“Ovarian cancer can be difficult to detect, which is why it’s so important for women to learn the symptoms and advocate for themselves. Awareness truly can make a difference.” — Dr. Rachel Wheeler
The Challenge of Diagnosing Ovarian Cancer
Ovarian cancer is often called the “silent killer” because its symptoms can be vague and easy to confuse with other common conditions. Many women don’t notice clear warning signs until the disease has progressed. Unlike breast cancer, which has mammograms as a routine screening tool, there’s currently no reliable test for detecting ovarian cancer in its early stages. That’s why diagnosis is often delayed. It usually takes six to twelve months from the time symptoms first appear to when an accurate diagnosis is made.
Why Is Ovarian Cancer Hard to Detect?
Despite years of research, there’s still no reliable screening test for ovarian cancer. That makes early detection especially difficult. The ovaries are small and tucked deep within the abdomen, so tumors can be complex to detect during a routine exam. To complicate things further, ovarian cancer symptoms are often subtle and can mimic more common conditions—like irritable bowel syndrome (IBS), diverticulitis, menopause or perimenopause, endometriosis, or even recurrent urinary tract infections. Because of this, many women dismiss their symptoms at first or are misdiagnosed before the actual cause is found.
Another reason ovarian cancer is so challenging to diagnose is the way it grows. Unlike many other cancers that form solid tumors with defined edges, ovarian cancer can appear less distinct, making it harder to detect on imaging scans or during a physical exam. Because of this, about 20–30% of patients aren’t diagnosed until exploratory surgery is performed—sometimes the only way to confirm whether the tissue is cancerous.
Common Symptoms of Ovarian Cancer
While symptoms can vary, some of the most common ones include:
- Bloating that doesn’t go away—often resulting in a distended abdomen
- Pelvic or abdominal pain—can range from mild to severe, debilitating pain
- Vaginal discharge or abnormal bleeding, postmenopausal bleeding
- Changes in bowel habits, such as diarrhea or constipation
- Feeling full quickly or having difficulty eating
- Frequent urination or urgency
- Fatigue
- Weight loss, gain
If these symptoms persist or feel unusual for your body, consulting a doctor as soon as possible is essential. You are the only person who knows what is normal for your body.
How Is Ovarian Cancer Diagnosed?
Since there’s no standard screening test for ovarian cancer, diagnosis often involves a combination of approaches. If a provider suspects ovarian cancer, they may perform a pelvic exam and order imaging tests such as an ultrasound or a CT scan to look for abnormalities. They may also look for Tumor Markers (Including CA-125), which look for proteins that may be elevated due to ovarian cancer. These blood tests sometimes provide clues, even though they aren’t specific enough to be used for routine screening. In many cases, the only way to confirm ovarian cancer is through surgery, where a surgeon examines the ovaries and surrounding tissue and sends samples to the lab for testing.
What Can You Do?
- Know your body – You are the best judge of what’s normal for you.
- Ask again – It’s okay to repeat yourself if you feel unheard.
- Record symptoms – Write them down to share clearly with your provider.
- Explore second opinions – Sometimes a fresh perspective makes all the difference.
- Never give up – You deserve answers and compassionate care.
Since early detection is challenging, listening to your body and advocating for your health is crucial. Begin by scheduling an appointment with your OB/GYN. They may want to start with an ultrasound, which can assess the uterus and ovaries. If anything unusual is seen, they may order some additional blood tests, such as a CA-125. Those with a family history of cancer, particularly ovarian, breast or uterine cancer, may also benefit from genetic testing to assess their risk. If you experience persistent symptoms and don’t feel you’re getting answers, consider seeking a second, or even a third opinion—such as an OB-GYN, PCP, or gastroenterologist.
Ovarian cancer can be tough to detect; knowing your “normal” and seeking medical care is crucial. If something feels off, trust yourself. Log your symptoms daily and share this information with your provider.
Dr. Rachel Wheeler is a much-loved OB/GYN at our Mechanicsville location. She is passionate about caring for women at every age and stage—offering guidance, support throughout pregnancies and deliveries, skilled care during surgeries and treatments, and being a compassionate presence during life’s more challenging health moments.