Ovarian Cancer Does Have Symptoms After All

[sbk]

Ovarian Cancer Not as Silent as Believed

By Peggy Peck, Managing Editor, MedPage Today

Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.

June 13, 2007

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Pelvic or abdominal pain is a symptom in the diagnosis of ovarian cancer

NEW YORK, June 13 -- Ovarian cancer is associated with a specific set of symptoms that should trigger further evaluation by a physician, "preferably a gynecologist," according to a consensus statement released today.

Although ovarian cancer is often not diagnosed until late stages because no disease-specific signs or symptoms had been previously identified, the statement urged that that a woman be evaluated if she has the nonspecific symptoms it cited "almost daily for more than a few weeks."

Action Points

* Explain to interested patients that the basis of the consensus statement was assessment of evidence from published studies.

* Explain to interested patients that the symptoms described here suggest the need for medical evaluation, and they do not confirm the diagnosis of ovarian cancer.

"Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies," said the statement. "The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms."

They are:

* Bloating

* Pelvic or abdominal pain

* Difficulty eating or feeling full quickly

* Urinary symptoms (urgency or frequency).

"Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved diagnosis," according to statement issued by the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists, and the American Cancer Society.

Only 19% of women with ovarian cancer are diagnosed at a stage when treatment has the best chance of extending survival beyond five years. According to the American Cancer Society 22,430 new cases of ovarian cancer and 15,280 deaths from ovarian cancer are likely this year in the United States.

The consensus statement also noted that although several other symptoms have been reported by women with ovarian cancer-notably fatigue, indigestion, back pain, pain with intercourse, constipation, and menstrual irregularities-those symptoms were judged to be not as useful in identifying ovarian cancer because they are also common among women without ovarian cancer.

The consensus statement was scheduled for release on June 25, but the contents of the statement were revealed in a front page article in today's New York Times.

Sherry Salway Black, executive director of the Ovarian Cancer National Alliance one of the groups that has endorsed the consensus statement, credited Barbara Goff, M.D., a University of Washington gynecologist, with much of the research that formed the basis for the statement.

Dr. Goff and Cindy Melancon, a co-founder of the Alliance, conducted a survey of ovarian cancer survivors aimed at pinpointing early symptoms. Those data were published in the Journal of the American Medical Association in 2004.

Black said the medical community has traditionally been dismissive of ovarian cancer patients' reports about symptoms. "We are proud that founders of the Ovarian Cancer National Alliance have been the catalyst for changing this thinking," she said.

I read in another report that women reported these symptoms but were often dismissed as being menopausal and weren't investigated.

[Nienke]

How do they check for possible ovarian cancer?

Nienke

[leisurely]

I think that there are certain hormones or tumour markers that can be detected on blood analysis. My Mum goes every six months for a vaginal ultrasound and blood tests as part of an ongoing medical trial in London. Seemingly there is a certain amount of genetics involved in your risk of contracting this disease.

[Sheryl]

Vaginal ultrasound (offered as part of the general check-up package at some of the international hospitals here) will show even a very tiny mass on the ovary. There is a blood test called CA-125 which will show elevations in about 80% of cases. It is not used for mass screening because it is also elevated in other conditions (such as endometriosis) plus about 20% of the time it won't be elevated even though cancer is present. However it should be done anytime a mass is seen on ultrasound or palpated during a pelvic exam. It is also a good idea to check it as part of annual physical in women with a history of Ca of the ovary.

One warning about vaginal ultrasounds: they will show even tiny masses such as are present during and after ovulation, and this can lead to a battery of unnecessary tests as doctors don't want to risk assuming that this is what it is. SO -- and I speak from expensive experience! -- only have a vaginal ultrasound done at the very beginning of your cycle if possible. Days 1-5 are best but up to day 7 would work.

[Jet Gorgon]

Good info, Sbk and Cheryl. Thanks.

I had cervical cancer many years ago in Japan. The doctor advised me to have a hysterectomy. No way! I went home and my doc did a cone biopsy in day surgery.

I do recommend all women to get a pap smear at least once a year; I do it twice a year. On Samui, my dentist and gyno were on the same block so did them both in one go. Which is worse? 555

I know many Asian women never go for a pap -- they think it's only for BG types. A real pity.

[donna]

very interesting reading.

i have been having terrible problems of late. i was initially diagnosed as being menopausal at just 41 yrs old, but then started menstruating again suddenly!

after many tests here and finding nothing 'wrong' with me at all, i finally went to see my doc in australia who found a 4.8cm cyst on my right ovary. he advised me to get straight to see a gyno in australia, but as the waiting list is about 3 mths, i did not have the time. so i brought my ultrasound films back here to phuket to show the doc here.

i went to see the doc on wednesday this week and showed him the ultrasounds (which were done on about day 21) and he immediately sent me down for more. this was day 5 or 6 i think. the first thing that the radiographer said was that the equipment that had been used in australia was far superior to the equipment that she used.

so, the cyst is now about 3.8cm which is down a tad, but its still there. the doctor informed me that there is a chance that it is cancer but he needs to check again in two more months. i am not sure i want to wait that long so i will go for another check with a different doctor and see what they say.

this thing does give me pain and a bloated feeling. i have also put on weight but not increased my food intake, so something is definitely wrong in there. so, i am not ignoring this thing. i am just waiting for the right time of my cycle to get checked.

in addition, a woman i used to work with has just died (on sunday) from complications arising from ovarian cancer. she was only 53.

now, THATS a wake up call.

