Ovarian cancer is difficult to detect in its early stages, often diagnosed only when it has already reached an advanced stage, contributing to its high mortality rate. Gastroenterologist Dr. Yip Ping-wai shared a case of a woman in her 50s who experienced abdominal pain and diarrhea, initially dismissed as gastroenteritis. Blood tests and an ultrasound showed no abnormalities, but a subsequent CT scan revealed Stage 3 ovarian cancer with peritoneal metastasis. The doctor emphasized that the late-stage diagnosis occurred because three key symptoms were ignored.
Appearing on the program "Doctor's Hot," Yip recalled that when the woman first visited his clinic, he also suspected simple gastroenteritis and told her she likely wouldn't need a follow-up if she improved. A week later, the woman returned for a check-up. While her diarrhea had significantly subsided, she still felt some persistent, nagging abdominal discomfort. Yip then ordered blood tests and an ultrasound, scheduling another follow-up in a week to review the results.
The woman felt her symptoms were about 80% better, but came back for her scheduled appointment in the third week just in case. Her blood work came back completely normal. However, during a physical exam, Yip detected a tender spot upon palpating her abdomen. He recommended a CT scan, which delivered a shocking diagnosis: Stage 3 ovarian cancer that had already spread to the peritoneum.
Yip explained that the ovarian tumor had metastasized to the abdominal wall, causing "metastatic pain" which generated her symptoms. Because the tumors on the abdominal wall weren't very large, and because gas in the intestines can obscure ultrasound images, the earlier scans failed to detect the cancer.
Obstetrician-gynecologist Dr. Cheng Shing-kit added on the same program that early symptoms of ovarian cancer—including lower abdominal bloating, mild pain, and indigestion—are nearly identical to common digestive issues. This is why over 70% of ovarian cancer patients are diagnosed at Stage 3, when survival rates are low. He stressed that seeking medical attention promptly upon noticing any abnormalities is crucial for improving survival chances and that delays must be avoided.
According to Hong Kong's Hospital Authority, because the ovaries are located deep within the pelvic cavity, early-stage ovarian cancer symptoms are often subtle. Additional symptoms to watch for include:
The Hospital Authority notes that some medical theories suggest that the rupture and repair of ovarian tissue during each ovulation cycle could trigger abnormal cell growth. Others believe the hormonal surge during ovulation may stimulate the growth of abnormal cells. However, the exact causes of ovarian cancer remain unclear, but certain factors increase a woman's risk:
Yip warns that while most abdominal pain cases are due to common issues like gastritis, ulcers, constipation, or gas, it's crucial to be vigilant about the possibility of cancer in certain patients. This is especially true for older individuals experiencing significant weight loss, poor appetite, and persistent, unexplained symptoms lasting a long time. Pancreatic, gastric, colorectal, liver, and other abdominal cancers can all cause abdominal pain
