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    Ovarian Cancer: Take Symptoms Seriously

    Doctors, Patients Should Discuss, Investigate Vague Symptoms

    WebMD Health News

    June 8, 2004 -- New research sheds light on symptoms of ovarian cancer, often referred to as a "silent killer." A cluster of symptoms -- increased bloating and abdominal size, pressure to urinate, constipation, and abdominal pain -- should not be overlooked, say study authors.

    "Women need to be aware of this cluster [of symptoms]," researcher Lynn S. Mandel, PhD, with the department of obstetrics and gynecology at the University of Washington in Seattle. "It doesn't mean they have ovarian cancer. But the symptoms should be investigated to see what it is. It could be a malignancy, or it could be something else -- an ovarian cyst or endometriosis."

    Mandel's study, which appears in this week's Journal of the American Medical Association, should also be a wake-up call for doctors, says Ira Horowitz, MD, vice chairman and director of gynecologic oncology at Emory University's Winship Cancer Institute in Atlanta.

    "Ovarian cancer is very silent in the early stages ... any symptoms are usually vague, nonspecific, and doctors tend to blow them off," Horowitz tells WebMD. "This study tells us that we need to heed those vague symptoms. They are screaming for our attention. We need to think of ovarian cancer first -- not last."

    Indeed, many women see numerous doctors for their symptoms, including gastrointestinal specialists, before ovarian cancer is even suspected. And, unfortunately, the symptoms are most noticeable when cancer is advanced -- not in the early stages, Horowitz tells WebMD. "When the mass [in the ovary] is significant in size, that's when symptoms are more intense. Then it's too late."

    It all points to the need for better -- and ongoing -- doctor-patient communication, writes Mary B. Daly, MD, PhD, in an accompanying editorial. "The early diagnosis of ovarian cancer must rely on the elusive practice of [the doctor's] judgment ... and thoughtful dialogue between patient and physician."

    "Women know their bodies, and when something changes, they need to make sure the physician is aggressive in evaluating it," Horowitz says.

    Frustrating, Deadly Disease

    Ovarian cancer has long frustrated doctors and their patients, writes Mandel. Very few cases of ovarian cancer are caught in the early treatable stages -- and chances of surviving late-stage ovarian cancer is poor.

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