Early Epithelial Ovarian Cancer Cases Present with At Least One Symptom

According to a recent article, a study shows that patients with epithelial ovarian cancer do present with at least one symptom the majority (72%) of the time.

Ovarian Cancer

Ovarian cancer is a type of cancer that forms in the ovaries, hence the name. An ovary is one of two almond-shaped organs found on each side of the uterus that store eggs and produces the hormones estrogen and progesterone. Depending on the type and stage, malignant cells are found inside, near, or on the outer layer of the ovaries. Common areas where cancer may spread from the ovary include the abdomen lining, bowel and bladder lining, lymph nodes, lungs, and liver. There are four types of ovarian cancers:

  1. Epithelial tumors, which refer to the thin layer of tissue that covers the ovaries and account for 90% of ovarian cancer cases
  2. Germ cell carcinoma tumors, in which the cancer begins in the cells that form the eggs and account for 5% of ovarian cancer diagnoses
  3. Stromal carcinoma tumors, in which the cancer develops in the connective tissue cells that hold the ovary together, produce estrogen and progesterone, and account for 5% of ovarian cancer diagnoses
  4. Small cell carcinoma of the ovary (SCCO), which is a rare, highly malignant tumor that accounts for 0.1% of ovarian cancer diagnoses

The staging of ovarian cancers is the following:

  • Stage I: Cancer is found in one or both ovaries
  • Stage II: Cancer has spread to the pelvis
  • Stage III: Cancer has spread to the abdomen
  • Stage IV: Cancer has spread to other parts of the body


The frequency and/or number of symptoms are key factors in the diagnosis of ovarian cancer, and symptoms become more noticeable as cancer progresses. Common symptoms include:

  • Bloating
  • Pelvic pain
  • Abdominal swelling
  • Loss of appetite
  • Urinary symptoms (urgency or frequency)

The Importance of an Early-Stage Diagnosis

Most of the patients who are diagnosed with ovarian cancer are diagnosed at an advanced stage. These patients will therein develop recurrent and chemo-resistant disease, which is why diagnosing patients at an early stage is vitally important for their overall survival.

The Study

Researchers looked at the charts of 419 patients from the Gynecologic Oncology Group (GOG) study 157 (a randomized phase 3 clinical trial). They specifically examined the symptoms of patients with high-risk early-stage ovarian cancer who had a mass.

Results of the Study

The study found that 72% of participants (301) with a mass had at least one symptom if not more. 167 of the patients just had one symptom, and 134 proved to have multiple symptoms. The other 28% of patients (118) were asymptomatic despite having a mass.

Furthermore, the size of the patient’s tumor was directly related to the proportion of patients who reported having symptoms. For patients who had a minimum of one symptom, 65% of those patients had tumors that were 10 centimeters or smaller. In addition, 71% of patients with at least one symptom had a tumor between 10 centimeters and 15 centimeters, and 79% of those with at least one symptom had tumors bigger than 15 centimeters.

The analysis showed that there were no correlations between a patient’s symptoms and their age, stage, histologic subtype, and risk for recurrence or survival.

The researchers found that females with ovarian cancer experienced abdominal pain, bloating, difficulty eating, or a combination of all three.  The most common symptom was abdominal or pelvic pain.

Moving Forward

The team of researchers suggested that there must be more studies looking at the symptoms of early-stage cancer symptoms. They also suggested looking into the potential of serum biomarkers and wearable monitoring devices.

Ovarian cancer is often misdiagnosed which can lead it to be diagnosed at a late-stage rather than an early-stage. It is vitally important to understand the early-stage symptoms of ovarian cancer so patients can be diagnosed and treated earlier.

Share this post

Share on facebook
Share on twitter
Share on linkedin
Share on pinterest
Share on print
Share on email