Ovarian Cancer: "Silent Killer" No More?

Possible Symptoms May Help Women And Doctors Detect The Disease Before It's Too Late

(CBS)  It's been called the silent killer because it's so hard to detect until it's too late.

More than 22,000 American women will be diagnosed this year with ovarian cancer. More than 15,000 are expected to die.

Most die within five years of their diagnosis — because by the time doctors find the disease, it has already spread. Until now, doctors have said there were no warning signs. But now they're compiled a list of symptoms that could point to ovarian cancer — in time to catch it, CBS Evening News anchor Katie Couric reports.

Forty-nine-year-old Janet Weinrib was diagnosed with ovarian cancer two years ago.

"Something was sticking out of my stomach," she said. "I mean, there was a pronounced bulge in my lower abdomen."

But in retrospect, there were signs of her cancer almost two months earlier.

"The feeling of being, I would say, bloated, would be the best description," she said.

According to new guidelines issued today, that's just one of the four common symptoms of early ovarian cancer. In addition to bloating, other symptoms include feeling full quickly, abdominal pain and frequent or urgent urination.

"We don't want to frighten everyone into having everyone think 'Oh my gosh I have ovarian cancer, because I have bloating,' said Dr. Barbara Goff of the University of Washington. "Most people will not. But symptoms that are concerning are symptoms that are new for a patient, that persist for several weeks and that occur almost daily."

Ovarian cancer, if detected early — is 90 percent curable. But only 19 percent of cases are discovered in the earliest stage.

"Ovarian cancer can grow very rapidly, so time is of the essence," said Dr. Carol Brown, an oncologist and surgeon at Memorial Sloan-Kettering Cancer Center in New York.

Couric asked Brown why if there's a PSA test for prostate cancer, mammograms for breast cancer and colonoscopies for colon cancer, why isn't there some kind of diagnostic test for ovarian cancer?

"The reason is partially because the ovaries are deep inside the body," she said. "So we're really relying on two modalities — one is imaging studies like X-rays and new types of X-rays, and then the other are blood tests to look for different substances that ovarian cancers may be shedding into the blood."

In the meantime, Brown says women must listen carefully to their bodies — and doctors must listen carefully to their patients.

"Part of the importance of this study is to let doctors know, too, that these symptoms exist," Brown said. "So it can really trigger in their minds, when they're seeing women like this, to think about this as a possibility."

[kansaslady1]

This is good news on the symptoms to watch for with fear of ovarian cancer. But I have all these symptoms and have had them for two years. But there is no way I can have ovarian cancer because one year and two months ago I had a complete hysterectomy done. My doctor told me they done test and found no cancer. Now I'm really afraid of not knowing what is going on. I lost my mother and grandmother to breast cancer and have had close family members with ovarian cancer. But like most I live where doctors don't test and they tell you it's all in your head. They don't have time to talk with you when they have 20 others waiting at the same time your appointment is. Doctors don't care about the people they treat they care about the dollar.
I have seen three doctors over this. So what is a person to do. I have to worry now that I have been lied to and have cancer. What happened to doctors that cared.

[mikealford3]

"Silent Killer" it's amazing people still say those words about cancer. It's only "silent" to those who have never had it and to those who wish to ignore it. Perhaps if each case of cancer diagnosed in the United States recieved the same attention in the media as the globe trotting TB patient, cancer would not be thought of as so "silent".

[vittoria1]

I'm perplexed by the claim that these symptoms are being communicated to the public for the first time. I've known about them for years, and not from physicians, but from articles I've read in newspapers and magazines. This is not new information, and the symptoms in question can easily involve entirely benign conditions. What we really need are reliable, early-warning diagnostic tests that can be done during an annual check-up.

[mdk2dude]

This killer is just as they described. My wife was in great health but continually felt uncomfortable in her abdomen She had been complaining to her doctor for a year and he told her is was nothing serious. Not serious, just deadly. She went with me to the ER one day as I had another problem that needed fixing. She told the doctor on staff how she felt and he had her take a scan immediately. It was already too late.She had surgery within three days and left me in 14 months. There should be a mandatory scan for all women when they reach the age of 50. We could save a lot more then we are doing now. This should be a part of her annual mammogram. For us it is too late. We lost. Me more than her.

[aviatrix2-2009]

Mayo Clinic oncologist Timothy Moynihan, M.D., and colleagues answer select questions from readers on http://Mayoclinic.com

Is ovarian cancer still possible after a hysterectomy? If this is true, should I continue to have regular Pap smears?

Answer
A simple hysterectomy removes your cervix and uterus but leaves your ovaries and fallopian tubes intact. So you can still develop ovarian cancer.

