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Signs of Ovarian Cancer You Might Miss

Dr. Elizabeth Yuko is the Health Editor at SheKnows. She is a bioethicist and writer specializing in sexual and reproductive health and the intersection of bioethics and popular culture. She is an adjunct professor of ethics at Fordham ...

Ovarian cancer is hard to diagnose, so get familiar with these symptoms

The Uterus User's Guide

Although ovarian cancer doesn't get as much press as breast cancer or even cervical cancer, it's still a major health concern. In fact, it's the fifth-leading cause of death in women ages 35 to 74. According to the National Ovarian Cancer Coalition, an estimated 1 in 75 people with ovaries will develop ovarian cancer in their lifetime.

And if you thought your annual Pap test detects ovarian cancer, think again. Though it can be difficult to diagnose, when ovarian cancer is detected in its early stages, the five-year survival rate is 90 percent.

What are the signs of ovarian cancer?

The tricky part is that the symptoms of ovarian cancer can be easy to dismiss according to Dr. Stephanie V. Blank, a gynecological oncologist and professor of gynecologic oncology in the Department of Obstetrics, Gynecology and Reproductive Sciences at the Icahn School of Medicine at Mount Sinai and Director of Women's Health at Mount Sinai Downtown, Chelsea Center. Some of these include bloating, bowel changes, abnormal urination and pelvic discomfort, she tells SheKnows.

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Most people who menstruate have these symptoms on a regular basis anyway, so it can be especially hard to know if they're signs of something bigger. Blank says that if you have a symptom that persists for more than two weeks or if it gets worse, it is worth discussing with a health care provider.

"Because there is not one hallmark symptom, you need a high index of suspicion to make the diagnosis," Blank explains. "Ovarian cancer is not necessarily at the top of the list of considerations, so oftentimes, patients will have had tests for many other conditions before the diagnosis is made."

Women with genetic predisposition to ovarian cancer are most at risk, she adds, including women with genetic mutations in some of the genes we know to be associated with ovarian cancer — BRCA1 and BRCA2 as well as several others.

How is ovarian cancer diagnosed?

Because there's no routine screening procedure — like a Pap test or mammogram — it's especially important that people with ovaries stay mindful of the signs of ovarian cancer. In some instances, it's possible ovarian cancer could be detected during an annual routine pelvic exam if the OB-GYN feels that the area around the ovary is abnormally swollen or tender.

People at an especially high risk of ovarian cancer could also have a transvaginal ultrasound to determine if cancerous cells are present in or around the ovaries. A blood test that determines the level of CA 125 (a protein produced by ovarian cancer cells) can be useful, but isn't enough on its own to definitively diagnose ovarian cancer, as some noncancerous conditions of the ovaries could also elevate CA 125 levels.

How is ovarian cancer treated, & can it be prevented?

The treatment for ovarian cancer is typically surgery and chemotherapy, Blank says, adding, "It is extremely important that every woman suspected of having ovarian cancer be evaluated by a gynecologic oncologist to make the decision regarding the order and choice of treatments."

Fortunately, there are ways to help reduce the risk of ovarian cancer. For instance, Blank says birth controls can protect against ovarian cancer — as does giving birth. Removing a person's tubes and ovaries, although extreme, is the most effective way to prevent ovarian cancer, Blank notes, but is not an option for everyone.

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Lastly, making efforts to get or stay healthy is important, but that doesn't mean you can avoid ovarian cancer altogether.

"Staying fit and eating well are always good lifestyle choices, but even someone who makes perfect lifestyle choices can get cancer," Blank says. "It is not caused by something a woman did."

So keep an eye on your pelvis and if anything seems abnormal for two weeks or more, it's probably time to see a doctor about it.

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