Every year, thousands of women in India are diagnosed with ovarian cancer, often at an advanced stage, when treatment becomes more difficult and survival rates decline sharply. Unlike breast or cervical cancer, ovarian cancer does not have a widely effective screening test, and its symptoms are frequently mistaken for routine gastric, hormonal or menstrual issues. This is why doctors often refer to it as the 'silent killer'.
On World Ovarian Cancer Day, experts are urging women to pay closer attention to persistent bodily changes and seek medical help early, especially if symptoms continue for weeks.
'Ovarian cancer rarely shows signs in the initial stages'
Ovarian cancer begins in the ovaries, the reproductive glands responsible for producing eggs and hormones. According to oncologists, one of the biggest challenges is that the disease rarely causes dramatic symptoms in its early stages.
Instead, women may experience vague signs such as bloating, abdominal discomfort, feeling full quickly, unexplained fatigue, back pain, urinary urgency, or changes in bowel habits.
Because these complaints are common and non-specific, many women ignore them or are treated initially for digestive disorders.
“Ovarian cancer presents with persistent symptoms that are typically misattributed to benign gastrointestinal or urinary conditions. One of the key challenges in early detection is the absence of a reliable population-level screening initiatives comparable to mammography for breast cancer or Pap smears for cervical cancer. Unlike cervical cancer, which can be detected through Pap smears and HPV testing, ovarian cancer does not yet have a reliable screening tool for the general population. Present tools, such as CA-125 and transvaginal ultrasound, have limitations in sensitivity and specificity for early-stage disease. This raises the necessity of timely recognition of symptom patterns, risks, and early gynaecological evaluation, which will also improve outcomes in ovarian cancer," says Dr Richa Bansal, Consultant Gynaec Oncology, Laparoscopic & Robotic Surgery, Apollo Hospitals, Navi Mumbai.
In India, many patients reach hospitals only after the cancer has spread within the abdomen. Specialists say awareness remains low, particularly among women who dismiss symptoms as part of ageing, menopause, stress or dietary issues.
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Ovarian cancer is among the leading gynaecological cancers affecting Indian women. According to estimates from the Global Cancer Observatory (GLOBOCAN), India reports tens of thousands of new ovarian cancer cases annually, with mortality remaining high because of delayed diagnosis.
Urban cancer registries have shown a gradual rise in incidence, especially in metropolitan regions. Doctors partly attribute this to lifestyle changes, delayed pregnancies, lower fertility rates, obesity, and increasing life expectancy.
Who is at risk of ovarian cancer?
While ovarian cancer can affect women at any age, the risk increases after menopause. Family history also plays a major role. Women with mutations in the BRCA1 and BRCA2 genes, commonly associated with breast cancer, have a significantly higher lifetime risk of developing ovarian cancer.
A family history of ovarian, breast, colorectal or endometrial cancer may indicate inherited cancer syndromes. Doctors say women with strong family histories should consider genetic counselling.
Other factors associated with increased risk include increasing age, obesity, endometriosis, never having been pregnant, hormone replacement therapy, and smoking.
At the same time, experts stress that having risk factors does not necessarily mean a woman will develop cancer.
How to diagnose ovarian cancer?
Tests such as ultrasound scans and CA-125 blood markers may help in evaluation, but they are not considered accurate enough for mass screening because benign conditions can also raise these markers. As a result, doctors emphasise symptom awareness and timely medical evaluation rather than routine screening for all women.
Standard treatment for ovarian cancer usually involves surgery combined with chemotherapy, and in recent years, targeted therapies and maintenance treatments have expanded options for patients.
PARP inhibitors, for instance, have shown promise in women with BRCA mutations and certain advanced cancers by helping delay recurrence. Immunotherapy is also being explored in selected cases.
Experts say personalised treatment based on tumor biology and genetic testing is increasingly shaping ovarian cancer care.
Doctors say one of the most important messages on World Ovarian Cancer Day is that persistent symptoms should not be ignored.
"Symptoms that occur almost daily for more than two to three weeks, especially bloating, pelvic pain, abdominal swelling, difficulty eating, or urinary symptoms deserve medical attention. For many women, early diagnosis can make a life-saving difference," says Dr Ramesh Shah, a family physician based in Mumbai.
As awareness around women’s cancers grows in India, specialists hope ovarian cancer will no longer remain a disease diagnosed only in its later stages.
Until science develops an effective screening tool, awareness and timely care remain the strongest weapons against this silent disease.
