Early-stage ovarian cancer is not so silent after all |
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Early-stage ovarian cancer is not so silent after all
Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India,  29 January 2022
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Most early ovarian cancers do present with symptoms, reveals a new study published in the journal Obstetrics & Gynecology.1


The researchers carried out a retrospective review of medical records of patients from the Gynecologic Oncology Group (GOG) 157 phase III trial to assess symptoms of early ovarian cancer. All 419 patients evaluated had surgically staged, high-risk early-stage epithelial ovarian cancer (stage IA-IB and grade 3, any clear cell, stage IC or II).


Out of the 419 patients, 72% (n=301) had at least one or more symptoms, while 28% (n=118) did not have any symptoms but on examination were found to have a mass. Abdominal and pelvic pain was the most common symptom reported by 31% patients followed by increased abdominal girth or fullness reported by 26% patients. Other symptoms described were vaginal bleeding (13%), urinary symptoms (10%) and gastrointestinal symptoms (5%). Forty percent of patients reported only one symptom, while 32% had more than one symptom. 


The number of symptoms increased with increase in tumor size. While 23% patients with tumor size ≤10 cm had multiple symptoms, this number increased to 27% with tumor size >10-15 cm and 46% with tumor size >15 cm. Symptoms at time of diagnosis showed no association with either survival or tumor recurrence.


According to this study, most patients with early-stage ovarian cancer, stage I and II, did have one or more symptoms prior to their diagnosis, the most common being abdominal or pelvic pain. And, as the tumor size increased, so did the number of symptoms. These findings break the myth that ovarian cancer is a “silent killer” and that symptoms are present only in advanced stages of the disease. Often symptoms are disregarded as being vague. Hence, physicians must have a high degree of suspicion in patients presenting with such symptoms and appropriately investigate them. Early diagnosis translates to better patient outcomes and improved survival.




  1. Chan JK, et al. Symptoms of women with high-risk early-stage ovarian cancer. Obstet Gynecol. 2022 Jan 6. doi: 10.1097/AOG.0000000000004642.
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