In recent years, researchers identified a list of symptoms that often seemed to crop up before a diagnosis was made, but the symptoms were vague and commonplace. After all, what woman doesn’t have occasional abdominal, intestinal or pelvic complaints? Many doctors worried that publicizing the list would scare women unnecessarily. But now, thanks to ongoing research, the list has been narrowed enough to give it real potential for saving lives. Rather than worrying that all types of abdominal distress may be an early signal of ovarian cancer, women are now being urged to take action when these symptoms are both new and persistent.
“What we’re concerned about are relatively new symptoms that appear every day, or every other day, or more than 12 times a month, and last for at least two or three weeks,” says Dr. Barbara Goff, a top ovarian-cancer researcher at the University of Washington. While most women who experience these symptoms won’t turn out to have ovarian cancer, they are more likely to have it than those who experience these symptoms more erratically and less frequently, Goff’s research shows.
Now the challenge is to get the word out to women and clinicians, so they take these commonplace symptoms as seriously as they do a lump in their breasts. If that happens, Goff says, there’s real hope that more cases of ovarian cancer will be caught earlier, when more can be done to cure it, or slow down its progress. Consider that 93 percent of women whose ovarian cancer is discovered and surgically removed while still in stage 1 are alive five years later, while the overall five-year survival rate for this disease is only 45 percent. Diagnosing the disease even a month earlier can make a significant difference. “There ’s a huge survival advantage if it’s found early and treated appropriately,” says Goff. “That may allow us to extend survival by five, seven, 10 years.” While ovarian cancer is most likely to occur in women in their 60s, it can develop anytime between 20 and 90. Currently, however, only 19 percent of all ovarian cancers are found that early so a more aggressive approach is clearly warranted, Goff argues. “So many women present with an advanced stage of this disease, that anything that can be done to identify them earlier should be tried,” she says.
So what do you do first if you experience any of these symptoms yourself? Start by promptly calling your Ob-Gyn and making an appointment for a vaginal and rectal exam. Goff says that if there is any reason to suspect ovarian cancer, the doctor should do a transvaginal ultrasound and possibly a blood test called CA-125, which measures the level of a protein associated with ovarian cancer. If either seems to confirm an increased risk of ovarian cancer, the woman should then be referred to a specialist, specifically, a gynecologic oncologist for a consultation. “Too often, small, community hospitals don’t have appropriate pathology labs, or think that all they can do is take out the ovary, because they still think that all women with ovarian cancer die,” Goff says. “As is the case with any complex surgery, you’re much more likely to survive if you’re operated on by a specialist.”
In most cases, the cause of the symptoms will not turn out to be ovarian cancer. But that doesn’t mean the effort was wasted. “Some may be symptoms of other types of cancers, like colon or pancreatic, or bowel inflammatory disease, or something less serious, like a urinary tract infection,” says Goff. But all of these things also need to be treated. What we don’t want is for women and doctors to just blow off these symptoms as nothing to worry about."
Part of the pressure to publicize these early symptoms comes from the survivor community, many of whom are angry that their early complaints were ignored for too long, Goff says. For example, in one follow-up study of women eventually diagnosed with ovarian cancer, Goff found that 12 percent were initially told that their symptoms were simply related to “stress”; another 15 percent were told they had irritable bowel disease; 6 percent, depression. Ten percent were told that “it was all in their head,” says Goff. “Six months later, they all discovered they had ovarian cancer, and not surprisingly, they’re up in arms. That’s why we’re trying to make a public announcement about this to alert both women and clinicians of this new research.”
Goff adds an important caveat: sometimes, even the best doctor won’t be able to find evidence of ovarian cancer the first time you’re checked. If symptoms persist or worsen, make sure you keep bringing up the topic with your doctor. It may take several tests to detect cancer. If you’re afraid you’ll be perceived as a hypochondriac, keep in mind that many women have saved their own lives through their persistence. If you feel your doctor isn’t responding appropriately, get a second opinion. But whatever you do, don’t ignore what the silent killer might be trying to say.
Ovarian Cancer: Warning Signs
These are the possible early symptoms of ovarian cancer that should be checked out: Persistent and new abdominal, intestinal or pelvic complaints such as: * Bloating or abdominal enlargement * Lack of appetite or unusual sense of fullness or pressure on the abdomen * Digestive problems, gas, distention, abdominal or intestinal pain * Constipation, diarrhea, nausea and stomach upset * Back pain * Pain during intercourse * Frequent or burning urination For more information about ovarian cancer and its symptoms, try the following Web sites:
