Ovarian cancer has long been termed a 'silent killer' because its symptoms are often subtle and easily overlooked. It is among eleven cancers on the rise, driven by increasing numbers of young women developing the disease. While studies have yet to pinpoint a precise reason for this surge, experts from Imperial College London suggest that rising obesity rates and smoking likely play a role.
Ovarian cancer is one of the most common cancers in the UK, with approximately 7,700 new cases diagnosed each year. It is also one of the deadliest forms of cancer, with only 40 per cent of women surviving for ten or more years after diagnosis. Roughly 4,000 deaths from ovarian cancer occur annually in the UK, primarily because the disease is typically detected at a late stage when treatment becomes more challenging.
What is Ovarian Cancer?
Ovarian cancer occurs when abnormal cells in the ovaries or fallopian tubes grow and divide uncontrollably, forming a tumour. If not caught early, cancer cells can invade surrounding tissues and spread to other parts of the body, making treatment far more difficult. The ovaries are two glands located deep within the pelvis, involved in the menstrual cycle and fertility, and responsible for producing hormones like oestrogen and progesterone.
Due to their position, symptoms of ovarian cancer can be vague and often mistaken for gastrointestinal issues such as irritable bowel syndrome, bloating, or urinary tract infections.
Types of Ovarian Cancer
There are several types of ovarian cancer, depending on where in the female reproductive system the disease originates. Epithelial ovarian cancer is the most common, accounting for about 90 per cent of cases, and develops on the surface of the ovary. This type also includes cancer of the fallopian tube. Germ cell cancers are rarer and typically affect younger women in their twenties and thirties, starting in cells that develop into eggs. Sex cord stromal tumours make up only five per cent of cases and begin in the tissue that supports the ovaries and produces hormones.
Key Warning Signs
Persistent Bloating
Research indicates that ovarian cancer symptoms develop much earlier than previously thought. Experts at Imperial College London found that women diagnosed with the disease purchased painkillers and indigestion treatments up to eight months before diagnosis to alleviate painful bloating. 'Many women experience bloating at some point, but with ovarian cancer it tends to be persistent and not linked to specific foods,' explains Dr Asiya Maula, an NHS GP. 'If it's happening most days or doesn't improve, it's important to take note.' In advanced stages, bloating can become severe, causing the abdomen to swell visibly, sometimes mistaken for pregnancy due to fluid buildup called ascites.
Irregular Bleeding
Spotting or bleeding between periods is an often-overlooked early warning sign of ovarian cancer, as women may assume their cycle is simply early. However, if spotting occurs alongside other symptoms like persistent bloating, especially if it is unusual for you, it should be discussed with a GP. 'Understanding what is normal for your body and noticing when something changes can make a significant difference,' Dr Maula advises.
Frequent Urination
Needing to urinate more often than usual can be caused by less serious issues such as UTIs, diabetes, pregnancy, or lifestyle factors like caffeine intake. But it can also signal ovarian cancer, as tumours press against the bladder, reducing its capacity and increasing urgency. Fluid buildup in the abdomen can also put pressure on the bladder. This symptom, especially when combined with unexplained weight changes and abdominal pain, warrants medical attention.
Feeling Full Quickly
Ovarian cancer often presents with subtle symptoms, one of which is feeling full after eating only a small amount. This occurs when tumours press against the stomach and digestive organs, reducing their capacity. However, this sensation can also be triggered by gastrointestinal issues, infections, certain medications, stress, or anxiety. Dr Maula notes, 'If someone finds they are getting full much more quickly than usual, or struggling to finish meals, that can be a sign something isn't quite right.'
Persistent Abdominal Pain
Ongoing discomfort or pain in the lower abdomen or pelvic area is another common symptom that may be mistaken for period pain. But persistent abdominal pain can result from ovarian cancer as tumours grow, fluid accumulates, or cancer spreads. Although more likely caused by benign conditions like constipation or menstrual cramping, Dr Maula emphasises that 'any persistent discomfort in this area that doesn't have an obvious cause should be checked.'
When to See a Doctor
While these symptoms do not necessarily indicate cancer, experts stress that patterns are important. Symptoms that are new, frequent, or worsening should always be assessed. Dr Maula adds that women often endure health issues silently and only seek help when symptoms become unbearable. 'People often wait until symptoms become severe, but early changes are when we have the best chance of identifying problems. If any of these symptoms are unusual for you, occur together, or are ongoing, it's always worth speaking to a GP.'
How to Minimise Your Risk
Most cancers become more common with age, especially ovarian cancer. Risk increases sharply around age 45 as women approach menopause. Those who started menstruation early, experience late menopause (after 55), or have not had children may have an increased risk due to more ovulations. Some research suggests a very slight increased risk with hormone replacement therapy, but the risk remains small and decreases after stopping HRT.
Anything that reduces overall cancer risk also helps minimise ovarian cancer risk. Although only about 10 per cent of cases are linked to lifestyle factors, maintaining a healthy weight, not smoking, and avoiding asbestos can help. Taking the combined contraceptive pill is thought to reduce risk, with protective effects lasting at least 30 years after discontinuation. Having children also appears to lower risk, with more children associated with greater protection.
The Need for Screening
Currently, there is no national screening programme for ovarian cancer in the UK. Diagnosis typically involves scans and biopsies. However, UK and US researchers are developing a blood test to detect ovarian cancer at its earliest stages by identifying substances the cancer sheds into the bloodstream. This could improve early diagnosis, leading to better patient outcomes and lower healthcare costs.
