Ovarian cancer has often been called the 'silent killer' because symptoms are not thought to develop until advanced stages when chance of cure is poor," write Barbara A. Goff, MD, from the University of Washington School of Medicine in Seattle, and colleagues. "Other investigators have also shown that 80% to 90% of women with early stage disease will report symptoms for several months prior to diagnosis. Identification of early symptoms may have important clinical implications because 5-year survival for early stage disease is 70% to 90% compared with 20% to 30% for advanced-stage disease."
Of 1,709 women who visited two primary care clinics and completed an anonymous survey of symptoms experienced for the past year (July 2001 to January 2002), 128 women had ovarian masses.
In the overall clinic population, 72% reported recurring symptoms with a median number of two symptoms; 45% had back pain, 34% had fatigue, 27% had bloating, 24% had constipation, 22% had abdominal pain, and 16% had urinary symptoms.
Compared with controls, ovarian cancer cases had significantly increased odds ratios for increased abdominal size (7.4), bloating (3.6), urinary urgency (2.5), and pelvic pain (2.2). Compared with women with benign masses or with controls, women with ovarian cancer had significantly more symptoms of higher severity and more recent onset, and they typically experienced symptoms 20 to 30 times per month. The symptom pattern of bloating, increased abdominal size, and urinary symptoms was reported by 43% of women with ovarian cancer but by only 8% of the overall primary care clinic population.
"While our current study did find that women who present to primary care clinics frequently have vague symptoms that can be associated with ovarian cancer, the important difference is that these symptoms are less severe and less frequent when compared with women with ovarian cancer," the authors write. "Women with ovarian cancer typically have symptoms of recent onset and have multiple symptoms that coexist. This study adds further evidence that ovarian cancer is not a silent disease."
The Ovarian Cancer Research Fund, Inc., supported this study.
In an accompanying editorial, Mary B. Daly, MD, PhD, and Robert F. Ozols, MD, PhD, from Fox Chase Cancer Center in Philadelphia, Pennsylvania, review the morbidity and mortality of ovarian cancer, and they note that one reason for the relatively high case-fatality rate is failure to identify early stage disease.
Because there are to date no acceptable screening approaches to detect early ovarian cancer, symptom recognition is crucial. Characteristics of the symptoms that should raise clinical suspicion of ovarian cancer are frequency, severity, time of onset, and total number of symptoms.
"The importance of this study is not the validation of a symptom cluster as a precise way to diagnose ovarian cancer, but rather the reinforcement of the need for an ongoing process of communication between patients and their physicians," Drs. Daly and Ozols write. "In the absence of more definitive diagnostic tools, early detection of ovarian cancer will continue to challenge both the artistic skill of astute clinicians as well as their accumulated scientific acumen."
JAMA. 2004;291:2705-2712, 2755-2756
Learning Objectives for This Educational Activity
Upon completion of this activity, participants will be able to:
List symptoms and organ systems associated with ovarian cancer.
Compare symptoms of ovarian cancer with other symptoms common to women seeking medical care.
Clinical Context
Ovarian cancer causes more mortality in the U.S. than any other gynecologic cancer. One reason for the lethality of this neoplasm is the fact that it is often diagnosed at an advanced stage, when the disease is more difficult to treat. According to the authors of the current study, the 5-year survival rate for early stage ovarian cancer is 70% to 90% compared with rates of 20% to 30% for patients with advanced disease.
A good screening tool for ovarian cancer remains elusive. Both transvaginal ultrasound and cancer antigen 125 levels present problems with sensitivity and specificity. However, clinical symptoms may offer another means to discover ovarian cancer at an earlier stage. In a survey of 1,725 women with ovarian cancer written by the same authors as the current study and published in the November 15, 2000, issue of Cancer, 95% of all women reported symptoms prior to their diagnosis of cancer. The systems most frequently affected were categorized as abdominal, gastrointestinal, pain, constitutional, and urinary. Pelvic symptoms were rarer than these other symptoms and were experienced by only 26% of patients.
