Ovarian cancer is the third most common cancer among women in India. And yet, most women who are eventually diagnosed with it will tell you the same thing: they had symptoms for months before anyone took them seriously. Approximately 70 to 80 per cent of ovarian cancer patients in India are diagnosed at advanced stages, not because the disease is impossible to catch earlier, but because its early signs are easy to explain away as something else entirely.Why it's called the silent diseaseOncologists have long referred to ovarian cancer as a "silent disease" because of how quietly it can progress without obvious, alarming signs.Dr Sampada Desai, Consultant Gynaecological Cancer and Robotic Surgeon at P. D. Hinduja Hospital, Khar, draws an important distinction: "Ovarian cancer is often called the silent cancer. But it is not silent, it whispers. The symptoms of ovarian cancer are usually very nonspecific. Though the ovary is a pelvic organ, most of the symptoms of ovarian cancer are upper abdominal or digestive system-related. This includes feeling full too early, bloating, upper abdominal discomfort, and poor digestion."That's the crux of why so many cases go undetected until late. The body is sending signals, but they're signals that could just as plausibly come from a digestive issue, PCOS, or a hormonal fluctuation. Women tend to file them under "I'll keep an eye on it" — and that window quietly closes.The symptoms that warrant attentionPersistent bloating is the one that comes up most consistently. Dr Shona Nag, Director of Oncology at Sahyadri Super Specialty, Hadapsar, Pune, notes that "most patients say that they experience extreme fullness even when consuming smaller portions of food." When bloating is continuous and accompanied by lower abdominal or pelvic pain that either recurs or steadily worsens, that combination warrants a visit to a doctor rather than a wait-and-see approach.Changes in menstrual patterns, heavier or lighter bleeding, irregular cycles, or any bleeding after menopause, are another set of symptoms that carry weight here. As Dr Nag explains, "irregular hormonal activity is normal for many women; however, continuous irregularities require professional attention." The same logic applies to unusual vaginal discharge. Discharge that is persistent, has an odour, appears bloody, or occurs post-menopause should not be quietly endured and attributed to nothing.The two-week ruleBoth doctors interviewed for this piece offer a practical framework that's worth remembering. Dr Desai advises that "individuals who experience these symptoms should keep a record for a month. If any of the symptoms last more than two weeks or occur more than 12 days a month, one should consult a gynecologic oncologist." Dr Nag similarly recommends that "should symptoms occur regularly during at least two or three weeks, one needs to address a doctor who will help diagnose a disease."Who should be especially alertWomen with a family history of ovarian, breast, or colon cancer carry a higher genetic risk and should be more proactive about monitoring and discussing these symptoms with a specialist. Dr Nag is direct on this point: "women with family history of ovarian, breast, or colon cancers need to pay close attention to their health, particularly because their genetic predisposition increases chances of developing cancer."What the evaluation looks likeThere is no routine screening test for ovarian cancer in the way there is for cervical or breast cancer. That absence makes symptom awareness all the more critical. As Dr Desai explains, "the evaluation of these symptoms may include clinical examination by a doctor, an ultrasonography, and blood tests, which measure something called a tumour marker. Early detection is an effective strategy to improve survival in cancer. There's no routine screening test for ovarian cancer, and subtle signs are often the only clues. This makes awareness incredibly important. It's said that ovarian cancer whispers. And listening to this whisper may help in early detection."That last point is the one worth sitting with. The gap between a stage one diagnosis and a stage three diagnosis in ovarian cancer isn't usually about biology, it's about how long the whisper was ignored.