Ovarian cancer history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Overview

Historically ovarian cancer was called the “silent killer” because symptoms were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that some symptoms are much more likely to occur in women with ovarian cancer than women in the general population.

Symptoms

• The are three scenarios when diagnosing Ovarian cancer based on the clinical presentation, stage of the disease, the condition of the patient, and the presence of peritoneal carcinoma
• If symptoms suggestive of epithelial ovarian cancer, pelvic exam and pelvic imaging should be done to look for adnexal mass
• Because ovarian cancer is diagnosed histologically, surgical exploration is the main approach for the definitive diagnosis of ovarian cancer
• Symptoms can vary based on the advancement of the disease:
• Women with advanced disease presents with acute symptoms such as:
  • Shortness of breath: due to malignant pleural effusion
  • Nausea and vomiting: due to bowel obstruction
  • Symptoms of venous thromboembolism (VTE) depending on the site of the thrombus and its extent such as:
    • Severe pain and swelling in the lower limb
    • Shortness of breath with pulmonary emboli
• Women with early, late or advanced disease presents with subacute symptoms such as:
  • Gastrointestinal symptoms: due to ascites, metastasis, bowel obstruction or distension of the ovarian tube
    • Abdominal pain
    • Abdominal bloating
    • Abdominal distension
    • Constipation
    • Early satiety
    • Nausea and vomiting
  • Urinary symptoms:
    • Increase frequency
    • Increase urgency
  • Symptoms related to adnexal mass
    • Pelvic pain
    • Pelvic pressure
    • Palpable abdominal or pelvic mass
  • Constitutional symptoms:
    • Fatigue
    • Weight loss
  • Other symptoms
    • Abnormal vaginal bleeding
    • Rectal bleeding
    • Painful intercourse

References

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