Ovarian Cancer Not as Silent as Believed

NEW YORK, June 13 -- Ovarian cancer is associated with a specific set of symptoms that should trigger further evaluation by a physician, "preferably a gynecologist," according to a consensus statement released today.

Although ovarian cancer is often not diagnosed until late stages because no disease-specific signs or symptoms had been previously identified, the statement urged that that a woman be evaluated if she has the nonspecific symptoms it cited "almost daily for more than a few weeks."

"Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies," said the statement. "The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms."

They are:

• Bloating
• Pelvic or abdominal pain
• Difficulty eating or feeling full quickly
• Urinary symptoms (urgency or frequency).

"Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved diagnosis," according to statement issued by the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists, and the American Cancer Society.

Only 19% of women with ovarian cancer are diagnosed at a stage when treatment has the best chance of extending survival beyond five years. According to the American Cancer Society 22,430 new cases of ovarian cancer and 15,280 deaths from ovarian cancer are likely this year in the United States.

The consensus statement also noted that although several other symptoms have been reported by women with ovarian cancer-notably fatigue, indigestion, back pain, pain with intercourse, constipation, and menstrual irregularities-those symptoms were judged to be not as useful in identifying ovarian cancer because they are also common among women without ovarian cancer.

The consensus statement was scheduled for release on June 25, but the contents of the statement were revealed in a front page article in today's New York Times.

Sherry Salway Black, executive director of the Ovarian Cancer National Alliance one of the groups that has endorsed the consensus statement, credited Barbara Goff, M.D., a University of Washington gynecologist, with much of the research that formed the basis for the statement.

Dr. Goff and Cindy Melancon, a co-founder of the Alliance, conducted a survey of ovarian cancer survivors aimed at pinpointing early symptoms. Those data were published in the Journal of the American Medical Association in 2004.

Black said the medical community has traditionally been dismissive of ovarian cancer patients' reports about symptoms. "We are proud that founders of the Ovarian Cancer National Alliance have been the catalyst for changing this thinking," she said.