Long term shoulder pain seems to be a common symptom of ovarian cancer. “Referred pain" is the term given to it - due to the diaphragm apparently being irritated by the ascites. Shoulder pain is a recognised symptom of ectopic pregnancies so there is clearly a link. Why is shoulder pain not listed as a possible symptom of ovarian cancer?
Shoulder pain can be a symptom of diaphragmatic irritation, which can happen when ovarian cancer presents at an advanced stage.
The symptoms used in awareness campaigns are taken from research which aimed to identify the early symptoms of ovarian cancer. The research did not identify referred pain (pain that appears somewhere other than at the site of where the cancer is) as a common symptom but that doesn’t mean more research into symptoms isn’t needed.
Symptoms awareness in the general public is very difficult to achieve which is why we stick to talking about the main four symptoms. However, we know that won’t cover every individual experience which is why we encourage anyone with symptoms that are unusual for them to see their GP.
The 2015 Cancer Strategy for England recommended a pilot of multi-disciplinary diagnostic services for vague or unclear symptoms. These services don't replace existing referral guidelines or pathways, but they do offer an extra option for GPs for patients with non-specific symptoms . If you would like to know more about the services, you can read our recent blog.