Symptoms Warn Of Ovarian Cancer

(WebMD)  A symptoms checklist, combined with a blood test, can catch 80 percent of ovarian cancer in its earliest, most curable stages, a new study
suggests.

Doctors used to call ovarian cancer "the silent killer." That's because it was thought to have no symptoms until the very late stages of disease. But women who had or who survived ovarian cancer insisted that they knew something was wrong, long before doctors finally diagnosed their malignancy.

Finally, a doctor listened. University of Washington researcher Barbara Goff, M.D., and colleagues analyzed patients complaints and, in a groundbreaking 2004 study, announced to the medical world that ovarian cancer is not silent.

In 2007, Goff, M. Robyn Andersen, Ph.D., of Fred Hutchinson Cancer Research Center, and colleagues came up with a "symptom index" indicative of ovarian cancer. But this index caught only 57 percent of early-stage cancers.

Now the same researchers find that by adding a blood test for the CA125 ovarian-cancer biomarker - which by itself misses about half of ovarian cancers - the symptom index can catch more than four out of five early ovarian cancers.

"The symptom index and the CA125 test each finds 50 percent to 60 percent of women with early disease," Andersen tells WebMD. "But when they're combined, if either one is positive, we might be able to identify 80.6 percent of women with early stage ovarian cancer. Women with early stage disease have good chance of a cure - it's just that right now, we don't find many of them in time."

Ovarian Cancer: Symptoms to Look For

The symptoms that warn of ovarian cancer aren't, in themselves, very specific. They may seem to be gastrointestinal or psychological rather than gynecological in nature.

"We hear all the time of women coming in with these symptoms and having them missed or dismissed by their doctors," Cara Tenenbaum, policy director for the Ovarian Cancer National Alliance, tells WebMD. "They get sent to eating disorder clinics, or treated for irritable bowel syndrome or depression."

But the symptoms are real, says Robert A. Smith, Ph.D., director of cancer screening for the American Cancer Society. A study that looked at the health records of women later diagnosed with ovarian cancer found that prior to their diagnosis, they were much more likely than other women to complain of abdominal symptoms.

So what are these warning signs? Andersen says there are three basic symptoms:

• Bloating or increased abdominal size


• Pelvic or abdominal pain


• Eating difficulty or feeling full too quickly

Normal women experience all of these symptoms from time to time. But if any of these symptoms started recently - within the last year - and if it's struck nearly every day for several weeks, it may signal ovarian cancer. Indeed, only 2 percent of women report recent, frequent onset of these symptoms.

"This isn't something that's been going on since a woman was 18," Andersen says. "This is something new happening to a woman's body."

Women identified as high risk by symptom index or CA125 testing would likely undergo transvaginal ultrasound to look for abnormal growths on their ovaries. Such growths are not uncommon, and the ultrasound test itself is not an appropriate test for ovarian cancer except in women with family histories or genetic backgrounds that put them at especially high risk.

"But if ultrasound is used in the group of women already selected because of symptoms or CA125 or both, then we might identify which women are the right ones to go to surgery," Andersen says. "We want to use transvaginal ultrasound to identify the false-positives among women who did report symptoms, so those who don't have ovarian cancer would not go to surgery."

Unfortunately, there's only one sure way for doctors to know if a woman has ovarian cancer: surgery.

"It is not trivial to open up the abdomen and check," Smith says.

That's why there's an intense effort under way to find a reliable way to detect cancer of the ovaries. Until that day comes, the symptoms index plus CA125 screening may be the best way to identify women who may have ovarian cancer.

"Even with this specific pattern of symptoms, most women who have them probably don't have ovarian cancer - just as most women who find a lump in their breast don't have breast cancer," Andersen says. "It is time to get it checked out, but it is still not likely to be ovarian cancer."

Andersen, Goff, and colleagues report their findings in the Aug. 1 issue of the journal Cancer.

By Daniel DeNoon
Reviewed by Louise Chang
©2005-2008 WebMD, LLC. All rights reserved

[djlny]

My Mother-In-Law went back repeatedly and was under treatment for the irritable bowl etc for over a year. She didn''t just give up - she listened. This BTW was in Holland where medical care is quite rationed.

[baileyccc]

gilliansings you sound very intelligent and I admire your resolve. But for all the good you have done the synthetic Hormone Replacement Therapy could be your down fall. I suggest that you see a Naturalist Doctor and get off of the HRT with natural products. Bioidentical hormones would be an excellent choice. I have seen and lost many good friends that used HRT. The risk of cancer is took great to justify the means.

[gilliansings]

I was told by my doctors over the past 10 years that I didn''t need to worry about my father''s female relatives history of ovarian cancer. I am a nurse and I have seen people I cared about not get diagnosed until it was too late. So, I insisted on getting CA125 testing every year and even discussed getting pelvic ultrasounds annually, but my insurance wouldn''t cover it because my family history wasn''t close enough and it wasn''t on my mom''s side.

I have long had painful periods with pelvic pain, as well as irritable bowel syndrome, so I was worried that I wouldn''t be able to tell the difference if I did get symptoms.

I chose to have a vaginal hysterectomy with removal of my ovaries and fallopian tubes. I knew the hysterectomy was indicated because of my gynecologic complaints, but it took a little pushing to get my gynecologist to agree to my reasons for wanting my ovaries out as well. I have been on estrogen replacement for 14 months now and feel wonderful.

[mellownnv]

We all have to listen to and trust what our bodies tell us. Medical doctors don''t have all the answers! You can''t just give up when a Doctor tells you that you are (medically) healthy if you know that you are not.

[djlny]

My Mother-in-law recently passed away from ovarian cancer and I can tell you she knew something was wrong long before the doctors did. She was told she had irritable bowl syndrome, sacs in her intestines from old , etc..., it was all normal. She was a good ol'' gal and listened them in all faith that the doctors knew better. They didn''t, and when it was finally diagnosed - it was inoperable.