Ovarian cancer: Subtle symptoms in younger women must not be overlooked
Among the early signs women should pay closer attention to are persistent bloating, reduced appetite, abdominal discomfort and a noticeable increase in abdominal size.
SUBANG JAYA - Ovarian cancer, long feared as a 'silent killer', is no longer a disease affecting only older women with cases now emerging among younger patients, often detected only after subtle symptoms are overlooked.
Subang Jaya Medical Centre (SJMC) consultant gynae-oncologist Dr Gibran Geh Hashim, said the biggest challenge in tackling ovarian cancer remains its elusive nature.
"Most of the time, there are no symptoms. Many women only find out during routine health screenings, when a doctor picks up something abnormal on an ultrasound scan," he said.
Even when symptoms do appear, they are often vague and easily dismissed.
"They may feel bloated or experience early satiety where they used to eat a full meal but now feel full after just a few spoonfuls. These are very non-specific symptoms and many people tend to brush them off as nothing serious," he added.
Younger women are not exempt
While ovarian cancer is more commonly associated with older women, Dr Gibran warned that younger individuals are also at risk.
"I recently operated on a patient who was only 24 or 25 years old. That’s very, very young," he said.
He said in that case, the patient sought help not because of severe symptoms, but due to a lingering sense that something was not right.
The patient, he said complained about a vague sense of discomfort in her abdomen, with on-and-off bloating.
Despite the absence of clear warning signs, he said the patient trusted her instincts and consulted a general practitioner (GP), which led to the referral and subsequent detection of the condition.
Subtle warning signs often ignored
Dr Gibran said tendency to overlook mild symptoms contributes significantly to late-stage diagnoses.
"By the time it becomes very symptomatic, it is usually already at a later stage," he said.
He said among the early signs women should pay closer attention to are persistent bloating, reduced appetite, abdominal discomfort and a noticeable increase in abdominal size.
"Some women might notice that their clothes feel tighter around the waist, possibly due to a growing cyst. They may not feel outright pain, just a sense of discomfort or something not being quite right," he said.
He said despite these warning signs, distinguishing ovarian cancer from less serious conditions remains difficult without medical evaluation.
He added that while specialist care is ideal, GPs can serve as an important first point of contact.
"Many GPs have access to basic ultrasound machines and can perform an initial scan or refer patients to a specialist if needed," he said.
No established screening method yet
Unlike cervical cancer, ovarian cancer still lacks a standard screening test, a gap that continues to hinder early detection.
"Unfortunately, there is no established screening method at the moment," he said.
He said although research is ongoing, including the development of blood-based detection methods, these are not yet widely available.
He added that there are studies looking into this, but it may take another five to 10 years before such tests become mainstream.
Currently, he said diagnosis relies heavily on imaging, particularly ultrasound scans, to identify abnormalities.
Genetics and underlying conditions matter
Dr Gibran said family history also plays a role in some cases.
He said if a family has a history of ovarian cancer, the risk may be higher.
"That is where genetic testing, such as BRCA mutation testing, comes in," he said.
Such testing can help guide families on their overall cancer risk and preventive measures.
He also highlighted a link between endometriosis and certain types of ovarian cancer.
"In some cases, endometriosis can transform into a cancer known as clear cell carcinoma. But it’s important to understand that not all endometriosis becomes cancer," he said.
Call for greater awareness
Dr Gibran said limited awareness and funding may also be contributing to the slow progress in early detection methods.
He said cancers affecting women’s reproductive organs are sometimes seen as niche and that may impact the level of attention and funding they receive.
He advised women of all ages to be more aware of their bodies and seek medical advice when something feels off.
Early checks can make all the difference, he added.
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