Another type of hysterectomy called a total hysterectomy with salpingo-oophorectomy removes your cervix and uterus as well as both ovaries and fallopian tubes. Removing the ovaries dramatically reduces your risk %u2014 by more than 95 percent %u2014 of ovarian cancer. But you still have a small risk of primary peritoneal cancer, which acts just like ovarian cancer and is treated similarly. It's not clear why the risk of peritoneal cancer remains. But the cells on the inner lining of the abdomen (peritoneal) are very similar to the cells lining the surface of the ovaries.

There is no standardized screening test for ovarian or peritoneal cancer. A Pap smear is a screening test for cervical cancer. So, if you've had your cervix removed as part of the hysterectomy, you usually don't need an annual Pap smear. But you still need regular pelvic exams. Doctors also recommend continued Pap smears for women who have had cervical, vaginal or vulvar cancer before a hysterectomy.

_______

Ask again, at a minimum they should help you find out what is wrong, even if it's not cancer.

[dhd42]

Thanks to Katie Couric for bringing another terrible cancer to the forefront!! This is indeed a silent killer because so often women overlook the signs and symptoms because they do not know what they are. At last a famous "face" talking about this terrible disease. Bless you Katie!!

[wiccantexan]

Gilda Radner had these symptoms for almost a year, and they kept treating her for intestinal issues. A simple blood test and questions about family history could have saved her life.

[trpms06]

I hope physicians will take the time to listen to patients. My aunt died in 1997 with ovarian cancer at age 52. My mom reported symptons repeatedly to physicans and would get the pat on the hand saying that's just part of aging. She was diagnosed at age 58 with ovarian caner and died at age 62 in 2005.

[colleen_yuan]

I missed the show, but what I would like to hear about is the Antioxidants play in the treatment of cancer.

Specifically Coenzyme Q10 / Ubiquinol...

Milk Thistle in the form of Siliphos or
Isosilyibin B... and

Omega 3 in the form of Fish Oil or Flax Seed Oil.


Colleen

[rroderick2]

I was diagnosed with ovarian cancer in 1998 because my doctor listened to me when I talked about vague symptoms like those listed in these guidelines. I kept going back and saying I'm not okay and she would look at the next thing. I only went 5 weeks from first visit to scheduling surgery. So I cannot stress loudly enough what a huge step forward this is. It also underlines the idea that most of us know when something is out of whack, even if it is hard to describe to a doctor. So this is a two way street; women need to be as forthright and clear about symtoms as they can be and doctors need to listen and decifer what they are hearing.

[aaabee-2009]

Flax seed is not good for women, it is better for men. Please don't use it without doing some research because you could add to your danger instead of decrease it.

Suppliments are not regulated. They come under the heading of cosmetics as far as the FDA is concerned. There is no guarantee that even the more expensive suppliments have the right dosage or even any at all of the ingredient/s on the bottle's label.

Use only suppliments from nationally known companies who have a reputation to uphold, those mail order things by unknown companies could be feeding you anything, and doing so legally.

[aviatrix2-2009]

Most nutrition experts recommend ground flaxseed because your body is better able to digest it. Whole flaxseed may pass through your intestine undigested, which means you won't get the health benefits of flaxseed.

Flaxseed is high in fiber, omega-3 fatty acids, and phytochemicals called lignans. Flaxseed can help reduce total blood cholesterol and LDL ("bad") cholesterol levels %u2014 and, as a result, may help reduce the risk of heart disease. Flaxseed oil also contains omega-3 fatty acids, but it doesn't have the beneficial fiber that the seeds have.

Although the Institute of Medicine has not set a recommended daily intake for omega-3 fatty acids, it has established adequate intake amounts of between 1.1 and 1.6 grams per day for adults. One tablespoon of ground flaxseed provides 1.6 grams of omega-3 fatty acids.

More on this at http://www.mayoclinic.com/health/flaxseed/AN01258

Also, the Mayo Clinic Book of Alternative Medicine was published in December and contains information about supplements, herbs, etc. collating what scientific evidence is available in support or debunking efficacy claims.

[me4prezz]

My mom has stage IIIC ovarian cancer and had symptoms for almost a year before they diagnosed her. They removed 4 liters of fluid from her abdomen during surgery.

Anything they can find that would improve your chance of early detection are much needed. BUT, my mom tells everyone and so have we that women need to push and push to have a routine CA125 blood test done every year with their PAP smear and mammogram. By the time they chose to ran one on her, it was over 500. Normal is 35 and below. Mine was 34 just recently and I had a complete hysterectomy with ovaries and tubes removed as well and I am only 24. It can be elevated for other causes, but they are ones that you would want to know about anyway, such as endometriosis, uterine fibroids, cervical cancer, etc. That is the only thing I can add to this, especially if there is a history of brain or ovarian cancer in the family, to get the CA125 test. Brain cancer has been genetically linked to ovarian cancer in families. My mom's father died of brain cancer at 50 and my cousin had brain cancer as a child.

Just be your own advocate. If my mom hadn't pushed the issue, she would be dead listening to the doctors. She demanded time and again that something was wrong and it was.