Ovarian cancer is the fifth leading cause of cancer death in women. It  has been known for a long time as the “silent killer”.  It earned this name because of the supposed lack of symptoms when cancer of the ovary is in early stages, when it is still highly curable. There are approximately 22,000 new cases, and over 15,000 deaths from ovarian cancer yearly. Most, but not all, cases of ovarian cancer occur in the post-menopausal years.

In three out of four patients, cancer of the ovary is usually discovered during late stages when it has spread inside the abdomen to other organs. At that point, the cure rates are low. Symptoms may include abdominal bloating or pain, feeling full early, or pelvic pressure.

Unfortunately, early stage cancer may not cause many symptoms, or they may be vague and overlooked.  Over the past five years, research has shown that some of these symptoms may actually occur earlier and are simply ignored by either the patient or the physician.  The trouble is that these general symptoms are most often not related to cancer and are simply intestinal disturbances due to something you ate or a viral infection.

If you have abdominal or pelvic symptoms that are new, seem unusual, persist for several weeks, or are worsening, tell your doctor.   This is especially important if you have a family history of cancer, especially breast or ovarian cancer.  

What happens after you talk with and are examined by your doctor depends upon what is found and your age.  It may be necessary to undergo ultrasound, computerized tomography (CT) or other imaging studies as well as the CA-125 blood test.

Unfortunately good screening tools are lacking, but the next best thing is early diagnosis. Knowing your body and answering its call to action is very important.  Equally important is to insist that your symptoms are explained fully by appropriate examination and testing. If not, it may be time for a second opinion with a gynecologist or gynecologic oncologist.

Here are the key references. A "level of evidence" is noted after each reference. These are categories, Level I to level III, of the quality of evidence.  Unfortunately, Level I is the gold standard and most of these are much lower. Nevertheless, it is important to keep looking into this very important issue so that we can find ovarian cancer in its more curable stages.