1 or a BRCA2 gene mutation has an increased chance of developing ovarian cancer compared with a woman in the general population.
- With the BRCA1 and BRCA2 mutation, breast cancer appears at younger ages and increases the risk of a second cancer.
- About 1 in 50 Ashkenazi Jews carry a BRCA1 or BRCA2 gene mutation that increases the risks for breast, ovarian and related cancers.
- French Canadians of certain ancestry may be at increased risk.
- BRCA gene mutations are known in the Icelandic and Dutch populations.
A small portion of ovarian cancers are related to other mutations, such as the Lynch Syndrome or hereditary nonpolyposis colorectal cancer (HNPCC) which relates to early onset of cancer (age younger than 50 years) and the development of multiple cancer types, particularly colon and endometrial cancer.
If you have a family history, it is important that you call this to the attention of your doctor. Genetic counseling is an important next step to help you understand the risks and benefits of genetic testing. For more information on hereditary and genetics specific information re: Ashkenazi or French-Canadian, please refer to these useful links:
To find a Genetic Counselor, contact your family physician as a first point of reference; also refer to
Types of Ovarian Cancer
- Epithelial cancers: the most common ovarian cancers grow in the cells lining or covering the ovaries
- Germ cell cancers: start from germ cells (cells that are destined to form eggs) within the ovaries
- Sex cord or stromal cell cancers: begin in the cells that hold the ovaries together and produce female hormones
Epithelial Ovarian Tumors
Epithelial ovarian tumors are the most common, and include:
- Serous Tumors: affect 40 % of women diagnosed with epithelial ovarian cancer
- Endometroid Tumors: affect 20% of women diagnosed
- Mucinous Tumors: these are more unusual and affect only 1% of women diagnosed with epithelial tumors
- Clear Cell Carcinoma: affect 6% of women diagnosed
- Borderline Ovarian Tumors: these belong in a separate category of epithelial tumors and they usually:
- affect younger women
- begin on the surface of the ovary, and have a better cure rate than other types of tumors
- are cured with just surgery and do not require chemotherapy
Germ Cell Tumors
Germ cell tumors affect about 5 in every 100 woman diagnosed with ovarian cancer. They can occur in women at any age, but tend to affect woman in their twenties.
- Dysgerminoma: About half the woman diagnosed with a germ cell cancer will have this type of tumor; most women diagnosed will be under 30 years old
- Endodermal Sinus Tumors: the second most common type of germ cell cancers, and can affect teenagers and women in their early twenties
- Embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryomas, and mixed germ cell tumors are less common types of germ cell cancers
Sex Cord-Stromal Tumors
These tumors generally occur in younger women under 50 years old. A common symptom is known as virilism, which can include:
- Infrequent menstrual periods
- Menstrual periods after menopause
- Appearance of facial hair
- A hoarse voice