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Physicians and Women Often Ignore Early Signs of Ovarian Cancer (dateline November 20, 2000)


Physicians often call ovarian cancer the "silent killer" because the symptoms of the disease are believed to vague and sometimes nonexistent until advanced stages of the disease. However, a large study of American and Canadian women found that many women do experience symptoms of ovarian cancer during early stages of the disease. Unfortunately, the study found that both women and physicians tended to ignore these symptoms or attribute them to another cause, such as irritable bowel syndrome or stress, without investigating them until the disease had significantly progressed.

To conduct the study, Barbara Goff and her colleagues from the University of Washington in Seattle studied 1,725 women with ovarian cancer to determine whether they experienced symptoms before being diagnosed with the disease. To their surprise, 95% of the women reported symptoms such as abdominal or gastrointestinal pain, bloating, pelvic pain, and abnormal bleeding prior to their diagnosis.

However, according to the researchers, many of the women or their physicians ignored the first signs of ovarian cancer or attributed them to other conditions. Nearly half of the women in the study did not schedule an appointment with their physician until three months after they began experiencing symptoms of the disease. Some of the women were told by their physicians that they had depression, stress, irritable bowel syndrome, gastritis, or no problem at all. Many of the women did not receive tests for ovarian cancer during their first medical visit (such as ultrasound, CAT scan, or CA125 blood test to check for an ovarian cancer biomarker). Other physicians dismissed the possibility of ovarian cancer because of the woman’s young age.

Some symptoms of ovarian cancer include:

  • Pelvic or abdominal pain or discomfort
  • Vague, but persistent, gastrointestinal upsets such as gas, nausea and indigestion
  • Frequency and/or urgency of urination in the absence of an infection
  • Unexplained changes in bowel habits
  • Unexplained weight gain or weight loss, particularly weight gain in the abdominal region
  • Pelvic and/or abdominal swelling, bloating, and/or feeling of fullness
  • Pain during intercourse
  • Ongoing fatigue
  • Abnormal post-menopausal bleeding

Each year, approximately 25,500 new cases of ovarian cancer are diagnosed. The American Cancer Society and National Cancer Institute report that approximately 14,500 women die annually from ovarian cancer. When detected in its early stages, the survival rate for ovarian cancer is over 90%. However, only 25% of all ovarian cancer cases are detected at an early stage.

In the study, the researchers found that 55% of the women were diagnosed with ovarian cancer less than three months after they first reported their symptoms to a physician. However, 26% were diagnosed after six months and 11% of women were diagnosed over one year after they first complained of symptoms.

Women are encouraged to learn about the symptoms of ovarian cancer and report symptoms to their physicians as soon as they develop. Physicians recommend that women have regular pelvic exams beginning at age 18 and find out whether ovarian cancer is prevalent in their families. Women with a strong family history of ovarian cancer or breast cancer may wish to consider genetic testing to determine whether they carry mutations of the BRCA genes. While most women with these symptoms will not have ovarian cancer, the researchers say that physicians should not rule out the possibility of ovarian cancer until a pelvic exam has been performed.

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