Ovarian Cancer Symptoms: A Guide for Young Women

Ovarian cancer???

Hello, Doctor: I am a 28-year-old unmarried female with no children.
I sometimes experience two menstrual cycles in a month.
I have previously taken birth control pills to regulate my cycle, but after finishing them, I only experienced severe pain without any improvement in my menstrual cycle (there is a family history of liver cancer).

Symptoms: Since I finished the birth control pills two weeks ago, I have been experiencing severe abdominal pain, bloating, nausea, vomiting, and loss of appetite.
At times, the pain is so intense that I cannot work during the day or sleep at night, although there is slight relief with heat application.
I have seen two gynecologists at a general clinic who performed ultrasounds and both said everything was normal, advising me to consult a gastroenterologist.
After seeing the gastroenterologist, I was told it might be gastrointestinal discomfort, but medication did not alleviate the severe pain.
Unsure of which specialty to consult, I visited a pain management clinic, where the doctor suggested I return to gynecology.
I then went to the Banqiao County Hospital to see a gynecologist again.
Another ultrasound was performed, and once again, everything was deemed normal.
However, after blood tests, it was discovered that I have endometriosis (as indicated by elevated levels in the blood test).
The doctor mentioned that having a child might improve the condition, and if the pain persists, they could only prescribe strong painkillers.
Later, I noticed that the symptoms of ovarian cancer are similar to what I am experiencing, and I still occasionally feel pain.
I would like to know if I should request another thorough gynecological examination to clarify what condition I might have.
Thank you for taking the time to read this letter, and I sincerely hope you can help me find answers.
Thank you!

Alley, 20~29 year old female. Ask Date: 2004/11/26

Dr. Shi Chengyang reply Obstetrics and Gynecology

Please consult at our hospital.

Reply Date: 2004/11/26

More Info

Understanding ovarian cancer symptoms is crucial, especially for young women who may be experiencing various gynecological issues. At 28 years old, you are in a demographic that typically has a lower risk for ovarian cancer, but it’s important to be vigilant about any concerning symptoms. Your symptoms of irregular menstruation, severe abdominal pain, bloating, nausea, vomiting, and loss of appetite warrant further investigation, especially since they have persisted despite previous medical evaluations.

Ovarian cancer can sometimes present with vague symptoms that are easily mistaken for other conditions, such as gastrointestinal issues or even menstrual disorders. Common early symptoms of ovarian cancer include:
1. Abdominal Discomfort: This can manifest as persistent bloating, pressure, or pain in the abdomen. You mentioned experiencing severe abdominal pain, which is a symptom that should not be ignored.

2. Changes in Appetite: Many women with ovarian cancer report feeling full quickly or experiencing a loss of appetite, which aligns with your symptoms of nausea and vomiting.

3. Menstrual Irregularities: While you have a history of irregular periods, any significant changes in your menstrual cycle should be evaluated.
4. Urinary Symptoms: Increased urgency or frequency of urination can also be a sign, although you did not mention this specifically.

5. Fatigue: Unexplained tiredness can accompany many conditions, including cancer.

Given your history of endometriosis, which was identified through blood tests, it’s essential to recognize that while endometriosis can cause similar symptoms, it does not rule out the possibility of ovarian cancer. Endometriosis can sometimes coexist with ovarian tumors, including endometriomas, which are cysts formed from endometrial tissue.

You have already undergone multiple evaluations, including ultrasounds and referrals to specialists. While these tests have not indicated any abnormalities, it is important to advocate for your health. If your symptoms persist or worsen, you should definitely consider requesting a more comprehensive evaluation. This could include:
- Repeat Ultrasound: Sometimes, changes in the ovaries can be subtle and may not be detected in initial scans. A follow-up ultrasound can provide more information.

- CA-125 Blood Test: This test measures the level of a protein that may be elevated in women with ovarian cancer. However, it is important to note that elevated CA-125 levels can also occur in benign conditions, including endometriosis.

- Pelvic MRI or CT Scan: These imaging techniques can provide a more detailed view of the pelvic organs and help identify any masses or abnormalities that may not be visible on ultrasound.

- Referral to a Gynecologic Oncologist: If there is a concern for ovarian cancer, a specialist in this field can provide a more thorough evaluation and discuss potential diagnostic procedures, including laparoscopic surgery if necessary.

In conclusion, while your symptoms may be related to endometriosis or another benign condition, it is crucial to remain proactive about your health. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion or request further testing. Early detection is key in managing any potential issues, including ovarian cancer. Your health and peace of mind are paramount, and you deserve thorough care and attention from your healthcare providers.

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