Warning Signs of Ovarian Cancer Released

Ovarian cancer is difficult to diagnose in its early stage due to the lack of a highly sensitive or specific screening test. The National Cancer Institute's website summarizes the meager data on screening tests, such as CA-125 levels or pelvic ultrasounds.

Now a coalition of cancer organizations including the American Cancer Society have released four warning signs that may represent the presence of ovarian cancer.

The experts say women should see their doctor if they suddenly experience any of these symptoms daily for at least three weeks:

Bloating

Pelvic or abdominal pain

Difficulty eating or feeling full quickly

Frequent or urgent urination

As with all cautionary statements about the presence of certain symptoms there are caveats, lest thousands of patients hit the panic button all at the same time (cf. 'Medical Students' Disease'). Things to keep in mind are the facts that most patients with these symptoms will not turn out to have ovarian cancer, many will undergo tests that may turn out to be unnecessary, anxiety levels will certainly rise in women being evaluated for the possibility of cancer, and there are no firm data to support the hypothesis that the mortality rate will fall if more tumors are detected early (see 'lead time bias').

"There's no evidence yet that links early detection of ovarian cancer with saving lives," says Debbie Saslo, a molecular geneticist and director of breast and gynecologic cancer at the American Cancer Society. It could be, she says, that certain women have slow-growing tumors that cause symptoms for months while contained in the ovary, while others have tumors that grow and spread so quickly that early detection is impossible. [Professor and Director of gynecologic Oncology at the University of Washington in Seattle Dr. Barbara] Goff says studies are planned to see whether earlier detection through symptom recognition will indeed reduce mortality rates.

The bottom line is that women should be aware of the four symptoms listed in the consensus statement and notify their health care provider (formerly known as 'doctor') if they have been present for longer than a fortnight. If they really want to feel educated the place to start is by learning the nine risk factors for the development of what is called the 'silent killer.' They can be found here, and just in case you were wondering, two of them are obesity and smoking.

Docendo discitur.

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I m these symptoms and they are caused by ovarian cancer, then you have metastatic disease and your disease is not curable
My onc ob/gyn doesn't think it's going to catch anything early enough to save any lives thanks .

By the time I got my first two recognizable symptoms... indigestion, feeling full and finally bloating... I was diagnosed with Stage IIIC Ovarian Cancer... that was Nov 2, 2005.. I have basically been on chemotherapy ever since. Getting the symptoms out to the community of women I think is very important... more so to get women to pay attention to what is going on in their bodies and not excuse away pains and aches or fatigue... just that could help with the silent killers of ovarian cancer, heart disease, high blood pressure... many others.
Hope I'm making some sense here - chemo brain is real and rampant in chemo patients.
Lastly Thank you so much for this blog... love to have the insite into the thoughts of an oncologist.

I think this pronouncement has some BS elements. Like "we haven't come up with a good screening measure yet so just watch for these [common] symptoms".

The second page of the NCI web site says:

The prognosis for survival from ovarian cancer largely depends on the extent of disease at diagnosis.[3] The overall 5-year survival rate for ovarian cancer is lower than 50%.[3] Fewer than one fourth of women present with localized disease at diagnosis

How in the world does that jibe with the quote?

"There's no evidence yet that links early detection of ovarian cancer with saving lives"

I appreciate that they are trying to let people know what to look for, but all things considering it isn't that reassuring.

Speaking broadly, I am sorry to say but these symptoms are caused by metastatic disease. If you have these symptoms and they are caused by ovarian cancer, then you have metastatic disease and your disease is not curable. If you have these symptoms and a localized nonmetastatic tumor is found, then that is simply good luck, because the localized tumor is itself asymptomatic.

By Ex ER Doc (not verified) on 15 Jun 2007 #permalink

I'm in a study that is evaluating the efficacy of CA125 and pelvic ultrasounds done every three months in women at high risk of ovarian cancer.

Any of the docs out there want to guess how the study will come out? My onc ob/gyn doesn't think it's going to catch anything early enough to save any lives. Then again, he enrolled me in the study, so he must have some hope that it will help.

Speaking broadly, I am sorry to say but these symptoms are caused by metastatic disease. If you have these symptoms and they are caused by ovarian cancer, then you have metastatic disease and your disease is not curable. If you have these symptoms and a localized nonmetastatic tumor is found, then that is simply good luck, because the localized tumor is itself asymptomatic.