These same authors' new research compares symptoms of patients with ovarian cancer with those found in women in benign pelvic masses and a general cohort of women seeking medical care.
Study Highlights
The study analyzed surveys of symptoms given to two groups of women. One group was a general cohort of women presenting for primary health care at one of two clinics. The other group comprised women scheduled for surgery to remove an ovarian or pelvic mass. Surveys were completed for a 6-month period, and patients were instructed to complete only one survey.
1,709 women from the primary care practices completed the survey. 62% of these patients were presenting for a specific problem, while 25% were interested in a general check up. This cohort was predominantly white and well-educated.
95% of the primary care group reported at least one symptom in the past year. The most common symptoms were back pain (60%), fatigue (52%), indigestion (37%), and urinary tract problems (35%). The median number of symptoms reported was 4, and the median severity of symptoms was between 2 and 3 on a 5-point scale in which 5 represented the most severe symptoms. 72% of women in the primary care group reported symptoms at least once per month.
Women presenting to primary care clinics for care of diabetes, thyroid disease, and irritable bowel syndrome (IBS) reported more symptoms than other women in this group.
The incidence of all symptoms except urinary tract symptoms decreased with age in the primary care group.
128 women with pelvic masses underwent surgery, and 84 were found to have benign disease or tumors with low malignant potential. 11 women had early stage ovarian cancer, and 33 had late stage cancer.
95% of women with benign disease reported symptoms in the last year, and 67% of these subjects had recurrent symptoms.
94% of women in the group with ovarian cancer reported symptoms in the last year, and 67% of the participants had recurrent symptoms. The median number of symptoms was significantly higher than the other groups (8) as was the number of recurrent symptoms (4).
Specific symptoms more common in women with ovarian cancer compared with the primary care group included pelvic pain, abdominal pain, difficulty eating, bloating, increased abdominal size, and urinary urgency.
When compared with women with IBS, subjects with ovarian cancer were more likely to have increased pelvic pain, bloating, abdominal size, and urinary tract symptoms. However, women with IBS were more likely to experience diarrhea and indigestion.
The combination of bloating, increased abdominal size, and urinary tract symptoms was positive in 43% of women with ovarian cancer, 10% of women with benign masses, 13% of women with IBS, and 8% of women from the overall primary care group.
The severity of symptoms was generally worse in women with ovarian cancer and IBS compared with other participants.
Women with ovarian cancer experienced more daily symptoms, while primary care group subjects were more likely to have symptoms on an average of 2 to 3 times per month, in many cases associated with menses.
Women with malignant masses had experienced symptoms for a median of less than 6 months, and results for women with benign masses were similar. However, women with IBS and in the general primary care population had experienced symptoms for a median of 12 to 24 months prior to the survey.
Pearls for Practice
Ovarian cancer causes significant mortality in women and has been associated with symptoms comprising several different organ systems.
Women with ovarian cancer are more likely to have certain symptoms with a higher frequency and a reduced total duration of symptoms than women presenting for primary care services.
2006-06-23 11:17:44
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answer #1
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answered by Anonymous
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Hi there, I have an ovarian mass right now and am a former cancer survivor. Usually some symptoms come and go, others stay. Example, bloating and swelling in the abdomen and a "full" kind of feeling would stay. Pain, possible bleeding, etc could come and go. See the mass can torque or shift and cause pain or press on something, if it breaks the pain can be relieved but will come back, therefore come and go. Best thing to do is get checked out. It could be cysts or endometriosis, fibroid, etc, lots of other things.
The gyno doc will do an exam, probably urine test, blood work, then send you for a pelvic ultrasound which you drink 1 quart of water 1 hour before the test, hold your urine/pee, and have the test done then you can go to the bathroom. The tech, most of them, will tell you right away if you have a fibroid or cyst, for cancer they would tell you the dr would talk to you. They may want to examine the mass closer so they would do a transvaginal sonogram, you insert a stick thing covered with a condom into your vagina, they take picture through that and it shows the ovaries much closer view.
