• Why is it important to know about ovarian cancer?

Ovarian cancer affects approximately 1/80 women. Although it is not frequent, it remains the main gynecological killer in developed countries. Most women are diagnosed at later stages of the disease, when treatment is less effective and survival is low. So, awareness is important to pick up the disease early and improve prognosis.

  • What are the symptoms?

Early symptoms are usually vague, including persisting abdominal bloating and distention, feeling full and loss of appetite. Sometimes pelvic or abdominal pain may be present, as well as increased urinary frequency due to bladder pressure from the enlarged ovaries. The latter can also affect bowel habits, causing diarrhea or constipation. Irregular periods and postmenopausal bleeding may be the first symptoms. In later stages of the disease fatigue and significant weight loss are present.

It is important to have early symptoms checked and not ascribe them to irritable bowel syndrome. Women over 50, who are the usual victims of ovarian cancer, do not usually develop irritable bowel syndrome; so, even when a general practitioner makes such a diagnosis, ovarian pathology needs to be excluded first.

  • Who is more at risk of developing it?

There are a number of factors that affect a woman’s risk to develop ovarian cancer. Age is one of them. Most cases present in menopausal years, where a check up to the gynecologist becomes rarer and this way cancer is being undiagnosed.

Another risk factor is the amount of ovulations in a woman’s lifetime. Having periods from an early age, or menopause very late, or not having children increases the risk. So getting pregnant for prolonged periods, breastfeeding and using contraceptive pills, thus suppressing ovulation for a long time, decreases the chances of developing ovarian cancer, without ever offering complete protection.

1 out of 10 cases of ovarian cancer is due to genetic inheritance, in women with mutations in BRCA1 and BRCA2 genes.  When there is a family history of ovarian or/and breast cancer in two or more close family members then a discussion should take place regarding the woman’s risk and the need for further genetic screening or not, as well as this screening’s implications.

Nevertheless, most cases of ovarian cancer are sporadic and attention to other origins needs to be given. Other parameters that increase the risk is obesity, multiple attempts with fertility medication and hormone replacement therapy after menopause, all of them affecting the hormonal status of women.


Ovarian cancer is a silent Killer! Being aware of the condition and its symptoms, and getting a doctor’s check is the only means to find the disease in its early stages and prevent its extensive consequences.


Christina Ioakeimidou

MD, BSCCP, MRCOG, MSc in Human Reproduction & Development