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Symptoms of ovarian and fallopian tube cancer

Ovarian cancer

Epithelial ovarian cancer

Ovarian cancer has been known as the "hidden disease in the abdomen" because of few symptoms. Later research has shown that a majority of epithelial ovarian cancer has vague or unspecific pelvic, abdominal or menstrual symptoms. This can lead to a delay in the diagnosis.

90% of women with early ovarian cancer and 100% with advanced ovarian cancer have reported at least one of the following symptoms:

  • Often uncharacteristic abdominal problems
  • A feeling of pressure and bloating
  • Increase in abdominal circumference
  • Change in bowel or urination patterns (diarrhea, constipation, frequent urination)
  • Weight loss or weight gain
  • Loss of appetite
  • General symptoms 
  • Shortness of breath 
  • Vaginal bleeding - sporadic
  • Acute pains - can occur in cases of torsion or rupture/bleeding
  • Paraneoplastic syndromes

Borderline tumors cause at least one of the above symptoms in 70% of cases, as well as distention of the abdomen. Women with borderline tumors have a longer duration of different symptoms. Abdominal pain/discomfort, intestinal problems, lasting fatigue, and weight loss are less common. 

Non-epithelial ovarian cancer

In contrast to epithelial ovarian cancer, non-epithelial ovarian tumors are characterized by rapid growth and one or more of the following symptoms:  

  • Pelvic pain. Germ cell tumors grow rapidly often causing pelvic pain due to capsule distention, bleeding, necrosis, or tumor rupture.
  • Pressure symptoms from the bladder or bowel. 
  • Increase in abdominal circumference in you women may be due to this type of tumor. Some of these tumors produce HCG and can therefore falsely represent pregnancy. 
  • Irregular bleeding. Granulosa cell tumors often produce estrogen causing endometrial hyperplasia or cancer.
  • Precocious puberty. Granulosa cell tumor must be considered.
  • Virilization. Sertoli-Leydig cell tumors often produce androgens.
  • A pelvic tumor in a girl before menarche will most often be a germinal cell tumor. 
  • An ovarian tumor in pregnant woman may be a non-epithelial tumor. 

Fallopian tube cancer

In fallopian tube cancer, symptoms occur more frequently and in an earlier stage than ovarian cancer. Discharge and vaginal bleeding are typical symptoms of fallopian tube cancer. In advanced disease, symptoms are often the same as ovarian cancer. It is rarely possible to differentiate between the two cancers preoperatively.

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