7 Clues to Ovarian Cancer
Researchers Find 7 Symptoms Linked With Ovarian Cancer, Dispelling ‘Silent Killer’ Reputation
Aug. 25, 2009 -- Seven symptoms often reported to doctors are associated
with ovarian cancer, according to a new study from the U.K., dispelling the
idea that the deadly cancer is a ''silent killer'' with few clues until the
''Ovarian cancer is not silent, it's noisy," lead author William Hamilton,
MD, a consultant senior lecturer at the University of Bristol, tells WebMD in
an email interview. "It's just we're not very good at deciphering the noise."
Ovarian cancer accounts for 4% of all cancers in women, Hamilton says, but it
has the worst prognosis of all gynecologic cancers. His study is published
online in BMJ.com.
Ovarian Cancer Study Details
In the study, Hamilton and his colleagues evaluated 212 women, aged 40 and
above, with a diagnosis of primary ovarian cancer and compared them with 1,060
healthy women. The women went to 39 different general practice doctor's offices
in Devon, England.
The researchers looked at the medical records for a year before the cancer
was diagnosed and did the same for the healthy women. They took note of what
symptoms the women had complained about and at what time.
Ovarian Cancer Study Findings
Seven symptoms were found associated with ovarian cancer, including:
- Abdominal distension
- Urinary frequency
- Postmenopausal bleeding
- Loss of appetite
- Rectal bleeding
- Abdominal bloating
The researchers calculated what they term the ''positive predictive value''
for each symptom -- that is, the chances that a woman with a specific symptom
actually does have ovarian cancer.
The symptoms had low positive predictive values -- less than 1% -- except
abdominal distension, which had a value of 2.5%.
The 2.5%, Hamilton tells WebMD, means that "one woman in 40 with this
symptom will have ovarian cancer." That is a value he considers high, he says.
''It's roughly the same as the risk of lung cancer when you cough blood and the
same as colon cancer when you pass blood rectally."
When they evaluated more closely, the researchers found that three of the
ovarian cancer symptoms -- abdominal pain, abdominal distension, and urinary
frequency -- were reported at least six months before the diagnosis and were
significantly associated with ovarian cancer.
Ovarian Cancer Symptoms and Screening
Women often use the term bloating for distension, Hamilton writes. But
medical experts generally consider distension as a progressive increase in
abdominal size; bloating is an intermittent increase and decrease.
Under current guidelines in the U.K., Hamilton notes in the paper, abdominal
distension is not a symptom that warrants "urgent investigation."
In the U.S., bloating is one of the symptoms that is likely to persist in
women with ovarian cancer compared to women in the general population,
according to the American Cancer Society. If a woman complains of bloating, her
doctor will likely do a thorough physical exam, and perhaps a CA-125 blood
test, which measures a protein found in the blood of many women with ovarian
cancer, or a transvaginal ultrasound.
Routine screening with CA-125 and transvaginal ultrasound isn't done in the
general population, according to the ACS, nor is routine screening for ovarian
cancer recommended by the American Cancer Society or other medical
organizations. But the tests are often offered to women at high risk of ovarian
cancer, such as those with a very strong family history of the disease.