[dekka007]

I have experienced this first hand my wife died from ovarian cancer 2.5 years ago at the age of 32. It is very much a silent killer with some vague symptoms that are usually misinterpretated by doctors especially if they are affecting younger low risk individuals.

My wife experienced back pain, cystitis and minimal bloating...........the doctors put it down to early pregnancy symptoms however on the first routine scan it showed a mass which at first was diagnosed as a cyst......

A CA125 done and it showed elevated levels - again doctors said could be down to the pregnancy etc.

Surgery was recommended and undertaken to find the cancer was extensive stage3c and had spread to a large area in the abdomen.

Having spoken to the best doctors in the UK - Ovarian Cancer is very much a hormone driven cancer and by being pregnant the hormones accelerated the growth dramatically.

Chemo followed but was unsuccessful and I lost her september 2004 and our first child also.............it is a a terrible disease and still somewhat a silent killer.

My advice is combine the yearly smears with a abdominal ultrasound. And if there is something there get the CA125 test asap.

it does not cost an awful lot of money to get the ultrasound once a year...........for peace of mind for yourself and your family.

[sbk]

So sorry for your loss Dekka, and thank you for sharing what must be a very painful story. Spreading the word is the best means of fighting this.

[Barryz]

I thought I would hang out in the ladies' forum for a while because the bloke's forum is getting a bit boring, but these stories of ovarian cancer are not turning me on. I feel I have nothing to contribute here.

The equivalent would be a bloke's thread on prostrate cancer, in which I also wouldn't be much interested, (because I'm healthy).

[donna]

thanks for popping in barryz but the information on here is of some help to some people. it may not be turning you on, so i suggest you pop back over to the blokes forum and talk about trucks and fishing.

[Barryz]

thanks for popping in barryz but the information on here is of some help to some people. it may not be turning you on, so i suggest you pop back over to the blokes forum and talk about trucks and fishing.

Trucks and fishing doesn't interest me, so it looks like I'm stuck with ovarian cancer (and shaving pubic hair etc,)

[LaReina]

SOrry Dekka.. that sounds like a lot to get thrown at a person, and all at once..

Thanks for sharing..

[LaReina]

Barryz I guess Bambi was not one of your childhood movies..

"If ya' ain't got nuthin' good to say, then.... ... .. ..... .. .... ."

[Barryz]

Barryz I guess Bambi was not one of your childhood movies..

Hey! I remember watching that movie many, many years ago. I vaguely recall being moved to tears.

[hansnl43]

The equivalent would be a bloke's thread on prostrate cancer, in which I also wouldn't be much interested, (because I'm healthy).

Barryz, you are healthy, but every man has or will get prostate cancer. Not everyone will die of it but of another illness.

[Barryz]

The equivalent would be a bloke's thread on prostrate cancer, in which I also wouldn't be much interested, (because I'm healthy).

Barryz, you are healthy, but every man has or will get prostate cancer. Not everyone will die of it but of another illness.

We're all going to die of something. I'd like it to be simply just old age, painlessly, but who knows the future! If the prognosos is not good, I'll be looking at euthanasia which seems particularly appropriate for ..asia (pun).

Seriously, how is euathanasi viewed in Thailand? Are the appropriate drugs easily available?

Sorry to end on such a cheerful note .

[Sheryl]

As we say in my home town..fuggetabuddit!

Thais will not even euthenize sick dogs and cats.

And, as elsewhere, drugs that would make for an easy exit are not sold over the counter.

[Barryz]

And, as elsewhere, drugs that would make for an easy exit are not sold over the counter.

That's surprising and very disappointing. I recall when I got my first case (and only case) of gonnorhaea about 44 years ago, in Bangkok, I didn't bother consulting a doctor. Just went to the chemist and got the appropriate dosage of antibiotics. Cleared up in a few days with no problem.

My! How things have changed. Sure hope the rules governing dispensation of drugs don't get as convoluted as the issuing of visas .

[cathyy]

The equivalent would be a bloke's thread on prostrate cancer, in which I also wouldn't be much interested, (because I'm healthy).

Actually, the male analogue is testicular cancer, which is another cancer often not diagnosed early enough. This particular cancer is most commonly found in young men, late teens to mid-twenties or so. I'll bet nobody ever told you that young men should do a monthly self-exam of their testicles, checking for lumps just like women do with their breasts! Catching it early can mean only losing one testicle, and so not needing hormones the rest of your life and being able to have children. But the men most likely to have it are the age group most likely to be in denial that ANYTHING might be wrong with their precious equipment...

And it isn't prostate cancer that all men get eventually. It's BPH, benign prostatic hypertrophy. That is the one that causes issues with frequent urination and trouble getting urination started, dribbling and such. But it's not cancer.

Edited June 18, 2007 by cathyy

[sbk]

Anyway, this is the Ladies forum and not really an appropriate place to discuss men's prostates. We are discussing women's health issues here, lets not hijack the thread with other issues.

Sorry cathyy, I know you are being kind and responding. But we all need to bear in mind that there are other places for men to discuss their health issues and a thread about ovarian cancer is not one of them.

[Barryz]

Anyway, this is the Ladies forum and not really an appropriate place to discuss men's prostates. We are discussing women's health issues here, lets not hijack the thread with other issues.

Sorry cathyy, I know you are being kind and responding. But we all need to bear in mind that there are other places for men to discuss their health issues and a thread about ovarian cancer is not one of them.

Quite right. I really shouldn't have got involved in this thread. As we say in Australia, 'this is women's business'.

[cathyy]

True enough. So sorry! I forgot I wasn't in the health thread, and was just trying to spread a little education around since it was being read by both genders.