Ovarian Cancer: “The Silent Killer”
Ovarian cancer is known as “the silent killer” because early-stage symptoms are very subtle and easily overlooked. It is the gynecological cancer with the highest mortality rate — over 70% of cases are detected when the disease has already progressed.
In Vietnam, approximately 1,500 new cases of ovarian cancer are diagnosed each year. Understanding early warning signs and getting regular screening is the key to improving treatment outcomes.
Types of Ovarian Cancer
Ovarian cancer is classified based on the type of originating cell:
Epithelial cancer
Accounts for 90% of cases, arising from cells covering the ovarian surface. This is the most common type in postmenopausal women. Subtypes include: serous carcinoma (most common), endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma.
Germ cell tumors
Account for about 5%, commonly found in young women (ages 20-30). Better prognosis, responds well to chemotherapy.
Stromal tumors
Account for about 5%, arising from the connective tissue of the ovary. May produce abnormal hormones.
Early Warning Signs
Although early symptoms are typically nonspecific, if the following symptoms appear continuously for over 2-3 weeks and differ from your normal patterns, seek medical attention immediately:
Main warning symptoms
- Bloating and abdominal distension: Feeling of tightness and abnormal belly enlargement — the earliest and most common symptom
- Feeling full quickly: Feeling full after eating very little, loss of appetite
- Abdominal or pelvic pain: Dull, unexplained pain
- Frequent urination or urgency: Tumor pressing on the bladder
Other symptoms
- Changes in bowel habits (constipation or diarrhea)
- Unexplained persistent fatigue
- Lower back pain
- Unintentional weight loss
- Abnormal vaginal bleeding (especially after menopause)
- Pain during intercourse
- Abnormally enlarged abdomen (due to ascites — fluid accumulation)
Important note
These symptoms can occur in many benign conditions (digestive disorders, irritable bowel syndrome). However, the key difference is that they are new, persistent, and do not improve with standard treatment.
Risk Factors
Non-modifiable
- Age: Risk increases with age, highest in women over 50
- Genetics: BRCA1 mutation (40-60% risk), BRCA2 mutation (15-30% risk), Lynch syndrome
- Family history: Mother or sister with ovarian or breast cancer
- Ethnicity: Caucasian women have higher incidence rates
Modifiable
- Never having been pregnant or had children
- Late menopause (after age 55)
- Early puberty (before age 12)
- Prolonged hormone replacement therapy (HRT) after menopause
- Obesity
- Smoking (especially mucinous type)
- Prolonged fertility treatment (still debated)
Protective Factors (Reduced Risk)
- Pregnancy and breastfeeding: Each birth reduces risk by 10-15%
- Combined oral contraceptives: Use for over 5 years reduces risk by up to 50%
- Tubal ligation or hysterectomy (30-40% reduction)
- Extended breastfeeding
Screening and Diagnosis
Screening for average-risk women
Currently, no ovarian cancer screening method has been proven to reduce mortality in the general population. However, regular gynecological exams combined with ultrasound help detect abnormalities early:
- Regular gynecological exams every 6-12 months
- Transvaginal ultrasound when suspicious symptoms arise
Screening for high-risk women
Women with BRCA mutations or strong family history need active screening:
- Transvaginal ultrasound every 6 months (starting from age 30-35)
- CA-125 blood test every 6 months
- Genetic counseling and BRCA gene testing
- Consider prophylactic oophorectomy after completing childbearing plans
Diagnostic tests
- Ultrasound: Evaluates tumor size and structure (solid, cystic, mixed)
- CT scan or MRI: Assesses extent of spread
- Blood tests: CA-125, HE4, ROMA index (Risk of Ovarian Malignancy Algorithm)
- Biopsy: Final diagnostic confirmation (usually through surgery)
Treatment Methods
Treatment for ovarian cancer depends on the disease stage, histological type, and patient health:
Surgery
- Total hysterectomy, bilateral oophorectomy and salpingectomy
- Omentectomy, lymph node biopsy
- Maximum tumor debulking
Chemotherapy
- Standard regimen: Carboplatin + Paclitaxel
- Usually 6 cycles after surgery
- Neoadjuvant chemotherapy for advanced stages
Targeted therapy and immunotherapy
- Bevacizumab (anti-VEGF antibody)
