Do you suspect yourself of having ovarian cancer? Read more to find out about the symptoms that ovarian cancer can cause!
This tumor is a female cancer that is usually detected at an advanced phase because it does not cause any outward bleeding. The symptoms usually only appear when the tumor is very big. If cancer is limited to the ovary, there may be several ways to detect it.
Situation 1: Before It Produces Symptoms, the Gynaecologist Detects Ovarian Cancer in the Pelvic Exam
In women who carry out their periodic reviews, ultrasound made by the doctor can determine if their ovaries are healthy. Sometimes, large cysts or masses in one of the ovaries are observed, requiring more tests, to eventually diagnose an ovarian cancer.
The feeling of having a swollen abdomen and even the possibility to palpate a mass in
the area of the ovaries is typical of tumors, that have already acquired a considerable size, at least the size of a tennis ball. In the abdomen, especially if the woman is overweight or obese, ovarian cancer can be hidden, unnoticed. These ovarian tumors can even weigh several kilos.
The ovary is a structure that is literally hanging from the fallopian tubes and ligaments that attach it to the surface of the pelvis. Through these structures, ovary gets the blood through the arteries, something that is essential to properly oxygenate. If the tumor is a medium-large size, ovary can be twisted with the movements of the woman, strangling the blood supply and therefore starting to suffer from lack of oxygen. This can cause death of cells in the ovary. When this cell death begins, the ovary starts to hurt. It is a pain that increases in intensity, often encourage visits to the Emergency Department.
If the tumor grows a lot and forward, it can push into the bladder. If ovarian cancer simply pushes the wall, then there is no problem. However, if it breaks the bladder wall, blood might appear in the urine producing symptoms of cystitis and staining urine red (phenomenon called hematuria). This only occurs in very advanced tumors. Before breaking the bladder wall, ovarian cancer can cause crushing of the entry into the bladder of one or both tubes that bring urine from the kidneys, the ureters, so that urine can no longer be ejected. Pressure in the kidney will increase, and hydronephrosis occurs. If we do not realize that in time, we may lose a kidney or both.
If the tumor prefers to grow backwards as their neighbours are the rectum and sigmoid colon, (the final sections of the large intestine where the feces accumulate before being expelled through the anus). When the ovarian cancer pushes them, it will make transit of stool more difficult which lead to constipation. It is very uncommon for a woman that her constipation is motivated by an ovarian cancer, but we must always take into account all our symptoms to discuss them with our doctor and let him have all the data.
When the tumor is already outside the ovary, maybe it is because it has followed one or moreof these three different ways:
- The tumor breaks the peritoneal membrane and spreads throughout the abdomen
- tumor escapes through the lymphatics
- tumor enters the blood
Ovarian cancer can spread through the peritoneal cavity, which is a virtual cavity lined by the peritoneum to enable frictionless movement of the abdominal viscera. If cells of ovarian cancer enter the peritoneal cavity because the tumor has grown and has broken the peritoneum covering the ovary, these cancer cells start to “swim”. It can be found anywhere in the abdomen. Groups of cells will grow and will even cause symptoms of peritonitis with diffuse abdominal pain. This even can cause cessation of movement through the intestine because it is compressed from the outside. Cancer cells can colonize the liver from the outside, irritating the capsule that surrounds it and causing a localized pain in the upper right abdomen.
Situation 2: The Tumor Has Escaped Through the Lymphatic Vessels
Ovarian cancer can leave the pelvis into the surrounding lymphatic chains. These nodes full of tumor cells often cause no symptoms. Seldom, when there is a large involvement of lymph nodes especially on one side of the pelvis, the rise of lymph fluid may be interrupted. These liquids will remain in the leg. That leg then will increase in thickness (lymphedema).
When cancer breaks a blood vessel near the tumor and access blood, tumor cells travel throughout the body. In places where due to their special conditions, they like to stay and live, these cells leave the blood vessel and settle, growing and multiplying.
In the case of ovarian cancer, the most common sites where metastases appear are:
- Within the Liver – When ovarian cancer cells are established within the liver where they have arrived through blood, they begin to grow wildly and begin to crush live cells. When broken, the contents of these liver cells, which are transaminases, will get into the blood, thus increasing their levels (as detected in a blood test). If metastases compress small channels that lead bile within the liver, the amount of bilirubin may increase in the blood. This can make the woman get a yellow tint in her skin (phenomenon called jaundice).
- In the Lungs – When tumor cells start living within the lungs, they usually form separate groups, eventually appearing multiple metastases, which will gradually grow. If they cancel enough lung function, this can cause difficulty breathing (a symptom called “dyspnoea”). If they touch a breathing tube (bronchus or their branches), this will irritate them producing a very troublesome dry cough, very difficult to alleviate. If they are placed near a blood vessel, this vessel can break giving a little blood with that cough.
- In the Bones – If tumor cells grow inside bone, when metastases become very large they can break the layer that covers bone: the periosteum. It has great sensitivity, causing pain. This growth compromises bone strength and especially if bone has to bear weight, it may break. A special case of bone metastases occurs when they affect vertebrae. It may cause a back pain and even when the vertebrae breaks, it can cause neurological symptoms that fall into the spinal cord compression syndrome, which is an oncologic emergency.
As you can see, ovarian cancer can cause the appearance of many signs and symptoms.