Ascites: 8 things to know about this ovarian cancer symptom

Ascites is the accumulation of fluid in the peritoneal space of the abdomen. Though it can be caused by several non-cancerous conditions, when seen alongside a pelvic mass, ascites is often a sign of peritoneal carcinomatosis, a classic symptom of advanced-stage ovarian cancer.

So, what causes ascites? Can it be treated? And, does it ever develop anywhere else?

We went to Travis Sims, M.D., a gynecologic oncologist specializing in ovarian and other gynecologic cancers. Here are eight things he shared about this ovarian cancer symptom.  

How is the word ascites pronounced?

It’s pronounced “as-SYE-teez.”

What causes ascites?

Ascites are thought to be caused by a combination of:

• high levels of fluid production in the peritoneal cavity 
• an obstructive process involving the peritoneal lymphatic system and increased vascular permeability –– or the exchange of fluids between organs and tissue. 

It is largely caused by increased levels of a protein called vascular endothelial growth factor (VEGF).

Does ascites ever develop anywhere else in the body?

Ascites, by definition, is the pathological accumulation of fluid in the peritoneal cavity. But fluid can also accumulate in other parts of the body. If fluid accumulates around your lungs, for instance, that is called a pleural effusion.

Are any other cancers associated with the development of ascites?

Several, but the ones I am most familiar with are:

• ovarian cancer
• fallopian tube cancer
• primary peritoneal cancer
• endometrial cancer

Can any conditions other than cancer ever cause ascites?

Yes. Chronic hepatitis, liver failure, congestive heart failure, and pancreatitis, to name but a few.

How is ascites typically diagnosed?

In our patients, we often discover ascites during a physical exam.

Ascites can cause the abdomen to become very distended. We can often perceive a “fluid wave,” or movement of liquid beneath the surface when assessing patients with it. Patients may also complain of shortness of breath, abdominal tenderness and pain, loss of appetite, indigestion, fatigue, constipation, or back pain.

We can confirm the presence of ascites with imaging, such as an abdominal ultrasound or a CT scan of the abdomen.

Can ascites be treated? 

Yes. Patients can undergo a procedure called therapeutic paracentesis, in which a needle is inserted into the abdomen to drain off the fluid. This can relieve their immediate discomfort, but the fluid tends to return without treatment of the underlying cancer.

In patients with advanced or recurrent cancer that is no longer responding to treatment, a catheter can be placed in their abdomen. This allows the patient to drain off fluid whenever they are uncomfortable or having painful symptoms.

What’s the one thing you want people to know about ascites? 

Unfortunately, ovarian cancer is a disease that we cannot screen for. That’s why it is important to pay attention to your body. If you have unexplained abdominal distention, pain, or any of the other symptoms mentioned above persistently for a couple of weeks, please talk to your doctor.

Request an appointment at MD Anderson online or call 1-866-414-5107.