Bloating, back pain or needing to go to the toilet during the night are among the subtle symptoms that could be an early sign of ovarian cancer, a gynaecologist has warned.
The disease mostly affects older women over the age of 50, with more than half of all cases in the UK in those aged 65 and over - but although the risk increases with age, anyone with ovaries can get the cancer and it sometimes runs in families, according to the NHS. The symptoms of ovarian cancer are not always obvious, the health service says, meaning that it can often be diagnosed late.
Speaking to The Mirror, Dr Susanna Unsworth said that the disease often does not cause significant symptoms until it has already become advanced. However, the gynaecologist said that there are several subtle symptoms that could potentially be an early sign of ovarian cancer and urged anyone who experiences them to see their GP.
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"Many of the symptoms are subtle and do not mean that you have ovarian cancer," Dr Unsworth explained. "But it is worth having them checked out to hopefully exclude any underlying problem."
The doctor said that the "key symptoms" to look out for are bloating, pain, urinary symptoms, and a lump or swelling. Other warning signs to look out for include persistent indigestion, change in bowel habit (either constipation or diarrhoea), unexplained weight loss, persistent fatigue or abnormal vaginal bleeding.
When it comes to bloating, if you experience "new onset bloating, bloating that does not settle within two to weeks, bloating that is happening frequently without an obvious trigger, and bloating that is not resolving with the usual treatments/dietary changes", it's worth making an appointment to see your GP, Dr Unsworth advised.
Next, the expert said that patients should be wary of "a new pain in the pelvis, back or lower abdomen that does not quickly settle". And if you notice you are passing "urine more frequently or developed the need to get up during the night to pass urine", this could also be a warning sign.
In addition to these symptoms, you may experience a loss of appetite or feeling full quickly after eating. If you notice any lump or swelling in the lower abdomen or pelvis Dr Unsworth recommended seeing your GP straight away, although she added that this would be an "unusual" early sign.
If you do book an appointment with your GP, the gynaecologist suggested telling them you are concerned about ovarian cancer. "As a doctor it is much easier for me if I also know what you are worried about – that way I can assess the problem fully for you, making sure whatever is done has helped answer the questions you had," she explained.
In terms of what to expect when you visit the doctor, Dr Unsworth said: "After discussing the symptoms, your GP will likely want to do an examination. This will include an examination of your tummy, and may also include an internal vaginal examination as this is the best way to see if there are any swellings around the ovaries.
"In early ovarian cancer, often the examination will actually be normal, as there may not yet be anything to feel. Therefore, your GP will likely arrange other tests for you such as a pelvic ultrasound or Ca125 blood test looking for a protein known as a tumour marker."
She added: "Your GP may also want to arrange other tests as the symptoms of ovarian cancer can be fairly vague and can overlap with other conditions. This might include other blood tests to look for inflammation or potential causes of tiredness, or may also include tests of your poo to look for any bowel problems.
"If any of these tests raise any level of concern, your GP will refer you to see a gynaecology specialist to arrange further assessment. If the tests are normal, the likelihood of ovarian cancer is extremely low and other options to manage the symptoms can be recommended."
Dr Unsworth is NHS Community Gynaecology and Menopause Specialist, and the Founder of Cambridge Women’s Health Menopause Clinic and menopause supplement Meno8.
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