Certain Symptoms may be Early Signs of Ovarian Cancer
Harvard Mental Health Letter
Volume 23 - Number 6 - December 2006

Ovarian cancer has long been called a "silent killer," because symptoms are thought to develop only after the disease has reached an advanced stage and is largely incurable. But health experts have identified a set of physical complaints that often occur in women who have ovarian cancer and may be early warning signs. These symptoms are very common, and most women with them do not have ovarian cancer. But for the women who do, the hope is that greater awareness will lead to earlier diagnosis and treatment.

In June 2007, the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists, and the American Cancer Society issued a consensus statement highlighting four symptoms that are more likely to occur in women with ovarian cancer than in women in the general population. These symptoms are bloating or increased abdominal size; pelvic or abdominal pain; difficulty eating or feeling full quickly; and urinary frequency or urgency.

The statement recommends that any woman who experiences one of more of these complaints almost daily for more than a few weeks should see a clinician (preferably a gynecologist) for a thorough pelvic exam. Pelvic exams that raise suspicions are usually followed up with a noninvasive test called transvaginal ultrasound and possibly a blood test for a marker called CA-125, which is sometimes elevated in women with ovarian cancer. (By itself, CA-125 testing is not a good screening tool.) The only way to diagnosis ovarian cancer is during surgery, which is best performed by a gynecologic oncologist or other surgeon skilled in ovarian cancer.

Research has shown that many women who have ovarian cancer complained about symptoms well before they were diagnosed, but their concerns were either ignored or attributed to something else. Certainly the symptoms highlighted in the consensus statement - bloating, abdominal pain, fullness, and frequent or urgent urination - accompany many other health problems, such as menstrual difficulties, irritable bowel syndrome, and bladder infections. But if such symptoms are new, persist for several weeks, and get worse with time, they may be a sign of ovarian cancer, according to Dr. Barbara Goff, whose research at the University of Washington in Seattle was instrumental in the development of the consensus statement.

It's estimated that more than 22,000 women in the United States will be diagnosed with ovarian cancer in 2007, and over 15,000 will die of the disease. Unlike cancers of the lung, colon, and breast, there is no good screening test for ovarian cancer. Although it's unclear whether recognizing these warning signs will lead to better outcomes, cancer experts and advocacy groups suggest that greater awareness of them may be the best hope for earlier diagnosis and improved survival.