The Silent Killer: Understanding Ovarian Cancer, Listening to the Body's Overlooked "Gentle Warnings"

Among malignant tumors of the female reproductive system, there is one cancer known as the "silent killer" due to its hidden early symptoms and difficulty in detection—this is ovarian cancer. The lack of effective early screening methods means many patients are diagnosed at an advanced stage, posing significant challenges for treatment. However, understanding it and being vigilant about it is the first step we can take to protect our health.

01 What is Ovarian Cancer?

The ovaries are a pair of important reproductive organs in females, responsible for producing eggs and secreting estrogen and progesterone. Ovarian cancer is a malignant tumor originating from the epithelium, germ cells, or stroma of the ovaries. Epithelial ovarian cancer is the most common, accounting for about 85%-90% of all ovarian cancers, and is the primary focus of our discussion.

02 Why is it Called the "Silent Killer"?

• Hidden Location: The ovaries are deep within the pelvis, are small in size, and early-stage tumors are difficult to feel or perceive.
• Atypical Symptoms: Early symptoms are very vague and can easily be confused with digestive system disorders or common gynecological issues.
• Lack of Effective Screening: Currently, there are no precise, universally applicable early screening methods like the TCT/HPV tests for cervical cancer. The sensitivity and specificity of ultrasound and the tumor marker CA125 test for early detection are limited.

03 Be Alert to These Overlooked "Gentle Warnings"

Although the early symptoms of ovarian cancer are not obvious, the body still sends some signals. You should be highly alert if the following symptoms are new, persistent (lasting more than 2 weeks), and occur frequently:

Abdominal Discomfort & Digestive Issues: Bloating, abdominal pressure or pain, loss of appetite, indigestion, nausea.

Abdominal Swelling or Mass: Feeling that the waistline has increased, clothes feel tighter, sometimes feeling a mass in the abdomen

Pelvic Pressure Symptoms: Frequent urination, urgency to urinate (but without pain), constipation, or diarrhea.

Other Non-Specific Symptoms: Unusual fatigue, unexplained weight loss (advanced stages may include ascites), back pain, menstrual irregularities, etc.

Key Tip: When a middle-aged woman sees a gastroenterologist for "bloating, indigestion" and treatment is ineffective, she must consider a gynecological examination to rule out ovarian cancer.

04 Who is at High Risk?

• Understanding risk factors helps increase vigilance:
• Genetics & Family History: This is the strongest risk factor. About 15%-20% of ovarian cancers are related to heredity. Risk increases significantly if there is a family history (especially in first-degree relatives) of ovarian, breast, endometrial, or colorectal cancer. The main genes involved are BRCA1 and BRCA2.
• Age: Risk increases with age, most common in postmenopausal women, but women of any age can be affected.
• Reproductive Factors: Never having been pregnant or infertility, early menarche, and late menopause increase risk due to prolonged ovulation.
• Endometriosis: Women with endometriosis have an increased risk of specific types of ovarian cancer (e.g., clear cell carcinoma, endometrioid carcinoma).
• Lifestyle: Obesity and smoking may also be associated with certain types of ovarian cancer.

05 How is it Diagnosed and Treated?

1. Diagnosis:

• Gynecological Examination: The doctor palpates the uterus and ovaries via a bimanual exam.
• Imaging: Transvaginal ultrasound is the preferred method, providing clear images of the ovary's shape, size, and blood flow.
• Tumor Markers: Blood tests for CA125, HE4, etc. Note: CA125 elevation is not specific to ovarian cancer; it can also be raised in endometriosis, pelvic inflammatory disease, pregnancy, etc.
• Final Diagnosis: Relies on pathological examination of tissue obtained from surgery, which is the "gold standard."

2. Treatment:
Ovarian cancer treatment emphasizes standardization and individualization, typically using a comprehensive model based on "Surgery + Chemotherapy".

• Surgery: The goal is to remove all visible tumor as thoroughly as possible (called tumor debulking or cytoreductive surgery). This is the most critical factor affecting prognosis.
• Chemotherapy: Adjuvant chemotherapy is usually needed after surgery to eliminate remaining cancer cells.
• Targeted Therapy: For specific patients, such as those with BRCA gene mutations, maintenance therapy with PARP inhibitors has significantly improved survival outcomes for advanced patients.
• Others: Includes radiotherapy, endocrine therapy, etc.

06 How Can We Prevent It?

While it cannot be completely prevented, the following measures can significantly reduce risk:Prioritize Routine Gynecological Check-ups: Even without symptoms, an annual gynecological exam and pelvic ultrasound are crucial for detecting abnormalities.

Genetic Counseling & Testing: If there is a significant family history, consult a doctor about whether genetic testing (e.g., for BRCA genes) is needed.

Medication & Surgical Prevention:

Long-term use of oral contraceptive pills has been proven to reduce ovarian cancer risk.

For women who have completed childbearing, carry high-risk gene mutations, or have a very strong family history, prophylactic bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries) can be considered. This is currently the most effective preventive method.

Healthy Lifestyle: Maintain a healthy weight, eat a balanced diet, and exercise regularly.

Ovarian cancer is indeed frightening, but medical advances are gradually transforming it from a "terminal disease" into a potentially manageable "chronic condition." Faced with this "silent killer," we no longer have to wait passively. Actively acquiring knowledge, listening to our body's signals, maintaining regular check-ups, and managing known risks are the strongest defenses we can build for ourselves.

Remember, you are the primary person responsible for your health.

When your body sends unusual "gentle warnings,"

Be sure to give them the attention they deserve.