Women, doctors miss signs of ovarian cancer

November 16, 2000

NEW YORK, Nov 14 (Reuters Health) - Ovarian cancer remains one of the deadliest

cancers to strike women, largely because it is often not caught until the later

stages. But new study findings show that contrary to what many doctors have been

taught, women with ovarian cancer often have tell-tale symptoms when the disease

is still highly curable.

In a study of 1,725 US and Canadian women with ovarian cancer, investigators

found that nearly all had symptoms before they were diagnosed with the disease.

Most had abdominal symptoms such as bloating and pain, while many others had

gastrointestinal problems, pelvic pain, abnormal bleeding or other signs of

ovarian cancer. Yet because these problems can signal a number of health

conditions, many women and their doctors did not recognize them as a cancer

warning.

Researchers led by Dr. Barbara A. Goff of the University of Washington in

Seattle report their findings in the November 15th issue of Cancer.

When ovarian cancer is caught early, the survival rate is high--up to 90%. But

only about one quarter of women have their cancer detected before it has spread

outside the ovaries. Once ovarian cancer hits an advanced stage, survival rates

drop to 20% to 30%, according to Goff and her colleagues. One reason for the low

rate of early detection is the vagueness of the disease's symptoms.

But ignoring symptoms such as chronic abdominal and pelvic pain can come with a

price. Goff's team found that women who initially ignored their symptoms were

significantly more likely than others to be diagnosed at a later stage of

ovarian cancer. About half of the women endured symptoms for more than 3 months

before seeing a doctor.

And many doctors were slow to make the right diagnosis. Only 20% of the women

were told they might have ovarian cancer at their first doctor visit. The rest

were diagnosed with conditions ranging from irritable bowel syndrome to

depression. Some were told nothing was wrong. Twenty-one percent of the women

blamed their doctors' " attitude " for their delayed diagnosis.

" The results of our study suggest that we may be able to reduce delays in

diagnosis by better educating both patients and healthcare providers about the

symptoms of ovarian (cancer), " Goff and colleagues write.

The authors add that while most women with abdominal or pelvic problems will not

have ovarian cancer, doctors should perform pelvic exams to rule it out before

" labeling " women with another condition.

SOURCE: Cancer 2000;89:2068-2075.

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