Ovarian cancer is sometimes called a “silent” disease — but in reality, the body often gives us clues. The tricky part is knowing what to look for. That’s why it’s so important to be familiar with the symptoms, know your risk factors and trust yourself if something feels off. Gynecologic oncologist Kellie Rath, MD, breaks down everything you need to know and explains how being aware can make all the difference.
Early symptoms are easy to miss
According to the American Cancer Society, more than 20,000 women in the U.S. are expected to be diagnosed with ovarian cancer in 2025. While ovarian cancers were thought to all start in the ovaries, researchers have learned that many actually begin in the fallopian tubes. Because of that, fallopian tube cancer and primary peritoneal cancer are now included under the umbrella of ovarian cancers.
Dr. Rath says one of the biggest challenges with diagnosing ovarian cancer is that its early symptoms often resemble those of other common issues like menstruation or indigestion.
The typical symptoms of ovarian cancer include:
- Pelvic or abdominal pain
- Changes in urination like going more frequently or feeling like you aren’t fully emptying your bladder
- Bloating and feeling full earlier when you eat
“The symptoms that people start noticing are very subtle, and it’s sometimes challenging to know exactly what’s going on,” says Dr. Rath. “You want to look for symptoms that are present most days of the week for a couple of weeks. If you have these symptoms and they’re just around your period and they go away and you totally feel normal for the rest of the month, it’s probably not cancer.”
The key thing to be aware of is persistence. Occasional bloating or discomfort happens to everyone. But when symptoms last longer than a couple of weeks or begin to interfere with your normal routines, it may be your body telling you something more serious is going on.
Why it’s called a “silent” cancer
Unlike breast cancer, there is no routine screening test for ovarian cancer — and that’s a big part of why it can be so difficult to catch early. “When we diagnose ovarian cancer, unfortunately it’s often in a more advanced stage,” Dr. Rath says. “There’s no great screening for ovarian cancer that helps us detect it earlier and many times symptoms are not present until after the cancer spreads outside the ovaries.”
This lack of a reliable screening tool is why doctors refer to it as a “silent” or “hidden” disease. “Pap smears don’t detect ovarian cancer,” Dr. Rath explains. “Pap smears are primarily used to screen for cervical cancer — a common misconception.”
To aid in detection, providers often recommend imaging tests such as a pelvic ultrasound or a CT scan of the abdomen and pelvis — tools that can offer valuable insights when symptoms or exam findings are concerning.
Risk factors you shouldn’t overlook
While ovarian cancer can affect any woman, certain factors can increase your risk, including:
- Age – Ovarian cancer is more common in women over 50.
- Starting your period early (around 12 years old) or starting menopause late (older than age 52).
- A personal or family history of melanoma, breast, ovarian, colon or prostate cancer.
- Genetic mutations like those in BRCA 1 and BRCA 2 genes and Lynch syndrome.
- Endometriosis.
“If you have a strong family history, particularly in a first-degree relative, it’s worth discussing genetic counseling or testing with your doctor,” urges Dr. Rath. Knowing the type of cancer and diagnosis age of your family member is helpful information to take to your healthcare provider when you start the conversation. Genetic testing can be a powerful tool for early detection and risk management, even in the absence of symptoms.
If you’re at risk or looking to lower your chances of developing ovarian cancer, there are several preventative steps you can take. Research shows that taking birth control pills may help reduce the risk. Maintaining a healthy lifestyle — including at least 120 minutes of cardio each week and a balanced diet — also plays a role in lowering cancer risk. Additionally, Dr. Rath recommends limiting alcohol consumption and avoiding smoking to further support overall health and prevention. If you’ve had a procedure, like a hysterectomy or surgical sterilization, or might in the future, this complete removal of the fallopian tubes can also greatly reduce the risk
Hope on the horizon
Despite its challenges, there is reason to be optimistic about the future of ovarian cancer care. New research is focused on targeted therapies, earlier genetic screening and greater awareness among providers.
“I’m incredibly hopeful that, with new drugs and targeted therapies, we’ll be able to keep ovarian cancer under control so people can live long lives with their disease,” says Dr. Rath. She adds that advances in personalized medicine and immunotherapy are helping specialists tailor treatment to each individual — offering better outcomes and fewer side effects.
When it comes to ovarian cancer, early detection can save lives. While there may not be a definitive screening test, there is one powerful diagnostic tool every woman can access: self-awareness and advocacy.
