Ovarian Cancer: Why It Is Called a Silent Killer and How It Can Be Prevented

Ovarian cancer is a highly significant and life-threatening disease for women, affecting countless women around the world every year. Despite advancements in medical science, this cancer is still referred to as a “silent killer.” The reason is that in its early stages, ovarian cancer often presents no clear symptoms, or if symptoms appear, they are so common and vague that women tend to ignore them, assuming they are minor physical issues. As a result, in most cases, the disease is diagnosed very late—by the time it has already spread to other parts of the body, making treatment more complicated.

What Is Ovarian Cancer?

Women have two ovaries on either side of the uterus. These ovaries produce eggs and regulate hormone secretion. When the cells in the ovaries begin to grow abnormally and uncontrollably, they form a tumor. If the tumor is cancerous, it becomes ovarian cancer. There are different types of ovarian cancer, such as epithelial ovarian cancer, germ cell tumors, and stromal tumors. Among these, epithelial ovarian cancer is the most common.

How Does Ovarian Cancer Occur?

Ovarian cancer originates in the ovaries—an essential part of the female reproductive system. The ovaries produce eggs and secrete hormones like estrogen and progesterone. For various reasons, if ovarian cells begin to grow abnormally and form a tumor, it may develop into ovarian cancer.

Statistics

Compared to many other countries, the scenario of ovarian cancer in Bangladesh is quite different—mainly due to a lack of awareness. There is a shortage of necessary diagnostic equipment and trained medical personnel as well.

·         Ovarian cancer is one of the leading causes of cancer-related deaths among women worldwide.

·         Every year, approximately 300,000 new cases are diagnosed, and around 200,000 women die from this disease.

·         In developed countries, the mortality rate is lower because the disease is detected at an early stage.

·         In Bangladesh, ovarian cancer ranks third among cancers affecting women—after breast cancer and cervical cancer.

·         Due to late diagnosis, the death rate in Bangladesh is higher than in many other countries.

·         According to the 2020 Cancer Registry of the National Institute of Cancer Research and Hospital, ovarian cancer is most commonly diagnosed among women aged 45 to 54.

In many rural and remote areas of Bangladesh, death rates continue to rise due to lack of awareness and limited access to proper healthcare.

Why Is Ovarian Cancer Called a Silent Killer?

1. Early symptoms are vague:

In the initial stage, symptoms such as bloating, abdominal discomfort, indigestion, mild abdominal pain, loss of appetite, or feeling full too quickly resemble very common digestive issues. As a result, many women do not take these symptoms seriously.

2. Difficult to detect through screening:

Unlike breast cancer or cervical cancer, there is still no reliable and widely used screening test for ovarian cancer. Ultrasound or CA-125 blood tests may be helpful, but they are not 100% reliable.

3. Spreads quickly:

Since the ovaries are located deep within the abdomen, even when the tumor grows gradually, it remains unnoticed for a long time. Consequently, the cancer may spread to other organs such as the uterus, fallopian tubes, liver, or intestines.

4. Pain or noticeable symptoms appear late:

In the early stages, there is usually no pain or significant discomfort. By the time pain begins, the disease has often reached the middle or advanced stage.

Risk Factors of Ovarian Cancer

Although any woman can develop this disease, certain factors significantly increase the risk—

·         Age: Women over 50 are at higher risk.

·         Family history: If the mother or sister has had cancer, the risk doubles.

·         Genetic mutations: Especially BRCA1 and BRCA2 gene defects.

·         Reproductive issues: Long-term irregular menstruation or not having children.

·         Hormone therapy: Long-term use of hormonal medications.

·         Obesity or unhealthy lifestyle.

What Are the Early Symptoms?

Although the symptoms are vague, if the following signs appear repeatedly, they should not be ignored—

·         Abdominal bloating or swelling

·         Feeling full after eating a small amount

·         Lower abdominal pressure or pain

·         Persistent indigestion

·         Sudden weight loss

·         Frequent urge to urinate

·         Constipation

·         Irregular menstruation

·         Pain during intercourse

If these symptoms occur 3–4 days a week and persist for 1–2 weeks, it is essential to consult a doctor.

Diagnosis of Ovarian Cancer

The following tests are generally used to diagnose ovarian cancer:

Pelvic Examination:

A gynecologist performs a physical examination of the lower abdomen to detect abnormalities.

Ultrasonography:

Creates images of the ovaries using sound waves. Helps detect tumors or abnormalities and determine if there is fluid (ascites) inside the abdomen.

CT Scan or MRI:

Provides detailed images of the ovaries and surrounding organs. Helps determine how far the cancer has spread and assists in cancer staging.

Blood Test:

CA-125 protein levels are measured. High levels may indicate ovarian cancer. This test also helps track disease progression during treatment. However, some patients may have normal CA-125 levels even with cancer.

Histopathology:

A tissue sample from the ovary is examined under a microscope. This is the most reliable method to confirm ovarian cancer. Typically, diagnosis is made from tissue collected after surgery rather than by core biopsy or FNAC.

These tests help identify the cancer type, stage, and extent of spread.

Treatment of Ovarian Cancer

Treatment depends on the patient’s condition, cancer stage, and tumor characteristics. The following approaches are commonly used—

1. Surgery

The most important treatment. Surgery involves removing the ovaries, fallopian tubes, uterus, and affected areas. In advanced stages, cancer may be removed from other abdominal organs as well.

2. Chemotherapy

Given before or after surgery. It is very effective in destroying cancer cells.

3. Targeted Therapy

Works by targeting specific genes or proteins. PARP inhibitors are effective for patients with BRCA mutations.

4. Hormone Therapy

Used for certain types of ovarian cancer.

5. Immunotherapy

Helps activate the body’s immune system to fight cancer.

Prevention and Risk Reduction

Although ovarian cancer cannot be completely prevented, several measures can reduce the risk—

1.      Childbirth and breastfeeding: Studies show that women who have children and have breastfed have a lower risk.

2.      Birth control pills: In some cases, taking oral contraceptive pills under medical guidance may reduce the risk.

3.      Healthy lifestyle: Balanced diet, regular exercise, maintaining healthy weight, and avoiding smoking lower cancer risk.

4.      Genetic testing: Women with a family history of cancer can undergo BRCA gene testing.

5.      Regular gynecological check-ups: Even without symptoms, women should visit a gynecologist at least once a year.

Conclusion

Ovarian cancer is truly a silent killer—because it remains hidden in the body for a long time and shows minimal symptoms in the early stages. The good news is that if detected early, the chances of successful treatment are much higher. Therefore, women should stay aware of their bodies, undergo regular check-ups, and seek medical attention promptly if any unusual symptoms persist. With awareness, early diagnosis, and modern treatment, ovarian cancer can be successfully defeated.