Unfortunately, most patients with ovarian cancer do not have any complaints, which explains why some have called this disease a “silent killer.”  Only after the cancer becomes very advanced does the patient complain of vague abdominal discomfort, pain, or distention.  Other symptoms may be back pain, weight gain, fatigue and gastrointestinal symptoms, such as gas.  There are no specific symptoms for ovarian cancer, and it is often confused with other illnesses.  In some fortunate cases, early ovarian cancers have been identified during a routine pelvic exam.  A physician usually feels an unusual mass during a rectal and vaginal exam. Subsequently, an ultrasound or CT scan is usually ordered which identifies a suspicious mass with a solid/cystic component.