Symptoms of Ovarian Cancer

In response to reports by patients with ovarian cancer of the symptoms they experienced, Dr. Goff and others have found that certain symptoms are much more frequent in women with ovarian cancer than in women in the general population. These symptoms include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary symptoms of urgency or frequency. "The symptoms are not specific, and all of us have had 1 or more of these symptoms from time to time," Dr. Goff says. "What's different about the symptoms of ovarian cancer is that they are new symptoms, not symptoms you have had all your life; they occur regularly, either daily or every other day; and they persist more than several weeks." The consensus panel recommended that women who experience these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist, because prompt medical attention might allow diagnosis at the earliest possible stage of ovarian cancer, when prognosis is better. Because there is no effective screening test for ovarian cancer, symptom recognition and regular pelvic examinations are essential for early detection. "We are not 100% sure that identification of symptoms will lead to earlier detection of ovarian cancer, but because there is a potential for that, we need more research to see what effect implementing this statement will have on outcomes," Dr. Goff says. "Even in stage 1, which is associated with a 90% cure rate, women have these symptoms. If women are having these symptoms even in early stages, then with recognition of these symptoms, we may be able to diagnose ovarian cancer in early stages when chance of cure is 70% to 90%, as opposed to the 20% to 30% chance of cure in advanced stages." Although other symptoms are often reported by women with ovarian cancer, such as fatigue, indigestion, back pain, pain with intercourse, constipation, and menstrual irregularities, these symptoms are not as helpful in diagnosing ovarian cancer because they are found in equal frequency in women without ovarian cancer in the general population. A nationwide poll conducted by GCF in May 2007 revealed that women agree that it is important to know the symptoms of ovarian cancer, but 65% did not feel sufficiently informed. There is therefore a great need for information dissemination and education of women and healthcare providers. "By highlighting these symptoms and their potential association with ovarian cancer, more women may seek medical attention, especially if these symptoms persist over a few weeks," Dr. Barakat said. "Since ovarian cancer is much less common than other cancers, such as breast and lung cancer, patient education has lagged behind. Increasing public awareness could potentially lead to more patients being diagnosed with early-stage disease, and potentially lead to fewer deaths from ovarian cancer." Dr. Barakat also highlighted the need for additional research on laboratory screening tests. "One of the most important areas of research in this disease should be the development of novel biomarkers that can detect early ovarian cancer," he says. "Currently, the best test we have is a CA-125 blood test. This tumor marker is only elevated in 50% of patients with early ovarian cancer and has not been shown to be an effective screening tool in this disease." "Our goal is not to scare people, but to arm people with the knowledge that if these symptoms persist, they could be a sign of ovarian cancer or other serious condition," Dr. Goff concludes. "If ovarian cancer is suspected because of these symptoms and a suspicious mass is detected, it is very important for the woman to see a gynecologic oncologist. In that situation, if there is ovarian cancer, women are significantly more likely to have the right surgery and a higher chance of cure, so it could mean the difference between life and death."