Ovarian cancer kills around 13,000 women in the United States annually, according to the National Cancer Institute (NCI), with nearly 20,000 new diagnoses each year. Yet doctors don’t typically bring it up at routine checkups, and women aren’t told to watch out for warning signs, as they are for breast cancer — in part because ovarian cancer appears in ways that can be difficult to pin down.
The lack of awareness can lead to confusion, fear, and all kinds of misconceptions. Combating misinformation can make all the difference in detecting and surviving the disease.
“Ovarian cancer is a hard disease to treat, and we can be much more successful if we catch it early,” says Jolyn Taylor, MD, assistant professor in the department of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center in Houston.
Here are a few of the most common ovarian cancer myths and the facts.
Myth: The Symptoms Are So Subtle, You Won’t Notice Until It’s Too Late
While it’s true that the symptoms of ovarian cancer can feel like other common sensations, certain changes in your body can be a sign that you should talk to your doctor.
“Ovarian cancer symptoms are subtle and can be attributed to other medical disorders, but what seems to be consistent is that women will report a change in how they’re feeling that occurs most days,” says Dr. Taylor. “You might feel very bloated, or can’t eat much because you feel too full.”
Another potential sign: an unusual cramp or new sense of heaviness. “Some women can press on their abdomen and feel something different, but sometimes you can’t feel something by pressing on it. You might also notice your pants or clothing fit a bit tighter,” she adds.
Changes to your bowel habits, such as more constipation than usual, more frequent heartburn, pain during intercourse, or an ache in your back, abdomen, or both, are other symptoms to note, says Taylor. She advises talking to your doctor “if you’re having [a symptom] most days and it’s happening consistently for over two weeks.”
Bleeding between periods, heavier menstruation, or irregular cycles are other reasons to speak to a doctor, notes the Cleveland Clinic, although those symptoms often have different causes, including other types of cancer, such as endometrial cancer.
Keeping a watch on changes can mean the difference between early and late detection of ovarian cancer or another underlying cause.
Myth: Your Annual Ob-Gyn Exam Will Catch Ovarian Cancer
“One of the most common misconceptions is that a Pap smear screens for ovarian cancer,” says Taylor. A Pap smear only screens for cervical cancer; there is currently no comparable test for ovarian cancer.
Given these limitations, it’s important to talk to your doctor about any consistent physical discomfort or changes you’re noticing. “Even if you’ve been seeing your doctor regularly and having Pap smears, if something feels new or different or wrong, listen to your body and go in to see your health professional,” says Taylor.
After discussing your symptoms, family history of cancer, and other risk factors, a gynecologist might start by doing a pelvic exam, and may prescribe blood work and an ultrasound or other imaging to look for suspicious growths. Your doctor may consult a gynecologic oncologist to take a closer look at the findings.
The specialist can then decide whether to do “something as invasive as surgery to be 100 percent sure if there’s ovarian cancer,” says Taylor.
Myth: Ovarian Cysts Are a Type of Ovarian Cancer
“Having an ovarian cyst does not mean you have ovarian cancer,” says Taylor. “A cyst in your ovaries is common and, in most situations, normal.”
Most ovulating women form cysts, small sacs filled with fluid, in their ovaries every month. Known as functional cysts, these are benign and usually disappear on their own. Other types of benign cysts can form around the ovaries too, and often go away without treatment.
When ovarian cancer develops, it’s often in the outside surface cells of the ovaries, known as epithelial cells, where most malignancies are found. It can also develop in the cells that form the eggs, the cells that create estrogen and progesterone, or the fallopian tubes.
The malignant ovarian cysts that characterize ovarian cancer are rare, and only 13 to 21 percent of ovarian cysts that are removed are cancerous, according to research.
Unusual symptoms can be a sign of a cyst that needs to be examined more closely and potentially removed, especially if a patient has other risk factors, such as family history or age (postmenopausal women are at highest risk).
“If you have an evaluation done because you’re feeling abnormal and they find a cyst, then you should have a conversation to see if there’s anything abnormal going on,” advises Taylor.
RELATED: Ovarian Cancer Resources: Information and Support
Myth: No Family History Means You’re in the Clear
Only about one-tenth of ovarian cancers are attributed to family history. Having the genetic mutations BRCA1 or BRCA2 does significantly raise the risk, but those mutations are responsible for only up to 15 percent of ovarian cancers, according to a study.
So what’s the most common reason women get ovarian cancer?
While a woman’s risk of getting ovarian cancer is about 1 in 78, according to the American Cancer Society (ACS), “most of the time we don’t know what caused it,” says Taylor.
Age is one risk factor: About one-half the women diagnosed with ovarian cancer are 63 or older, the ACS explains.
Having endometriosis, which affects about 10 percent of women, can also raise the chances of getting ovarian cancer, says Taylor, but it only increases risk slightly. Around 2 percent of women who have the disease will develop ovarian cancer, according to a report in The Lancet.
RELATED: Ovarian Cancer: Understanding Genetic Testing
Myth: Talcum Powder Causes Ovarian Cancer
Lawsuits linking talcum powder to ovarian cancer have led to big settlements with companies that use the ingredient in bath and baby products. But while a large study published in 2020 did find a slightly greater incidence of ovarian cancer in women who had reported using talcum powder in the past, the National Institute of Environmental Health Sciences and the NCI concluded the link is not statistically significant. The report from 2020 was based on four studies that looked at a total of more than 250,000 women.
“Among women from four prospective cohorts, there was not a statistically significant association between use of powder in the genital area and ovarian cancer,” the report stated, but added that the findings did not rule out “a small increase in risk” from using talcum powder.
Myth: Ovarian Cancer Is Incurable
About 80 percent of ovarian cancers are discovered in the late stages, according to the ACS, which tend to have worse outcomes. That can scare women away from seeing their doctor, for fear of a diagnosis.
But ovarian cancer can be cured, especially when it’s detected early. “Early-stage actually has a good prognosis,” says Taylor, with a five-year survival rate of 92.4 percent, according to the ACS.
Even certain late-stage ovarian cancers can have good treatment outcomes, depending on a variety of factors. New targeted therapies are helping women with late-stage ovarian cancer live longer, and patients who don’t respond to one of the therapies may have success with another.
“There is a chance of survival for stage 3 to 4,” adds Taylor. According to the NCI, when all stages are grouped together, about 50 percent of women diagnosed with ovarian cancer are still alive after five years.
Because early detection plays a key role in survival, the most important advice, says Taylor, is “empowering women to know that if you feel like something is wrong, believe yourself. Ask your doctor about it.”
