Symptoms — the quiet cancer
Ovarian cancer rarely causes early symptoms, which is why it is often found at stage III. The warning signs are persistent rather than occasional: bloating that does not settle, feeling full quickly, pelvic or abdominal pain, and urinary frequency. Symptoms present most days for three weeks justify investigation with a pelvic ultrasound and CA-125 blood test.
- Persistent abdominal bloating or increase in girth
- Early satiety — feeling full after a few mouthfuls
- Pelvic pain or pressure
- New urinary urgency, or unexplained weight change
Diagnosis and staging
Ultrasound and contrast CT map the disease, CA-125 supports the diagnosis, and image-guided biopsy confirms the cell type. For advanced disease, diagnostic laparoscopy scores how much tumour is on the peritoneal surfaces, which decides between upfront surgery and chemotherapy first.
Surgery: completeness is everything
The goal of ovarian cancer surgery is CC-0 — no visible disease left behind. This can mean removing the ovaries, uterus, omentum and peritoneal deposits in a single operation. In selected patients, HIPEC is delivered at the end of surgery: chemotherapy heated to 42°C is circulated through the abdomen for 90 minutes to treat microscopic residual disease.
- Complete cytoreduction (CC-0) as the operative objective
- HIPEC in selected interval-debulking cases
- Fertility-sparing staging for carefully selected early cancers
- Integration with BRCA testing and targeted maintenance therapy
After treatment
Chemotherapy usually follows surgery, with targeted maintenance for BRCA-mutated or HRD-positive tumours. Follow-up tracks CA-125 and symptoms, with scans when indicated. Most patients return to normal activity within six to eight weeks of major cytoreduction.
Common questions
- Does a raised CA-125 mean I have ovarian cancer?
- No. CA-125 rises in endometriosis, fibroids, pelvic infection and even menstruation. It is a piece of the puzzle alongside ultrasound — not a diagnosis by itself.
- Is HIPEC available for ovarian cancer in North India?
- Yes — HIPEC is offered at Paras Health, Panchkula as part of the peritoneal surface malignancy programme, for appropriately selected ovarian, colorectal, appendiceal and mesothelioma cases.
- Can young women keep fertility with ovarian cancer?
- In carefully selected early-stage cases, surgery can remove one ovary and stage the cancer while preserving the uterus and the other ovary. This decision needs expert review of imaging and tumour markers.
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.