At the end of December 2022, Emily Campbell, then 32, became uncomfortably bloated and looked as if she were expecting.
"My abdomen was very distended, and normally when I have had bloating before, it goes away," the now-35-year-old from Miami tells TODAY.com. "It was not like that. (It was) rock hard. The best way to describe it is as a pregnant belly feeling."
Throughout that month, Campbell visited serval doctors trying to understand her symptoms, though they often dismissed her. About six weeks after her symptoms began, she insisted on an ultrasound and was eventually diagnosed with Stage 3 borderline ovarian tumors, a type of pre-cancerous mass.
"It's disappointing to know that I am not the only one who has been through this experience of being gaslight by a health care professional or being misdiagnosed or being brushed off," Campbell says. "The larger problem is there's a lack of awareness and understanding and education around the symptoms (of ovarian tumors)."
The first bodily change Campbell noticed was her unusual abdominal bloating, but she developed other worrisome symptoms as time passed.
"I couldn't walk. I had to waddle (because) my stomach was so big. I couldn't sleep," she says. "I also felt extremely full after just eating a few bites, having heartburn." She visited a few doctors, who prescribe laxatives to help her with what they thought could be constipation. But her symptoms didn't improve, and soon her husband, Chris Campbell, encouraged her to continue to seek answers.
"My husband was like, 'You look physically different. You need to keep going to the doctors until you get a different answer,'" Campbell recalls. "The answers that I was receiving were, 'You have a gluten allergy.' 'You're probably just constipated.'"
Doctors even tested her for bacterial and viral infections, which she did not have. About mid-January 2023, she visited a doctor to ask for an ultrasound, which revealed something unusual.
"They found that there was fluid all around my abdomen, and that was the abdomen distension," she says. "The doctor sat me down and said, 'There is a lot of fluid in your abdomen that is not normal.' She's like, 'I cannot let you go home in good conscience.'"
The doctor advised Campbell to go to the emergency room for more tests, including an MRI, ultrasound and a PET scan. Doctors there found masses on both her ovaries in addition to the fluid collecting in her belly.
These signs indicated that Campbell had a malignancy, and the doctors admitted her to the hospital. About a week later, she underwent surgery to remove the masses. The tumors had already spread throughout her abdomen, and doctors removed her uterus, cervix and both ovaries.
"The tumors were extensive. They were on both ovaries, all over the uterus," she says. "Doctors (saw) a little bit on the colon and bladder and appendix as well."
Campbell experienced a lot of emotions after undergoing such an extensive surgery that impacted her fertility.
"I was grateful that they did take all the tumors out. The surgery was successful. They didn't feel like they had to go back," she says. "For me, that was the No. 1 goal. I was so uncomfortable the weeks leading up to this with all the symptoms that at that point I was like, 'Do anything.'"
At first, doctors told her she had low-grade serous ovarian cancer, but she later learned she had borderline ovarian tumors. Campbell pursued a second and third opinion, which is how she was able to learn the correct diagnosis.
"Because of the rarity, it can be easily mistaken for one or the other," Campbell says.
As part of her treatment plan, doctors prescribed a medication to suppress her estrogen production. That put her into menopause immediately, and grappling with the symptoms and physical changes that come with early-onset menopause feels difficult at times.
"My bone density is unfortunately minimizing," she says. "The menopause symptoms are real, so I do feel those. But I also feel strong and healthy today as well."
People can have benign or malignant tumors, but there are also tumors that show characteristics of cancer but aren't yet cancerous, says Dr. Brian Slomovitz, director of gynecologic oncology at Mount Sinai Medical Center in Miami Beach, Florida. Called borderline ovarian tumors, they can return as cancer in some cases.
"Borderline tumors are pre-cancer," Slomovitz says. "A small category of them could actually recur as what's called a low-grade serous ovarian carcinoma."
While borderline ovarian tumors are rare, they occur more often in young women, whereas ovarian cancer risk increases with age. Ovarian cancer most often occurs after menopause with 50% of these cancers developing after age 63, the American Cancer Society notes.
Symptoms of borderline ovarian tumors are the same as "any signs of ovarian mass," Slomovitz explains. Signs include:
Symptoms often do not occur until after a person's masses have spread.
"A lot of times patients have symptoms, and it takes a while for their surgeon to operate," he says. "(When) there are symptoms, appropriate workup is necessary in order to ideally catch it at an earlier stage ... so it's not truly invasive yet."
Surgery is the first-line treatment to remove the masses, which can also include removing the ovaries and uterus, as the tumors can spread there. Slomovitz notes that, when appropriate, doctors try to avoid hysterectomy in younger women to preserve fertility.
Patients with borderline ovarian tumors undergo follow-up surveillance for the rest of their lives, whereas people with ovarian cancer are considered cured and no longer need surveillance if they go five years without disease.
That's because borderline tumors can come back after more than five years, with an estimated 80% of tumors like the one Campbell had recurring, Slomovitz explains. That said, the overall survival rate for borderline ovarian tumors is quite high.
After her experience, Campbell and her husband founded an organization Not These Ovaries to raise money to fund screening for ovarian cancer and developing a treatment. There's currently no screening for ovarian cancer, Slomovitz notes.
"Most ovarian cancers are detected at an advanced stage," Campbell says. "That's a really hard cancer to detect because of lack of symptoms, lack of screening, and women deserve better."
Campbell also hopes that people speak up if they notice something is wrong with their health.
"It's OK, if something doesn't feel right, to push until you get an answer. I think it's really hard to do that ... because our symptoms often get gaslit or dismissed," she says. "You know your body best, so advocate for yourself."