Ovarian Cancer Symptoms Consensus Statement:Early ovarian cancer may not cause obvious symptoms. Ovarian cancer is called a “silent killer” because symptoms were not thought to develop until the disease had advanced and the chance of cure or remission poor. However, the following symptoms are much more likely to occur in women with ovarian cancer than women in the general population. But, as the cancer grows, these symptoms may include:

• Bloating:A swollen or bloated abdomen
• Pelvic or abdominal pain
• Pain or Pressure in the back or legs, pain in the abdomen, pelvis.
  
• Diarrhea, gas, nausea, constipation, indigestion
• Difficulty eating or feeling full quickly
• Feeling very tired all the time
• Urinary symptoms (urgency or frequency)
• Pain during sex
• Abnormal vaginal bleeding
• Trouble breathing

Ovarian cancer may grow to a size of about 12 centimeters (5 inches) before it start encroaching to other organs, and produce more distinctive symptoms like increased urinary frequency and rectal pressure or fluid in the abdomen. Physicians may detect early ovarian cancer at the time of a routine pelvic examination or on a routine CT scan or ultrasound examination done for some other purpose.

Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms. Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved prognosis.

Several other symptoms have been commonly reported by women with ovarian cancer. These symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities. However, these other symptoms are not as useful in identifying ovarian cancer because they are also found in equal frequency in women in the general population who do not have ovarian cancer. Most often these symptoms are not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.

Symptoms of advanced ovarian cancer
In the later stages of ovarian cancer patients may present with symptoms of abdominal bloating or swelling. Large ovarian cancer may cause symptoms due to pressure on the adjacent structures. This may cause bladder or rectal symptoms. Some patients may develop fluid in the chest and this may cause difficulty in breathing.

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