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In order to produce the optimal chance of achieving a cure in patients with ovarian cancer, it is essential that the cancer is diagnosed and treated as early as possible. Unfortunately, due to a lack of definitive symptoms, the majority of women with ovarian cancer are not diagnosed until their cancer has reached an advanced stage, when it is considered incurable. For this reason, ovarian cancer has been referred to as the “silent killer”. However, results from a recent clinical study published in the journal Cancer indicate that the majority of women with ovarian cancer actually do experience symptoms caused by their cancer prior to diagnosis. Since symptoms may be discreet and vary from person to person, women and/or health care practitioners may not immediately recognize the direct association of these symptoms with ovarian cancer. The delay in treatment may literally be the difference between life and death for patients with this disease.

Ovarian cancer is a common malignancy occurring in women in the United States, with about 25,000 new cases diagnosed each year. The ovary makes female hormones and stores all of the eggs that are released once a month during ovulation. There are two ovaries, one on each side of the uterus. The earlier ovarian cancer is detected, the higher the cure rate.

A recent study evaluated over 1,700 women in the United States and Canada who had been diagnosed with ovarian cancer. Ninety-five percent of these patients reported having symptoms prior to their diagnosis. Almost 80% of the patients who experienced symptoms reported abdominal abnormalities, including increased abdominal size, abdominal bloating and abdominal pain. Other frequently experienced symptoms included the following: indigestion, abnormal vaginal bleeding, constipation, pelvic pain, urinary frequency or incontinence, pain with intercourse, nausea, fatigue, back pain and diarrhea.

In this study, only 20% of patients were initially told that they may have ovarian cancer. Eighty percent of patients were initially misdiagnosed or were told they had no medical problem. The type of health care providers that patients went to included family practitioners, internal medicine physicians and obstetrician-gynecologists. Although there was no difference in time to diagnosis between the types of physicians, obstetrician-gynecologists made correct diagnoses more frequently and diagnosed significantly more early stage ovarian cancers than family practitioners or internal medicine physicians.

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These results indicate that many symptoms caused by ovarian cancer may not be appropriately recognized by health care providers in a timely manner, causing a delay of diagnosis and treatment for patients with this disease. Moreover, patients experiencing these symptoms may choose to ignore them for months, delaying the process of effective treatment even further. In order to ensure optimal initial treatment, it is imperative for patients who experience these symptoms to see a health care provider without delay. Furthermore, patients concerned that their symptoms may be attributable to ovarian cancer may wish to see a gynecologic oncologist to receive the most appropriate care. Additionally, it is essential for health care providers to perform standard procedures for the detection of ovarian cancer, including a pelvic examination, transvaginal ultrasound, and/or a blood test for CA 125 levels, in patients who present with any of these symptoms.

Increased awareness of symptoms associated with ovarian cancer may potentially facilitate earlier diagnosis and treatment of the disease, which is essential to improving outcomes of this “silent killer”. (

Cancer, Vol 89, No 10, pp 2068-2075, 2000)

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