Issue: July 1, 2007
July 01, 2007
2 min read

Experts release list of ovarian cancer symptoms

Ovarian cancer had been previously believed to be asymptomatic until the disease had significantly progressed.

Issue: July 1, 2007
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Although ovarian cancer will claim approximately 15,000 lives this year, many doctors had referred to the disease as the “silent killer,” because symptoms often did not manifest until the disease had progressed.

However, a new consensus statement from the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists and the American Cancer Society, outlines the symptoms.

“This agreement on common symptoms of ovarian cancer hopefully will lead to earlier diagnosis when a cure is more likely,” Barbara Goff, MD, a gynecologic oncologist at the University of Washington in Seattle, said in a press release. “We know that when women are diagnosed in stage I of the disease it is 90% curable. Unfortunately, until now, there has been no agreement on common symptoms, allowing women to go undiagnosed, despite visits to the doctor, until it was too late.”

The following symptoms are much more likely to occur in women with ovarian cancer than women in the general population: bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly and frequent or urgent urination.

Women who have these symptoms should see their doctor, preferably a gynecologist.

Persistent symptoms

Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer, according to the consensus statement.

According to the consensus statement, several other symptoms have been commonly reported by women with ovarian cancer. These symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities.

“However, these symptoms are not as useful in identifying ovarian cancer because they are also found in equal frequency in the general population who do not have ovarian cancer,” according to the consensus statement.

Unlike cervical cancer, there is no screening test for ovarian cancer, making symptom recognition and early diagnostic testing the primary ways to detect the cancer early.

Ovarian cancer ranks fifth in cancer deaths among women. At present, about 80% of these cancers are not diagnosed in their early stages, leading to a reduced chance of survival.

Editor’s note: While the intent of this effort is laudable, there is unfortunately insufficient evidence-based data to support changing any guidelines. For example, there is precious little data for the suggestion that finding ovarian cancer six months earlier will influence either treatment or outcome, since the large majority of patients present with advanced disease. Rather, what must clearly be the major influence on outcome is the inherent biology of the cancer and its chemoresponsiveness. The symptom cluster proposed as ‘early signs’ of ovarian cancer are actually likely to present again in the very large majority of patients as ‘initial symptoms of advanced disease.’ How often these symptoms represent ‘early disease’ should be addressed in a well-designed and well-conducted prospective study. When such data are available, it is reasonable to discuss changing guidelines. The current proposal runs the very real risk of patients experiencing self guilt, or anger at their primary health care providers. Either of these outcomes would be potentially very harmful. – Maurie Markman, MD