When cancer experts announced yesterday that they had identified certain symptoms that might indicate ovarian cancer, they sent a pointed message to patients and clinicians: Scrutiny of seemingly benign physical complaints can save lives.
The "first national consensus on ovarian cancer symptoms" urged women and clinicians to regard bloating, abdominal pain, eating difficulties and urinary symptoms as possible early warning signs. According to the statement by the American Cancer Society, the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists, women should contact their doctors if they experience such symptoms almost daily for a few weeks.
Ovarian cancer is the fifth most deadly cancer among women. This year, more than 15,000 women will die from the disease.
Regular pelvic exams can help detect some ovarian cancers. But the disease is notoriously difficult to diagnose at an early stage when life-prolonging interventions are most effective. Unlike cervical cancer, there are no screening tests to detect it.
According to the foundation, there is a 90 percent cure rate for women diagnosed in the first stage of the disease.
The groups issued the statement after recent research led by Dr. Barbara A. Goff of the University of Washington School of Medicine linked the symptoms with ovarian cancer.
When persistent symptoms such as bloating are taken seriously, researchers believe that earlier diagnosis and treatment of ovarian cancer will be possible. "I think we should be seeing a dramatic decrease in the death rate," says Neila Parrish, a nurse practitioner in the gynecologic oncology program at the University of Maryland Greenebaum Cancer Center.
"I think that these are symptoms that in the past we as clinicians may have overlooked because they can be related to a number of other diseases and illnesses that are very benign," Parrish says.
Patients as well are apt to overlook early warning signs. In a survey of women last month by the foundation, 65 percent said "that they do not know enough about the disease."
By identifying a list of symptoms linked to ovarian cancer in research studies, women can no longer ignore them, Parrish says. "I think they are really starting to verbalize symptoms that years ago, they never would have.
"The patient has to take responsibility for identifying the symptom and the clinician must take the responsibility to listen and give the patient the environment in which she is comfortable enough" to relate her concerns, Parrish says.
The need to pay attention to certain symptoms "is nothing new to gynecologic oncologists," says Dr. Dwight Im, who practices at Mercy Medical Center and the Greenebaum Cancer Center. "We've known this for a long time. This is for primary care physicians."
For Sharon Bryant, yesterday's announcement came too late for an early diagnosis. She went to her primary care physician repeatedly over the course of four months complaining of bloating, abdominal pain and difficulty eating.
Based on those symptoms, her physician diagnosed diverticulitis, an inflammation of the bowel. When the problem persisted, he performed a CAT scan that suggested cancer. "He was so surprised," says Bryant, 56, a medical secretary from Pasadena. They were the "same symptoms as diverticulitis." Her doctor immediately referred her to Im, who diagnosed ovarian cancer.
Bryant is undergoing chemotherapy at Mercy.
Symptoms that may indicate ovarian cancer can also be related to other maladies, notes Dr. Paul Celano, head of oncology at Greater Baltimore Medical Center. "But the point is well taken," he says. "Any woman who has these symptoms should be evaluated."
For more information about ovarian cancer, the foundation suggests visiting the Women's Cancer Network at wcn.org
SYMPTOMS TO NOTE
Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist:
Pelvic or abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (urgency or frequency)
[Source: Gynecologic Cancer Foundation]