2006-06-23 17:29:13
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answer #2
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answered by Tina of Lymphland.com 6
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There are just too many symptoms of ovarian cancer to list. Getting a papsmear does NOT detect ovarian cancer. Usually if you have painful ovaries, your doctor will send you for an ultrsound, MRI or even a CT scan depending on what the Dr "feels" when they are doing your exam. There is blood work that can be done,(its called a CA125). If you have pain, go to thr doctor, if your at risk, go to the doctor....moral of the story...go to the doctor. I hope you find some relief and answers
2006-06-23 10:21:10
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answer #3
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answered by mel 2
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With every day pass, our country is getting into more and more trouble. The inflation, unemployment and falling value of dollar are the main concern for our Government but authorities are just sleeping, they don’t want to face the fact. Media is also involve in it, they are force to stop showing the real economic situation to the people. I start getting more concern about my future as well as my family after watching the response of our Government for the people that affected by hurricane Katrina.
According to recent studies made by World Bank, the coming crisis will be far worse than initially predicted. So if you're already preparing for the crisis (or haven't started yet) make sure you watch this video at http://www.familysurvival.tv and discover the 4 BIG issues you'll have to deal with when the crisis hits, and how to solve them fast (before the disaster strikes your town!) without spending $1,000s on overrated items and useless survival books.
2014-09-24 08:11:03
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answer #4
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answered by Anonymous
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I was diagnosed with Stage IV Ovarian Cancer in Aug of 1999. My aches and pains were always there. They weren't always as bad, but, yes, always there.
I have been CANCER FREE for 6 years now. The possibilities of that are low. If you think you have ovarian cancer, be seen by your doctor IMMEDIATELY!!!!!!!!!!!! I saw my doctor and had MAJOR surgery the next week. He told me if I had waited another month, I would've died.m
PLEASE GET CHECKED OUT IF YOU EVEN THINK YOU HAVE OVARIAN CANCER...............
2006-06-28 05:27:17
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answer #5
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answered by bejustmissy 1
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My Mother had Ovarian Cancer her aches and pains got worse as the cancer spread and I believe they were constant
2006-06-23 20:19:55
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answer #6
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answered by Anonymous
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Uterine fibroids would be the non-cancerous tumor growths in the smooth muscle levels of the uterus. The Uterine Fibroids is quite popular among the feminine sexuality during early, mid and later reproductive years and if you intend to remove it you'll need Amanda Leto's Fibroids Miracle guide from here https://tr.im/lePN0 .
Fibroids Miracle guide is really a complete manual to treating uterine fibroids naturally from home.
The Fibroid wonder is undoubtedly the most effective and most basic program to make use of to get your human body in good wellness and it'll revitalize the quality of your daily life. The fibroid miracle is the answer to a lasting option of your uterine fibroids health condition.
2016-04-28 07:22:10
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answer #7
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answered by ? 3
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If you want to remove the uterine fibroids with simple to apply ideas and methods you then need the Fibroids Miracle process from here https://tr.im/F7IjB
Fibroids Miracle use a mix of organic solutions and a multidimensional method of get rid of uterine fibroids, reduce their recurrence, boost fertility, carry the body back in a hormonal harmony, and completely eliminate all signs such as pelvic stress and suffering, bloating, vexation, bleeding, and suffering throughout sex.
The fibroids miracle is one of many easy stay more proficient healing practices of the fibroids wellness conditions.
2016-05-17 10:17:57
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answer #8
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answered by ? 2
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Some women have no pain whatsoever until it is too late. Best thing to do is get the Pap test. Also - if something hurts - go to the doctor. Don't take any chances.
2006-06-23 09:46:40
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answer #9
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answered by Blond Logic 4
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Ovarian cancer is deadly. The reason is because as the tumor webs in your pelvis, it obstructs your colon and you die from not being able to absorb nutrients.
2016-03-14 01:05:25
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answer #10
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answered by Anonymous
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Consult your Dr., he should order a pelvic ultra-sound, if this test is inconclusive, he may order a CT scan with contrast along with lab work. Any pain experienced for over a week should be seen by your Dr. especially if you have a family history.
2006-07-02 03:55:40
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answer #11
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answered by Sandy 4
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