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    Ovarian Cancer: Take Symptoms Seriously

    Doctors, Patients Should Discuss, Investigate Vague Symptoms

    Frustrating, Deadly Disease continued...

    The reason: There has been no clear pattern of symptoms. For many women, the symptoms are so common and vague that they don't realize anything is wrong. In fact, not all women even have symptoms.

    Mandel's research group and others have attempted to unravel this mystery. In an earlier study, her group found a pattern of gastrointestinal and abdominal problems, pain, fatigue, and urinary difficulties that seemed fairly predictable.

    This new study attempts to pinpoint the pattern more closely. The survey asked about a variety of symptoms that are often dismissed as unimportant: pelvic, abdominal, and back pain; indigestion; bloating and increased abdomen size; urinary and bowel problems, menstrual problems, and problems during intercourse (like pain or bleeding); and fatigue and leg swelling.

    Of the 1,709 women in the study -- all patients at two primary care centers -- 128 were diagnosed with either a benign or malignant pelvic tumor. All the women completed surveys asking about a list of symptoms.

    Mandel found this pattern among women diagnosed with ovarian cancer:

    • They were more likely to be postmenopausal, average age of 55.
    • 94% had symptoms during the past year; 67% had recurring symptoms.
    • They experienced their symptoms 15 to 30 times per month -- just about every day.
    • Symptoms had become severe in the past two or three months.

    Compared with women without cancer, those with ovarian cancer were also:

    • Seven times more likely to have increased abdominal size
    • Four times more likely to have bloating
    • Two-and-a-half times more likely to have increased urgency to urinate
    • Twice as likely to have pelvic and abdominal pain

    The symptom cluster of bloating, increased abdominal size, and urinary symptoms was found in 43% of women with cancer, Mandel reports. Only 8% of the other women had this pattern. This underscores the importance of coexisting symptoms.

    "Younger women reported more symptoms," she tells WebMD. "Postmenopausal women didn't have any symptoms, except for urinary symptoms."

    Her findings underscore the fact that these symptoms do exist, says Mandel. "It reinforces the ongoing need for communication between women and a health professional -- whether they go to a doctor, a nurse practitioner, a nurse. If anything is different from your normal, you need to be seeing a doctor. If you're not satisfied with the response you get -- if your symptoms don't resolve, if you're told it's in your head, insist that your doctor find out what it is."

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