Ovarian cancer, referred to as a silent killer, makes itself apparent only at its late stages when prognosis is poor. But according to UC Davis researchers, four in 10 women with ovarian cancer have symptoms that they tell their doctors about at least four months — and as long as one year — before they are diagnosed. Published in Cancer, a peer-reviewed journal of the American Cancer Society, the study finds that patients with ovarian cancer were more likely than women in the other two groups to have seen their physicians for four symptoms: abdominal pain, abdominal swelling, gastrointestinal symptoms and pelvic pain. Overall, about 40 percent of women with ovarian cancer had physician claims indicating one or more visits for these symptoms four months or more before the cancer was diagnosed.