Article Authored By Dr. Nikhil Parwate, Associate Director – Surgical Gynae Oncology & Robotic Surgery, Aditya Birla Memorial Hospital

MUMBAI, 8 MAY, 2025 (GPN/ Dr. NIKHIL PARWATE) Each year on World Ovarian Cancer Day, we turn our focus to one of the deadliest cancers in women—one that often advances quietly and without warning. Ovarian cancer remains notoriously difficult to detect early, largely due to its vague symptoms and lack of standardized screening. What’s even more concerning is a growing trend I’ve observed over the years: an increasing number of younger women being diagnosed with this disease.

A Shifting Age Spectrum

Traditionally, ovarian cancer has been considered a condition of postmenopausal women. However, there’s an increasing trend of ovarian cancer in women in their 20s and 30s, particularly with epithelial ovarian cancers, which were once largely seen in older age groups.

Dr. Nikhil Parwate highlighted how he has encountered patients across an age range as wide as five to ninety-four. One remarkable case involved a 21-year-old who was carrying a 14 kg ovarian tumor, yet performed and won a Kathak dance competition just a week prior to surgery. It’s a powerful example of how silently this disease can grow, evading even the patient’s own awareness.

Why Early Detection Is So Elusive

The biggest challenge lies in the non-specific nature of ovarian cancer symptoms. Most women experience mild, often overlooked signs such as bloating, vague abdominal discomfort, or an unexplained increase in waist size. These are easily mistaken for digestive issues, hormonal imbalances, or even post-COVID lifestyle effects. Unfortunately, this leads many women to consult physicians from other specialties, like gastroenterology or pulmonology, rather than a gynecologic oncologist. As a result, the diagnosis often comes late—sometimes only during imaging conducted for unrelated reasons.

Not All Cysts Are Malignant—But Vigilance Is Key

Roughly half of all ovarian masses turn out to be benign. In fact, if 100 asymptomatic women were to undergo pelvic ultrasounds, as many as 90 might show some form of cyst or irregularity. Many of these are functional or hormonal cysts—especially in younger women—and don’t require aggressive treatment.

Still, it’s important to note that most ovarian cancers originate in the fallopian tubes and then spread to the ovaries and surrounding abdominal areas. A small proportion—under 5%—are secondary cancers, metastasized from other organs like the stomach or intestines.

The Screening Gap

Despite its severity, ovarian cancer lacks a global screening protocol, even for women with a family history of the disease. While there’s no need for panic, we recommend that women over the age of 40–45 consider a pelvic ultrasound every 2–3 years as a precautionary step. Most small (5–7 cm), simple cysts—especially if asymptomatic—can be monitored safely without immediate intervention.

Robotic Surgery- Precision With Promise

Robotic-assisted surgery is becoming a valuable tool in managing select ovarian cancer cases. In early-stage cancers or those that have responded well to chemotherapy, robotic surgery offers excellent outcomes, with benefits such as minimal blood loss, quicker recovery, and shorter hospital stays. In many cases, women are able to return to work within a week. However, this technique isn’t appropriate for all cases—especially not for those with large, bulky tumors at diagnosis.

Importantly, fertility preservation remains an option in appropriately selected patients—whether through robotic, laparoscopic, or open surgical approaches.

Nutrition: Supporting the Body Through Treatment

While there’s no universal “cancer diet,” good nutrition remains a cornerstone of treatment. We advise patients to focus on high-protein foods to prevent muscle loss, iron-rich meals to address anemia, and adequate calcium and hydration to maintain strength throughout therapy.

A Call to Awareness

Ovarian cancer is not a disease that announces itself loudly. In fact, it often goes unnoticed until it’s too advanced to treat easily. As I often say, “The ovary remains with the doctor,” emphasizing the need for regular gynecological check-ups and heightened awareness.

On this World Ovarian Cancer Day, our smessage is simple: while the disease may be silent, our awareness and response must not be. Timely evaluation, informed choices, and trust in medical guidance can go a long way in saving lives.