Ovarian cancer, long known as the “silent killer” since it was thought to have no symptoms in its earlier, more treatable stages, is not actually so quiet. This is news every woman should hear, loud and clear. A panel of cancer experts and advocacy groups recently identified symptoms they say should serve as early warning signs for ovarian cancer and recommend women who have them longer than two weeks should see their doctor. The goal is to save lives by making sure both women and physicians know signs of the early stages of this deadly disease, since the sooner it is caught the greater likelihood of survival.
I spoke with Barbara Goff, MD, director of gynecologic oncology at the University of Washington School of Medicine and lead author of several studies on ovarian cancer, to ask about what this new information means. Doctors have long considered ovarian cancer to have vague, hard-to-pin-down symptoms, she said. “Just recently we’ve been able to distinguish the symptoms of early-stage ovarian cancer from seemingly benign symptoms many women experience from time to time,” she told me.
WHAT TO WORRY ABOUT…
The experts recommend that women who have the following symptoms daily or almost daily for more than a few weeks should see their doctor — preferably a gynecologist:
• Bloating or increased abdominal size.
• Pelvic or abdominal pain — typically below the navel, on one side or the other and made worse with exercise and intercourse.
• Difficulty eating or feeling full quickly.
• Urinary symptoms, including urgency or frequency.
Before you panic, realize this important point — you don’t have to worry about the bloating that typically accompanies your menstrual period or the indigestion you feel after eating a bowl of chili or too much ice cream. “We all have some of these symptoms from time to time,” said Dr. Goff. “But, if there is a symptom that is new for you or it persists for more than a couple of weeks, we recommend you go to your doctor. Odds are it won’t be cancer… but it is worth having it checked just in case.”
WHY THIS NEWS IS SO IMPORTANT
Contrary to the previously held belief that ovarian cancer only makes its presence known when the disease has reached a late and incurable stage, numerous studies have now confirmed that the symptoms listed above are much more likely to occur in women with ovarian cancer than women in the general population. Researchers finally have enough statistically significant studies that can distinguish the symptoms of ovarian cancer from day-to-day symptoms. “We now have an evidenced-based statement that these symptoms are predictive of ovarian cancer,” said Dr. Goff, who is a spokesperson for the Gynecologic Cancer Foundation.
Dr. Goff and her colleagues hope that earlier diagnosis will save more lives from this lethal disease. The American Cancer Society estimates there will be 22,000 new cases of ovarian cancer and 15,000 deaths from the disease this year, making it the most deadly female reproductive system cancer and the fifth most common cause of cancer death in women. Overall, about three-quarters of women with ovarian cancer survive one year after they are diagnosed, and nearly half (45%) survive longer than five years after diagnosis. But that figure soars to 93% when ovarian cancer is diagnosed and treated before it has spread outside of the ovary — though unfortunately, historically it has usually been diagnosed after that point, in which case the chances for survival decrease considerably.
There’s no screening test available at present for ovarian cancer, making awareness of symptoms all the more important. The risk factors for ovarian cancer include a personal and/or family history (mother, sister or daughter) of ovarian cancer or cancer of the breast, uterus, colon, or rectum… age over 55… never being pregnant… and taking estrogen alone (not with progesterone) for menopausal hormone therapy. A woman’s lifetime chance of developing ovarian and/or breast cancer is greatly increased if she inherits an altered BRCA1 or BRCA2 gene (short for breast cancer one and two). This genetic abnormality can be identified through a genetic screening blood test.
MISDIAGNOSIS HAS BEEN A MAJOR PROBLEM
That the symptoms are so non-specific has meant that many women with early ovarian cancer are told there’s nothing wrong or are given wrong diagnoses. “Misdiagnosis of ovarian cancer is common,” said Dr. Goff. “One study conducted in 2000 showed that a significant percentage of ovarian cancer patients were wrongly diagnosed with other conditions prior to their diagnosis of ovarian cancer.” She said that 12% had been told they had irritable bowel syndrome… 12% were told it was stress… 10% were told nothing was wrong… and 6% were diagnosed with depression. Thirty percent of these women were treated with medication for other diseases — and all subsequently went on to learn that it was, in fact, ovarian cancer that was causing their symptoms.
WHAT EVERY WOMAN NEEDS TO KNOW
• If you have persistent symptoms, see your doctor. If, for no particular reason, you feel pain in your abdomen, experience bloating or find you are feeling full after eating only a bit, and especially if these symptoms last longer than a couple of weeks, see your doctor — soon. He/she will conduct a pelvic and rectal exam and, depending on the results, may order additional tests such as a transvaginal ultrasound or a CA125 blood test, which measures the elevation of an ovarian tumor marker.
• Don’t be afraid to get a second opinion. If you feel your doctor hasn’t taken you seriously or you aren’t confident in the opinion or diagnosis, seek a second opinion, Dr. Goff urges. “People are so worried about insulting their doctor. It’s no different than getting a job done in your house. You’d get more than one bid, wouldn’t you?”
• If diagnosed with ovarian cancer, seek care from a gynecologic oncologist. Cure rates among women with ovarian cancer are much higher if they are cared for by a gynecologic oncologist (a surgeon who has trained extensively in treating female reproductive cancers), says Dr. Goff.
• Spread awareness, it’s critical. Right now, because there is no screening test, awareness of the symptoms of ovarian cancer remains our first and best opportunity to fight this deadly disease.

