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Experts bare an ovarian cancer myth

Medical groups now say the disease has early warning signs

Published: Thursday, June 14, 2007 12:04 a.m. MDT

By Liz Szabo
USA Today

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Doctors have long assumed that ovarian cancer grows in secret, often producing no symptoms until it's too late.

Hoping to dispel that myth, three leading medical societies released a paper Wednesday to educate women and their doctors about its early warning signs.

Possible symptoms include:

• Pelvic or abdominal pain

• Bloating

• Difficulty eating or feeling full quickly

• Urgent or frequent urination.

Women with one or more of these conditions may want to see a gynecologist, especially if the problems are new, severe and occur almost daily for more than two or three weeks, says Barbara Goff, director of gynecologic oncology at the University of Washington in Seattle.

Goff notes that most women with these symptoms — which are relatively common — don't have cancer.

Doctors are concerned, though, that only about 20 percent of women with ovarian cancer are diagnosed early, when the disease is curable, says Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, which authored the paper with the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists. Seventeen other cancer organizations have endorsed it.

"We know this has the potential to scare people," Goff says. "But because ovarian cancer is such a deadly disease, we feel they should be checked out promptly. This has the potential to save lives."

Ovarian cancer is expected to kill about 15,000 U.S. women this year.

Goff's research has shown that 89 percent of women with early ovarian cancer have symptoms six to 12 months before diagnosis, along with 97 percent of those with advanced disease. Many women go undiagnosed for months, however, because they or their doctors don't recognize their symptoms.

Experts today don't agree on what to do about these symptoms, Saslow says. Gynecologists may perform pelvic and rectal exams, a transvaginal ultrasound and a blood test for a cancer marker called CA-125, she says. These tests aren't very accurate, however. The CA-125 test misses about half of ovarian cancers, and half of its positive tests turn out to be false alarms, Saslow says.

Even if those tests show no sign of cancer, doctors may refer patients to gynecologic oncologists if their symptoms are very severe. Saslow notes that diagnosing ovarian cancer involves far more invasive tests than those used in prostate and breast cancers, which are typically confirmed through needle biopsies. Surgeons may remove a suspicious cyst and, if cancerous, take out the entire ovary.

Saslow says it's possible that publicizing the symptom list could increase anxiety among women, as well as unnecessary surgeries, which pose their own risks of infection and bleeding.

"It's a difficult balance," she says.

Ovarian cancer at a glance