Is It Ovarian Cancer or Irritable Bowel Syndrome (IBS)?
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When ovarian tumors are diagnosed early, the odds of survival are good. Indeed, when the most common type of ovarian cancer is diagnosed before it has spread, or metastasized, five-year survival rates (a measure often considered indicative of a cure) are above 90 percent, according to the American Cancer Society (ACS).
The rub: Only 20 percent of ovarian cancers are discovered at an early stage, according to the ACS, because ovarian tumors are very difficult to detect.
One of the main reasons that early detection of ovarian cancer is so difficult is that we don’t have efficient screening tools for it, as we do for breast cancer, and its signs and symptoms are usually vague and nonspecific, says Marilyn Huang, MD, the director of gynecologic oncology at UVA Health in Charlottesville, Virginia.
Some of these signs — such as abdominal bloating, indigestion, nausea, and changes in bowel movements — overlap with and are often confused with the symptoms of a very common gastrointestinal problem: irritable bowel syndrome (IBS).
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What Are the Symptoms of IBS Versus Ovarian Cancer?
If you compare the symptoms of IBS and ovarian cancer, you’ll see why ovarian cancer sometimes gets mistaken for IBS in the beginning stages.
The symptoms of ovarian cancer include:
- Abdominal bloating
- Indigestion
- Nausea
- Pressure in your pelvis and back
- Decrease in appetite or feeling full soon after eating
- Unexplained weight loss
- Changes in bowel movements
- More frequent urination or urgency
Meanwhile, the symptoms of IBS include:
- Abdominal pain (often accompanying bowel movements)
- Changes in bowel movements
- Bloating
- Feeling of having incomplete bowel movements
- Whitish mucus in your stool
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IBS and Ovarian Cancer: Sorting Out Symptoms
Why are the symptoms so similar?
“The ovaries are attached to the uterus and dangle off the uterus, meaning they’re free-floating in the pelvis,” explains Dr. Huang. The small bowel also free-floats in the abdominal pelvic cavity. As an ovarian mass grows, it can become attached to the intestines and affect how they function, she explains.
Because of that, the initial symptom — one often ignored by women and even the initial providers they see — is a vague sense of pressure or discomfort in the abdomen, along with crampiness.
Another defining symptom of ovarian cancer that the two disorders share is bloating. In the case of ovarian cancer, it occurs as a result of fluid collecting in the belly. In the case of IBS, bloating may be triggered by what people consume, such as fiber-rich foods, fried fatty foods, and carbonated drinks. In each case, though, the bloating sensation is remarkably similar, notes the Gastrointestinal Society, a Canadian research organization.
With the overlap in symptoms, it can be hard to tell what’s causing them. But one clue may be whether the symptoms come and go or get progressively worse.
“Irritable bowel syndrome is a chronic problem, and its symptoms are intermittent,” says Adnan R. Munkarah, MD, the chief clinical officer of the Henry Ford Health System in Detroit. “Cancer is a disease where symptoms continue to progress.”
If you’re concerned about symptoms, your best bet is to talk to your gynecologist and ask if testing is necessary.
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Testing for Ovarian Cancer
Vague abdominal symptoms should raise suspicion, especially if you are a woman in her mid-fifties to early sixties, when ovarian cancer is most commonly diagnosed, according to The University of Texas MD Anderson Cancer Center. In this case, your gynecologist should be your first stop.
“Ovarian cancer [should] be considered as a possible diagnosis when a woman has these symptoms,” says Dr. Munkarah. “Proper radiologic imaging needs to be performed to rule out ovarian cancer before a woman is given the diagnosis of irritable bowel syndrome.”
The most common tools used to begin to evaluate whether ovarian cancer is present are an ultrasound and a blood test known as CA-125, which tests for proteins associated with ovarian cancer, per the ACS.
If those tests are negative, your doctor will discuss next steps — including whether you should be evaluated for IBS.
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