Endometriosis vs. Cancer: How to Tell The Symptoms Apart

How to Tell the Difference

Ovarian cancer and endometriosis are two conditions that can affect a woman’s reproductive system. Understanding how they may be related and how they differ is important. Ovarian cancer is relatively uncommon, with approximately 20,000 new cases found annually in the United States and a lifetime risk of 1 in 78. At the same time, millions of women live with endometriosis, affecting up to 1 in 10. Because some symptoms overlap, recognizing the differences is essential for accurate diagnosis and proper treatment. This article explains how to tell the difference between ovarian cancer and endometriosis.

What Is Endometriosis?

Endometriosis occurs when tissue similar to the lining inside the uterus grows outside the uterus, including on the ovaries, fallopian tubes, and other organs in the pelvis and beyond. It can cause pain, infertility, and a range of other problems. Diagnosis can be suspected based on symptoms, blood tests, and various scans, but surgery is the only way to determine accurately whether endometriosis is present.

Symptoms of endometriosis can include painful periods, pain during sex, chronic pelvic pain, bloating and pain after eating, fatigue, and infertility.

What Is Ovarian Cancer?

Ovarian cancer is a type of cancer that begins in the ovaries and Fallopian tubes. It is often called the “silent killer” because it is difficult to detect in its early, more curable stages. As with endometriosis, a diagnosis can be suspected using scans and blood tests, but confirmation requires a biopsy, which is usually performed during surgery.

Symptoms of ovarian cancer can include bloating; pelvic pain or pressure; abdominal pain that is initially vague; difficulty eating or feeling full quickly; and urinary symptoms such as urgency or frequency.

The symptoms of these conditions are similar, but there are subtle distinctions and some clear differences in findings and presentation. When it comes to pain, both can cause pelvic and abdominal discomfort, but endometriosis-related pain often follows a cyclical pattern around the menstrual cycle, whereas pain from ovarian cancer tends to be more constant and dull, though endometriosis pain can be variable. With bloating, endometriosis may cause symptoms that come and go, often related to intestinal gas from inflammation and associated conditions such as small intestinal bacterial overgrowth (SIBO), while ovarian cancer can cause bloating due to gas and the accumulation of a fluid called ascites; this type of bloating typically worsens and does not fluctuate. Considering age, endometriosis is typically diagnosed during the reproductive years, whereas the most common type of ovarian cancer is usually found in women over 50, although endometriosis can persist into menopause and symptoms can even begin after menopause. Regarding family history, a family history of ovarian cancer increases risk and there are genetic links that can be tested for; endometriosis does not have a clear genetic link but does run in families. In terms of how symptoms unfold, endometriosis typically develops gradually over years, while ovarian cancer symptoms may appear more suddenly over weeks to months, with bloating that can be more pronounced and unremitting.

In general, ovarian cancer presents an immediate threat to life, while endometriosis presents a lifelong threat to quality of life, potentially spanning decades. The two can overlap because the risk of developing ovarian cancer in women with endometriosis is elevated by 1.5- to 3-fold. Although that increase is worrisome, it still represents a tiny percentage; however, even a fraction of one percent of millions of women translates to thousands or tens of thousands who may be affected. Expert opinion from a specialist and possibly genetic testing can help determine your risk. Research is underway to identify gene-driven biomarkers that could enable more accurate diagnosis.

It is important to remember that both endometriosis and ovarian cancer can share symptoms, and some women may have both conditions at the same time. If you are experiencing any of the symptoms described, speak with your healthcare provider. Many other conditions can cause similar symptoms, but if they persist and do not resolve, it is better to be cautious. For example, most people can have a bout of stomach flu with bloating, nausea, and painful diarrhea that typically passes within a few days to a week; symptoms lasting longer than that should be evaluated.

Navigating Specialist Care: Choosing the Right Expert for Endometriosis or Ovarian Cancer Concerns

Endometriosis and ovarian cancer are distinct conditions that affect the female reproductive system. While they share similarities such as pelvic pain, their differences can guide appropriate evaluation and treatment. Understanding these distinctions helps you and your doctor pursue the right diagnosis and care plan.

Getting an expert opinion from a specialist can be critical to getting on the right path for diagnosis and treatment. In most cases, a general gynecologist can point you in the right direction. If concerns are not addressed and endometriosis seems most likely, an endometriosis specialist may be the best next step. If both endometriosis and ovarian cancer are concerns due to your symptoms, age, or family history, consulting a gynecologic oncologist may be more appropriate or serve as an additional opinion. There are a few gynecologic oncologists who truly specialize in both endometriosis and ovarian cancer.