Ovarian cancer

Not silent, as it is often called. It has symptoms; they are just persistently mistaken for irritable bowel syndrome.

What it is

Cancer of the ovaries, fallopian tubes or the lining of the abdomen, most often diagnosed after the menopause but possible at any age.

The description of it as a silent killer is wrong and has cost lives. Most people do have symptoms for months before diagnosis: bloating, feeling full quickly, abdominal pain and needing to pass urine more often. The problem is that those symptoms are common, unglamorous, and get treated as irritable bowel syndrome or as ordinary middle age.

The rule of thumb that helps: IBS starting for the first time after 50 is unusual, and deserves investigation rather than a diagnosis.

Family history matters. BRCA1 and BRCA2 gene changes raise the risk substantially, and a strong family history of ovarian or breast cancer is a reason to ask about genetic testing, which can lead to preventive surgery.

Signs you might notice

Persistent bloating, rather than bloating that comes and goes.

Feeling full quickly, or loss of appetite.

Pelvic or abdominal pain.

Needing to pass urine more often or more urgently.

Change in bowel habit, unexplained weight loss, or extreme tiredness.

The pattern that matters is persistent and frequent: happening on most days for three weeks or more. Anybody over 50 with new IBS-type symptoms should be tested rather than reassured.

How it can affect day-to-day life

Being disbelieved is a common part of the story. Many people report several appointments over months before anybody tested, and that experience shapes how they engage with everything afterwards.

Treatment is usually surgery and chemotherapy together, and surgical menopause at once is a major event that is often addressed as an afterthought. See menopause.

Recurrence is common and the follow-up years are lived under a particular kind of pressure. Anxiety around each scan is close to universal and treatable, and worth naming.

Supporting someone well

Keep a symptom diary for three weeks: what, how often, how bad. It converts a vague complaint into evidence.

Ask specifically for a CA125 blood test and an ultrasound if symptoms fit, and ask again if nothing changes.

Ask about family history on both sides, and about genetic testing where there is breast or ovarian cancer in the family.

Ask about HRT after surgical menopause, particularly for younger women; it is often not offered and is frequently appropriate.

Ask for the clinical nurse specialist's number and use it. It is the fastest route into the service.

Where to get help

A GP practice, asking directly for CA125 and ultrasound if symptoms fit.

Target Ovarian Cancer have a nurse-led support line and the clearest symptom information.

Ovacome run a support line for people living with ovarian cancer and their families.

Macmillan Cancer Support on 0808 808 00 00.