It's been considered a silent killer because it seems to give no warning. Yet many women who've had ovarian cancer say they had symptoms for several months before diagnosis. In June the Gynecologic Cancer Foundation, Society of Gynecologic Oncologists, American Cancer Society, National Ovarian Cancer Coalition (NOCC), and others released a joint consensus statement (see http://www.wcn.org/ov_cancer_cons.html) identifying the following symptoms as more likely to occur in women with ovarian cancer:
* abdominal bloating
* pelvic or abdominal pain
* difficulty eating or feeling full quickly
* urgent or frequent urination
Women who have any of these symptoms almost daily for several weeks should consult a physician, preferably a gynecologist.
Each year in the United States, 21,000 women are diagnosed with ovarian cancer and 15,000 die, largely because they have advanced-stage disease at the time of diagnosis. "Nurses should encourage women to listen to their bodies and seek medical attention if they have symptoms that are of concern," says Barbara Goff, a gynecologic oncologist at the University of Washington in Seattle, whose research contributed to the consensus statement's formulation. In one study, Goff and colleagues surveyed 1,725 women about 23 symptoms previously found to be associated with ovarian cancer. Women with ovarian cancer had symptoms 12 or more times a month within the year preceding diagnosis, whereas women without the disease reported them much less frequently.
An editorial in the Lancet, while supportive of the consensus statement, notes that "the statement provides no specific guidance for doctors about what to do when such women present to them." Still, women can be on the alert, despite the fact that these symptoms are common to other diseases. If detected before cancer spreads beyond the ovary, the cure rate is 70% to 90%. When the cancer is diagnosed at an advanced stage, the five-year survival rate is 20% to 30%. To increase awareness the NOCC has launched a nationwide campaign; go to http://www.ovarian.org and click on "Break the Silence."
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Postmenopausal women using hormone replacement therapy (HRT) have a significantly increased risk of developing ovarian cancer, say researchers conducting the Million Women Study in the United Kingdom. They estimate that 1,300 ovarian cancers and 1,000 additional deaths since 1991 have resulted from HRT use. The risk of developing ovarian cancer increases along with the duration of HRT use, but there was no difference in risk according to the type of HRT used (estrogen-only versus estrogen-progestagen preparations) or the route of administration (oral versus transdermal). For more information, see http://www.millionwomenstudy.org.
Carol Potera