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Warning signs may lead to better early detection of ovarian cancer

Curator: Prabodh Kandala, PhD.

Ovarian cancer is one of the leading gynecological malignancies. Although rare, it is deadly and affects more than 35,000 female population every year in U.S alone. It was referred to as silent killer in the past and affects one in 70 women. The most difficult part of the ovarian cancer is its detection. There are no sufficiently accurate screening tests that can diagnose this malignancy. Although several tests were proposed and tested, none of them confirmed the accurate detection. Two recent reports suggested that early detection is key in the fight against ovarian cancer.

Northwestern Memorial Hospital (2011, September 19). Early detection is key in the fight against ovarian cancer. ScienceDaily. Retrieved September 23, 2012, from http://www.sciencedaily.com­/releases/2011/09/110915163957.htm

Catching ovarian cancer early increases five-year survival odds from 30 percent to more than 90 percent. But the symptoms of ovarian cancer often mimic other less dangerous conditions making it difficult to recognize. Women should be aware of possible early warning signs which include

1. Bloating

2. pelvic of abdominal pain

3. Difficulty eating or feeling full quickly

4. Urinary symptoms (urgency or frequency)

5. Increased abdominal size

Women who frequently (almost daily for two to three weeks) experience one or more than one symptoms listed above should see the doctor.

Doctors say it is not clear what causes ovarian cancer but there are factors that increase the odds of developing the disease including carrying a mutation of the BRCA gene, having a personal history of breast cancer or a family history of ovarian cancer, being over the age of 45 or if a woman is obese. If a woman is high-risk, doctors recommend screening begin at age 20 to 25, or five to 10 years earlier than the youngest age of diagnosis in the family. In addition, there are genetic tests available that can identify women who are at a substantially increased risk.

Studies have shown there are ways to reduce the risk of developing the disease. Women who use birth control pills for at least five years are three-times less likely to develop ovarian cancer. In addition, permanent forms of birth control such as tubal ligation have been found to reduce the risk of ovarian cancer by 50 percent. In cases where women have an extensive family history of breast or ovarian cancer, or who carry altered versions of the BRCA genes, may receive a recommendation to remove the ovaries and fallopian tubes which lowers the risk of ovarian cancer by more than 95 percent.

Eating a diet rich in fruits and vegetables, getting regular exercise, maintaining a normal body weight and managing stresses are all ways women can help decrease their risk of ovarian cancer

The best scenario would be to prevent this cancer entirely but until that day comes women need to focus on good health behaviors, listen to their bodies and know their family history

Ovarian Cancer Screening: Simple Two-Minute Questionnaire That Checks for Six Warning Signs May Lead to Better Early Detection

M. Robyn Andersen, Barbara A. Goff, Kimberly A. Lowe.Development of an instrument to identify symptoms potentially indicative of ovarian cancer in a primary care clinic setting. Open Journal of Obstetrics and Gynecology, 2012; 02 (03): 183 DOI:

Researchers at Fred-Hutchison cancer center came up with a simple three question paper and pencil survey that effectively identify those who are experiencing symptoms that may indicate ovarian cancer. This study represents the first evaluation of an ovarian cancer symptom-screening tool in a primary care setting among normal-risk women as part of their routine medical-history assessment. The survey asked about the frequency and duration of above mentioned symptoms: how many days a month and for how long?

This study also strengthens the above report from Northwestern memorial hospital.

“Symptoms such as pelvic pain and abdominal bloating may be a sign of ovarian cancer but they also can be caused by other conditions. What’s important is to determine whether they are current, of recent onset and occur frequently,” said lead author M. Robyn Andersen, Ph.D., a member of the Hutchinson Center’s Public Health Sciences Division. Previous research by Andersen and colleagues has found that about 60 percent of women with early-stage ovarian cancer and 80 percent of women with advanced disease report symptoms that follow this distinctive pattern at the time of diagnosis.

“Women with symptoms that are frequent, continual and new to them in the past year should talk to their doctor, as they may be candidates for further evaluation with ultrasound and blood tests that measure markers of ovarian cancer such as CA-125,” she said. “Recent research indicates that approximately one in 140 women with symptoms may have ovarian cancer. Aggressive follow-up of these symptoms can lead to diagnosis when ovarian cancer can be caught earlier and more effectively treated.”

The study involved 1,200 women, age 40 to 87, who were seen in a Seattle women’s health clinic. More than half of the study participants reported being postmenopausal and approximately 90 percent were white. About half of the clinic visits were for a current health concern or for follow-up of a health problem reported at an earlier visit. The other half were for routine appointments such as mammography screening.

Of those surveyed, 5 percent had a positive symptom score that indicated the need for further testing. Of this group of about 60 women, one was diagnosed with ovarian cancer shortly thereafter. Of the 95 percent of women who tested negative on the symptom survey, none developed ovarian cancer during a 12-month follow-up period, which attests to the accuracy of the screening tool.

Those who reported current symptoms on the questionnaire or reported other medical concerns scored higher than those who did not. Non-white women were also about twice as likely to receive a positive symptom score as compared to white women.

“If ovarian cancer screening using symptoms is widely adopted, maximizing the specificity of screening programs will be important,” the authors wrote. “Until better biomarkers are identified and tested, collecting information about symptoms appears to have promise.” The bottom line, Andersen said, is that the screening tool can be used easily in a primary-care setting, is acceptable to patients and providers, and identifies women with symptoms that are worthy of concern with minimal false-positive results.

The study questionnaire that was tested in the clinic was based on a symptom-screening index developed in 2006 by Andersen and co-author Barbara Goff, M.D., professor and director of Gynecologic Oncology at the University of Washington School of Medicine.

Ref:

http://www.sciencedaily.com/releases/2012/09/120921161638.htm

http://www.sciencedaily.com/releases/2011/09/110915163957.htm