From the American Cancer Society:

Specific Symptoms May Signal Ovarian Cancer

Article date: December 18, 2006

Hope for Earlier Detection?

Ovarian Cancer is typically detected only after it has spread beyond the ovary, making it difficult to treat. That's one reason it is the deadliest of the gynecological cancers, accounting for more than 15,000 deaths among US women in 2006.

Now researchers from the University of Washington say they may have a way to help find this disease earlier, and potentially save lives. They've identified 6 specific symptoms common in women with ovarian cancer:

pelvic or abdominal pain
abdominal bloating
urinary urgency (needing to get to a bathroom immediately)
urinary frequency (having to urinate often)
feeling full
having difficulty eating

Women with these symptoms should be checked thoroughly for the disease, they write in the online edition of the journal Cancer.

Not every woman who has these symptoms will have ovarian cancer, of course. This disease is rare, accounting for just 3% of cancers among women. These symptoms can also signal other more common conditions, like irritable bowel syndrome.

But lead researcher Barbara Goff, MD, says women need to know when to take such symptoms seriously, and doctors need to know when to look for ovarian cancer. Goff is a professor and director of gynecologic oncology at the University of Washington.

"The important thing is to recognize that we all have these symptoms from time to time, but we do not have ovarian cancer," she explains. "Having these occasionally does not mean you have cancer, but if it's something new to you and it persists for more than a couple of weeks and occurs almost daily or every day, you need to bring it to a doctor's attention."

Ovarian cancer is still unlikely, she emphasizes. Nevertheless, doctors need to consider ovarian cancer along with other conditions when they try to figure out what's causing these symptoms.

Other experts agree. Doctors should first rule out more common causes for these symptoms, says Debbie Saslow, PhD, director of breast and gynecologic cancers at the American Cancer Society. But once they've done that, they should look for ovarian cancer -- not let the woman go.

"It's not the first thing you'd look for, but it should be one of the things," she says.

Narrowing the Field

Goff and colleagues came up with the symptom list by questioning women with and without ovarian cancer about 23 symptoms that have been identified in previous studies as potentially linked to ovarian cancer. The full list included things like indigestion, constipation, bleeding after menopause, and back pain, among others.

Women with ovarian cancer were more likely to report one or more of the 6 symptoms on the list, and typically experienced them 12 or more times per month. However, the symptoms had developed relatively recently; the women had had them for less than a year.

The next step is to see if the symptom list can actually help doctors find ovarian cancer earlier, says Goff. Right now, routine screening for ovarian cancer isn't recommended because there is no reliable test for the disease.

Until such a test is developed, Goff says women and their doctors could use this symptom list as a guide for figuring out who needs a more thorough workup to look for ovarian cancer.

She says women with the symptoms should get a full physical and a gynecological exam that includes pelvic and rectal exams. If either of these is abnormal, women should get an ultrasound to look for ovarian masses, and may also need blood tests or other procedures, depending on what the ultrasound finds.

If the gynecological exam is normal, "it's reasonable to wait and see if the symptoms go away," Goff says. If they don't, ultrasound should be done to look for ovarian problems. If no ovarian problems are found even then, Goff says doctors should consider other tests, such as colonoscopy or CAT scans, to find the cause of the symptoms.