- PARP inhibitors (Olaparib) — especially effective for BRCA mutations
- Immunotherapy (under research)
Ovarian Cancer Prevention
- Regular gynecological exams: Ultrasound detects ovarian abnormalities early
- Know your family history: Genetic testing if family members have had ovarian/breast cancer
- Maintain a healthy weight: Reduces the risk of many cancers
- Don’t smoke
- Breastfeed when possible
- Consult your doctor about oral contraceptives as a protective measure
Distinguishing Ovarian Cancer from Benign Ovarian Cysts
Many women are alarmed when an ultrasound reveals an ovarian mass. It is important to distinguish between benign cysts (very common) and cancer (less common):
Functional ovarian cysts (benign)
- Follicular cysts: Form during each menstrual cycle, usually resolve on their own
- Corpus luteum cysts: After ovulation, the corpus luteum may enlarge with fluid, resolving within 1-2 cycles
- Ultrasound features: Simple cyst, thin walls, clear fluid, usually under 5 cm
- Management: Monitor, repeat ultrasound after 1-2 menstrual cycles
Signs suspicious for malignancy on ultrasound
- Mixed mass (both solid and cystic components)
- Thick, irregular walls with papillary projections
- Multiple thick septations
- Ascites (abdominal fluid) present
- Doppler showing increased vascularity within the tumor
- Bilateral ovarian masses
When suspicious signs are found, the doctor will order additional CA-125, HE4 tests and possibly MRI or CT for evaluation before deciding on surgery. Read more about ovarian cysts for further information.
Prognosis by Stage
Ovarian cancer prognosis depends heavily on the stage at detection:
| Stage | Description | 5-Year Survival Rate |
|---|---|---|
| I | Confined to the ovary | 85-90% |
| II | Spread to the pelvis | 60-70% |
| III | Spread to the abdomen, lymph nodes | 25-40% |
| IV | Distant metastasis (lungs, liver) | 10-15% |
These figures highlight the critical importance of early detection. When detected at stage I, the 5-year survival rate reaches 90% — compared to only 10-15% at stage IV.
Living with Ovarian Cancer
For women undergoing or after treatment for ovarian cancer, long-term follow-up is essential:
- Regular follow-up visits: Every 3 months for the first 2 years, then every 6 months
- CA-125 testing to monitor treatment response and detect recurrence
- CT scan or MRI when recurrence is suspected
- Nutritional support: High-protein diet, plenty of vegetables and fruits
- Light exercise: Walking, yoga to improve physical fitness and mental health
- Psychological support: Counseling, cancer patient support groups
When to See a Doctor
See a gynecologist immediately if you experience:
- Persistent bloating for over 2-3 weeks not improving with digestive treatment
- Feeling full quickly, unintentional weight loss
- Abnormally enlarging abdomen
- Postmenopausal bleeding — always needs evaluation to rule out cancer
- Chronic pelvic pain of unknown cause
- Family history of ovarian or breast cancer — needs specialized screening
Related Articles
- Ovarian Cysts — Differentiating benign from malignant cysts
- Cervical Cancer Screening — Regular gynecological cancer screening
- What Exams Should Women in Their 30s Get? — Comprehensive health screening packages
- Cancer Screening Services — Gynecological cancer screening program at Phòng Khám Bác Sỹ Lâm
Doctor’s Advice
Dr. Lâm emphasizes: “With over 30 years of experience, formerly working at the National Cancer Hospital (Viện K Trung Ương), Hanoi Medical University Hospital, Hanoi Andrology Hospital, and Medlatec Hospital, I have witnessed many cases of late-detected ovarian cancer simply because seemingly minor symptoms were ignored. Ovarian cancer is frightening because it is silent, but it is not impossible to prevent. If you frequently experience bloating, feeling full quickly, or unexplained lower abdominal pain — don’t self-diagnose it as a digestive issue. Come in for a gynecological exam and ultrasound. Early detection can save your life.”
Don’t wait until symptoms are obvious — take the initiative to screen today.
Book a Screening
Taking the initiative to screen for ovarian cancer is the best way to protect your health.
Phòng Khám Sản Phụ Khoa Bác Sỹ Lâm
- Address: 125 Hàm Nghi, Kim Tân, Lào Cai
- Phone: 0986 321 000
- Hours: Monday – Saturday
Book now: 0986 321 000 — 125 Hàm Nghi, Kim Tân, Lào Cai
