What Are the Symptoms of Stage 1 Ovarian Cancer?

Ovarian cancer may cause abdominal pain, urinary problems, bloating and other issues.

Ovarian cancer is a type of cancer that occurs when cells in the ovaries, female reproductive glands, become abnormal and grow out of control. 

Ovarian cancers were thought to originate solely in the ovaries, but new data suggests many ovarian cancers may start in cells in the tail ends of the fallopian tubes. 

Ovarian cancer is the fifth leading cause of cancer deaths among women, causing more deaths than any other cancer of the female reproductive system.

Symptoms of ovarian cancer that may be present in stage 1 and later include:

• Bloating/abdominal distension 
• Pelvic pain
• Lower abdominal pain
• Loss of appetite 
• Feeling full quickly or after small amounts of food
• Urinary symptoms such as urgency or frequency 
• Fatigue 
• Upset stomach
• Back pain
• Pain during intercourse
• Constipation
• Menstrual changes, such as heavier bleeding than normal or irregular bleeding
• Weight loss
• Mass felt in the abdomen

The cause of most ovarian cancers is unknown, but certain risk factors may make a woman more likely to develop ovarian cancer, such as

• Inherited genetic mutations
• Acquired genetic changes
• Aging: ovarian cancer is rare in women younger than 40, and most cases develop after menopause
• Being overweight or obese
• Having children later or never carrying a pregnancy to term
• Hormone therapy taken after menopause
• A family history of ovarian cancer, breast cancer, or colorectal cancer
• Having a family cancer syndrome
  • Hereditary breast and ovarian cancer syndrome (HBOC): mutations in BRCA1 and BRCA2 genes
  • Hereditary nonpolyposis colon cancer (HNPCC)
  • Peutz-Jeghers syndrome
  • MUTYH-associated polyposis
• Fertility treatments
• Having breast cancer
• Smoking

There are also theories about risk factors that may make a woman more likely to develop ovarian cancer, such as:

• Pregnancy and birth control pills lower the risk of ovarian cancer. Both reduce the occurrence of ovulation, and it is believed there may be a relationship between ovulation and the risk of developing ovarian cancer.
• Tubal ligation (getting your “tubes tied”) and hysterectomy lower the risk of ovarian cancer. A theory suggests cancer-causing substances may enter the body through the vagina and pass through the uterus and fallopian tubes to reach the ovaries, thus, removing the uterus or blocking the fallopian tubes can reduce ovarian cancer risk.
• It is also theorized that male hormones (androgens) may cause ovarian cancer.

Ovarian cancer is diagnosed starting with a medical history and pelvic examination. If ovarian cancer is suspected, tests may include: 

Imaging tests:

• Ultrasound
• Computed tomography (CT) scans
• Colonoscopy 
• Magnetic resonance imaging (MRI) scans
• Chest X-ray to determine if the cancer has spread (metastasized) to the lungs
• Positron emission tomography (PET) scan
• Barium enema X-ray (not often used)

Other tests:

• Laparoscopy of the pelvis or abdomen 
• Biopsy
• Blood tests
• CA-125 test
• Human chorionic gonadotropin (HCG)
• Alpha-fetoprotein (AFP)
• Lactate dehydrogenase (LDH)
• Inhibin 
• Estrogen and testosterone 

If you have been diagnosed with an epithelial ovarian cancer, genetic counseling and genetic testing for certain inherited gene changes may be recommended. 

Ovarian cancer treatment may include one or more of the following: 

• Surgery to remove the cancerous growth (most common method of both diagnosis and therapy)
• Chemotherapy
• Radiation  
• Complementary therapies to treat symptoms such as fatigue, pain, and nausea
• Clinical trials

• Stage I ovarian cancer: 
  • Cancer is limited to the ovaries and has not spread to the abdomen, pelvis, lymph nodes, or to distant sites
• Stage II ovarian cancer: 
  • Cancer is in one or both ovaries and has spread to the pelvic region, such as the fallopian tubes or uterus
• Stage III ovarian cancer: 
  • Cancer is in one or both ovaries, and has either spread beyond the pelvis to the lining of the abdomen, or has spread to the lymph nodes in the back of the abdomen
• Stage IV ovarian cancer: 
  • Cancer has spread (metastasized) to distant sites, such as the inside of the spleen, liver, lungs or other organs outside the abdomen and pelvic region

Life expectancy for ovarian cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. Survival rates vary depending on the types of ovarian cancer. 

Invasive epithelial ovarian cancer 5-year survival rates:

• Localized (no sign the cancer has spread outside the ovaries): 92%
• Regional (cancer has spread outside the ovaries to nearby structures or lymph nodes): 76%
• Distant (cancer has spread to distant parts of the body, such as the liver or lungs): 30%

Ovarian stromal tumors 5-year survival rates:

• Localized (no sign the cancer has spread outside the ovaries): 98%
• Regional (cancer has spread outside the ovaries to nearby structures or lymph nodes): 89%
• Distant (cancer has spread to distant parts of the body, such as the liver or lungs): 54%

Germ cell tumors of the ovary 5-year survival rates:

• Localized (no sign the cancer has spread outside the ovaries): 98%
• Regional (cancer has spread outside the ovaries to nearby structures or lymph nodes): 94%
• Distant (cancer has spread to distant parts of the body, such as the liver or lungs): 74%

It may be possible to reduce the risk of developing the most common type of ovarian cancer, epithelial ovarian cancer. 

• Avoiding certain risk factors
  • Maintain a healthy weight
  • Don’t take hormone replacement therapy after menopause
• Use oral contraceptives (birth control pills), which decrease the risk of developing ovarian cancer 
• Gynecologic surgery: tubal ligation and hysterectomy may reduce the chance of developing certain types of ovarian cancer, but these surgeries should only be reserved for valid medical reasons and not for their influence on ovarian cancer risk
• Prevention for women with a family history of ovarian cancer or BRCA mutation
  • Genetic testing 
  • Using oral contraceptives 
  • Tubal ligation or removal of both ovaries and fallopian tubes: usually not just for ovarian cancer prevention