Ovarian Cancer: Listening for the Body's Signals

I distinctly recall the advice, twenty-five years ago, of my own OBGYN when searching for a pediatrician as a first-time mother:   find someone who listens to your child's symptoms and who can diagnose a problem quickly and accurately from your input. There's nowhere this recommendation is more relevant than in the case of women's health and ovarian cancer.   Clearly, one of the most valuable functions a trained health professional performs is that of diagnostician. Because there is no single, accurate test for ovarian cancer, the most effective way women can protect themselves from the mortality risks of the disease is to know the risk factors, signs and symptoms.

Don't be lulled into thinking, as many women do, that there are no symptoms to identify.   According to the Ovarian Cancer Research Fund, the most common symptoms are:

  • A sense of bloating, with vague but persistent and unexplained gastrointestinal complaints
  • Pelvic or abdominal pain
  • Difficulty eating or feeling full quickly
  • Unexplained change in bowel habits
  • Unexplained weight gain or loss
  • New and unexplained abnormal postmenopausal vaginal bleeding
  • Frequent or urgent urination

With the possibility of symptoms that mimic those of overactive bladder (OAB), it's particularly important that women can identify the additional signs of ovarian cancer that would distinguish it from OAB.   In fact, peri- or post-menopausal women are at greatest risk of the cancer, and they are also much more likely to be experiencing OAB as well.   Therefore, it's helpful to be aware of other high risk categories:   nullparous women, or women who have not been previously pregnant; women with no prior use of oral contraceptives, or women who have experienced uninterrupted ovulation; those with a family or personal history of breast and/or ovarian cancers; and women with the presence of BRCA 1 or BRCA 2 gene mutations.   Any woman faces a lifetime risk of 1 in 67 of facing ovarian cancer.

What is the connection between the symptoms of frequency or urgency and ovarian cancer?   Because the signs and symptoms of ovarian cancer are vague and can be misdiagnosed, less than 1 in 5 cases are found in early stages.   In advanced stages, symptoms become more pronounced as the tumor grows, putting pressure accordingly on the bladder and rectum sufficient to trigger frequent or urgent urination and other symptoms previously noted.   If you or anyone you know is experiencing OAB and its symptoms are not responding to behavioral strategies, medications, and minimally invasive interventions, you should consider asking your gynecologist if warning signs of ovarian cancer are present.

Too many women assume that the PAP test is used to detect all cancers of the pelvic area.   The PAP is used to detect only cervical cancer, not ovarian cancer.   A combination of a vaginal-rectal pelvic examination, a transvaginal ultrasound, and a CA125 blood test is needed to confirm a diagnosis of ovarian cancer.   None of these tests is definitive when used on its own, according to OCRF.

Unfortunately, too many women fail to listen to their bodies, recognize symptoms for what they are, and communicate them to their doctors in a timely fashion.   According to the American Cancer Society, 21,650 cases of ovarian cancer were diagnosed in 2008, and 15,520 women died from the disease.   The low detection and the high mortality rates account for the fact that patients are usually diagnosed in advanced stages after the cancer has spread beyond the ovaries.   Only 45% of all women diagnosed with ovarian cancer live more than 5 years after being diagnosed.   But if detected early, it is highly treatable with surgery, offering a survival rate exceeding 92%.   According to the Gilda Radner Familial Ovarian Cancer Registry, only 20-25% of those diagnosed after the cancer has spread live for five years or more.

Bottom line:   get educated, get in touch with your body, and get a proper and complete diagnosis early.

Nancy Muller