Cancer Experts Identify Symptoms For Early Diagnosis Of Ovarian Cancer

The American Cancer Society, Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists on June 25 are expected to formally announce recommendations for identifying symptoms that could signal early stages of ovarian cancer, the New York Times reports. Experts from the groups are calling on women who experience the symptoms -- which include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and a frequent or urgent need to urinate -- every day for two to three weeks to see a gynecologist.

Some physicians said the recommendations will make women and doctors more aware of early symptoms of ovarian cancer and will lead to earlier diagnosis. "The majority of the time this won't be ovarian cancer, but it's just something that should be considered," Barbara Goff, director of gynecologic oncology at the University of Washington and an author of several studies that helped identify the symptoms, said. She added that new and persistent problems were the most important for women to monitor.

According to the Times, if ovarian cancer is diagnosed and surgically removed before it spreads outside the ovary, 93% of patients are alive after five years. However, only 19% of cases are diagnosed early, and 45% of all women with ovarian cancer survive at least five years, compared with 89% of women diagnosed with breast cancer. About 22,430 new cases of ovarian cases and 15,280 deaths are expected in the U.S. this year, the Times reports.

According to Goff and other specialists, women who have the symptoms should visit a gynecologist for a pelvic and rectal exam. If the exams suggest a possibility of ovarian cancer, the next step would be a transvaginal ultrasound, which costs between $150 and $300, and a $100 blood test to detect CA125, a substance that is often elevated in women who have ovarian cancer.

Women whose test results suggest ovarian cancer should be referred to a gynecologic oncologist. Women who still experience symptoms but who have normal test results could be monitored or advised to undergo a CT scan or magnetic resonance imaging, but they likely will be recommended for immediate surgery if cancer is "strongly suspected," the Times reports. Debbie Saslow, director of breast and gynecologic cancer at ACS, said the question over what to do in such cases remains unresolved.

Reaction
Thomas Herzog, director of gynecologic oncology at Columbia University Medical Center, said the recommendations are important because medical community previously had said there were no early symptoms of the disease. Carol Brown, a gynecologic oncologist at Sloan Kettering Cancer Center, said that the recommendations are "something that women themselves can do and we can familiarize clinicians with, to help make diagnosis earlier." Brown added that the list of symptoms might be the best solution for early diagnosis until a screen test to "find ovarian cancer before it has symptoms" is developed.














Saslow said that ACS agreed to the recommendations with reservations. "We don't have any consensus about what doctors should do once the women come to them," Saslow said, adding that the group recognizes that physicians in some cases disregarded symptoms in women who were later diagnosed with ovarian cancer (Grady, New York Times, 6/13).

Broadcast Coverage
Several broadcast programs on Wednesday and Thursday reported on the recommendations.

ABC's "Good Morning America": The segment includes a discussion with ABC medical editor Tim Johnson (Sawyer, "Good Morning America," ABC, 6/14). Video of the segment is available online.

CBS' "Evening News": The segment includes comments from Goff, Brown and a woman who was diagnosed with ovarian cancer (Couric, "Evening News," CBS, 6/13). Video of the segment is available online.

PBS' "NewsHour with Jim Lehrer": The segment includes comments from Goff (MacNeil, "News Hour with Jim Lehrer," PBS, 6/13). Audio of the segment is available online.

NBC's "Nightly News": The segment includes a discussion with NBC News chief medical editor Nancy Snyderman (Williams, "Nightly News," NBC, 6/13). Video of the segment is available online.

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