Why a Diagnosis Often Comes Late

It is difficult to detect ovarian cancer early. Symptoms can mimic other conditions, and you may not have any. In addition, doctors and gynecologists do not have reliable screening tests to detect the first signs of the disease. These are the main reasons women are diagnosed with stage I or II ovarian cancer, before it spreads a lot, only about 20% of the time.

But there are things you can do to take charge of your health. Know the symptoms that you need to be aware of so that you can have them checked by your doctor or gynecologist. And find out what puts women at high risk for disease, so you can get preventative treatment when needed. Here’s what two doctors who treat gynecologic cancers want you to know about catching ovarian cancer as early as possible.

Talk about it if you have symptoms

Sometimes ovarian cancer doesn’t cause any symptoms at first, especially in the early stages of the disease. This is when the cancer is confined to one or both of your ovaries, which store eggs and produce the female hormones estrogen and progesterone.

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“There is 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 the gynecologic oncology division at NYU Langone. “So generally stage I ovarian cancer is a pretty silent disease.”

Katherine Kurnit, MD, a gynecologic oncologist at the University of Chicago, agrees. Usually, she says, women start having symptoms when the cancer begins to spread, grow on other structures, or invade other parts of the body.

However, it is possible to have symptoms in the early stages of the disease. Some of them are:

  • Bloating
  • Pain in the stomach or pelvis
  • Feel full quickly when you eat
  • An urgent or frequent need to pee

Talk to your primary care doctor or gynecologist if you have such symptoms, especially if they are new to you and don’t go away, Kurnit says. Since ovarian cancer can lead to nonspecific issues like gastrointestinal or intestinal issues, be aware that it’s often misdiagnosed as a gastrointestinal or intestinal issue, say Kurnit and Boyd.

If you are receiving treatment for any of these conditions and your symptoms persist for 2 weeks or more, see another doctor or your gynecologist. A pelvic ultrasound is a quick test that can give your gynecologist a lot of information about what’s going on with you, Boyd says.

Find out what could put you at high risk

There are a number of factors that increase your chances of developing ovarian cancer, such as getting older. The disease is rare when you are under 40. It is much more common when you are 63 or older. Most of the time, it starts after menopause.

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

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

Hereditary mutations in genes called BRCA 1 and BRCA 2 are also linked to a higher risk of ovarian cancer and other cancers. The way to know if you have either mutation is to have 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 best way to identify someone at high risk, or with one of these genetic mutations that puts them at higher risk for familial cancer, is to have a consultation with a genetic counselor,” Boyd explains. “They can go over the risks and benefits of getting the genetic test and then proceed with the test if that makes sense to that patient.”

If you decide to have genetic testing, a counselor can also help you explain your results. “Sometimes it’s very difficult to understand what it means to have a genetic mutation for someone who is not in the medical field or for someone who is just not as familiar with it,” Kurnit says.

If you are diagnosed with a mutation in one of your BRCA genes, the counselor can explain how this affects your risk for ovarian cancer and other cancers. They can also tell you the best way to share information with your siblings, “men and women, who would also be potentially at higher risk of developing cancer syndromes,” Kurnit says.

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Genetic tests directly intended for consumers are also available. Boyd says trying to interpret the results on your own without the help of a counselor, however, could be intimidating.

If you learn that you have a high risk of ovarian cancer, your doctor or gynecologist will closely monitor your health and tell you what preventative treatments might be right for you, along with the risks and benefits of each.

What to do if you are at medium risk

Doctors would like to have an accurate screening test to detect ovarian cancer early before it causes symptoms, but it doesn’t exist. Tests like the Pap test for cervical cancer are not effective at detecting signs of early ovarian cancer. For now, the US Preventive Services Task Force recommends that doctors do not routinely screen women at average risk who do not 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 postmenopause, you are most at risk of developing the most common gynecological cancers.

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Kurnit agrees. “Often women think that after menopause they no longer need to see a gynecologist.” She recommends that you continue to receive all the gynecological care and routine examinations recommended by your doctor.

It can give you some peace of mind knowing that your overall risk for ovarian cancer is “pretty low,” Boyd says. The chances of you getting it in your lifetime is about 1 in 78, or 1.3%.

If you have ovarian cancer, treatments help people live better and longer lives than before, she says.

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