Source(s): ??Barbara A. Goff, MD, is professor and director of gynecologic oncology and adjunct professor of surgery at the University of Washington School of Medicine in Seattle. Her research interests include ovarian cancer and early detection, complex gynecologic oncology surgery, and clinical trials for gynecologic malignancies. Dr. Goff is coauthor of “Development of an ovarian cancer symptom index,” which was published in the January 15, 2007, issue of the journal Cancer.

??? ??????? ??? ???? ??????

I’m from the Netherlands. We girls here love your column. We also have our share of Jonolans here too. They always want to tell women what to do. But we stand up to the ones that peep their heads out and try to set the tone for policy to keep women in their place.

Now that you have stood up to this closet bigot he will not return. They are basically cowards. Evil little cock roaches that scurry along under the cover of darkness doing their dirt. And YES, YES, YES, they do have very tiny winnies. Sorry, Jonolan but it’s true, but of course, you know that.

Shelli

Stinson Beach??! I’m in! When? You know I’ll just do another roadie so tell me, maybe we can go visit Mt tam where we were supposed to be meeting Azza right around this time of year, also? Is that nearby, could check a map but I’m writing here right now : )

Obama’s got the moves, I’d dance with him, he’s already got my vote and I don’t know about his stick size but he certainly shows though his easy groovin’ that he can roll with ‘it’- speak softly, be diplo, in response to whatever ‘it’ is, let’s hope I’m right…and let’s hope he gets the presidency or I’ll be researching another country to live in, don’t think I can watch the same same channel.

Doug, very nice sentiment about women and the ‘men we love’ but you came to your own logical conclusion in the last sentence, ‘…it is difficult to see where the love and respect actually come from…’ no further comment from the gallery of peanuts : )

Elaine, you and Kara can use my favorite tactic, which is to show your man that you know a few self defense moves and that you can shoot, NOT that I would ever carry a gun or use one on another human (though show me some of those nasty males harming women and I could justify it) and when I went once only w/C to a shooting gallery, he shit when I chose a Smith & Wesson 44 and shredded the brains and heart of the target, hahaha, the kick was hard for me to control but well worth it, overall it was friggin’ priceless, all the other men at the exec ‘retreat’ laughingly told him he’d better watch his ass, hahaha, makes me laugh just thinking about it, he’d tried to pawn
off a pretty 22 rosewood handled handgun as my ‘choice’ yeah right…having a decent roundhouse kick and letting them see it helps also. I’m a lover, not a fighter but I’m fairly prepared for anything that comes my way…
Thanks for the admiration : )

- Zen Lill

I liked Rosanne’s diatribe about Jolie and her fam in reference to how our government finances the exact reason Jolie needs to be an ambassador in the first place. You and I talked about this before, and she can’t seem to make up her mind?! What is that about…oh yeah…stupidity!

Elaine,
Perhaps, in reference to the comment that “If we as a group can get past the jealous rantings of the men we love and respect, this country has a chance”, I would say that getting past it is not this issue, but respecting yourselves enough to CHANGE these men’s ideas as what is right and fair and educating them to why you feel this is the case. Respect comes from when two people listen and appreciate eachother’s thoughts, needs, ideas and desires. If these men don’t do that, and you are trying to get past this, I am finding it difficult to see where the love and respect actually come from?