Delayed Diagnosis for Ovarian Cancer Can Cost Lives
Nov. 16, 2000 -- Vague symptoms, such as abdominal bloating and gastrointestinal upset, may be a sign of ovarian cancer and should not be ignored, according to a study in the Nov. 15 issue of Cancer.
Ovarian cancer is often called a "silent killer," according to study author Barbara A. Goff, MD, who is with the University of Washington department of obstetrics and gynecology in Seattle. She writes that the disease is usually not detected until an advanced stage because it has been thought that most women with ovarian cancer don't have specific symptoms. In fact, ovarian cancer does produce symptoms, but both patients and doctors may not give them proper attention.
Goff and colleagues surveyed more than 1,700 women with ovarian cancer and found that 95% of them did experience symptoms before their diagnoses, most often increased abdominal size, abdominal bloating, abdominal pain, and fatigue. Other symptoms included indigestion, constipation, back pain, and change in urination frequency. Most importantly, only a quarter of the women experienced specific pelvic symptoms, such as pelvic pain or pain with intercourse.
Today, all women know that a breast lump is a warning sign for breast cancer, something you don't ignore. Now women need to become aware that vague abdominal symptoms possibly could point to an ovarian tumor or the spread of a cancerous tumor.
About one in five of the women who took the survey ignored their symptoms at first. When the women did go to see the doctor, 30% said they had been given an incorrect diagnosis such as stress, depression, or irritable bowel syndrome. Still, more than half of them did get a correct diagnosis in less than three months from the time they first talked to the doctor; 11% waited more than a year.
One in five of the surveyed women believed doctors' attitudes toward their symptoms were a barrier to accurate diagnosis. Among the women who weren't diagnosed for more than a year, almost half felt one of the reasons was their provider's attitude.
"Women must pay attention to these symptoms and go to a doctor if they have them. Consumers sometimes have to be an advocate for themselves," says Anil Sood, MD, assistant professor of gynecologic oncology at the University of Iowa College of Medicine in Iowa City.
James Fiorica, MD, agrees. "The message from this study is, don't ignore these symptoms. Don't assume it's just some virus. See your physician and ask if these symptoms could be due to ovarian cancer." Fiorica is program leader of the gynecologic oncology program at the H. Lee Moffitt Cancer Center and Research Institute and professor at the University of South Florida, both in Tampa.
A pelvic exam is one of the most valuable tools we have to diagnose ovarian cancer, say both Fiorica and Sood. It allows the physician to feel with the fingers to see whether there's an ovarian mass. It helps the doctor decide whether further tests, such as ultrasound, are needed.