NYT, pg1: First official recognition of early symptoms of ovarian cancer: when to see a doctor

[DeepModem Mom]

Symptoms Found for Early Check on Ovary Cancer
By DENISE GRADY
Published: June 13, 2007

Cancer experts have identified a set of health problems that may be symptoms of ovarian cancer, and they are urging women who have the symptoms for more than a few weeks to see their doctors.

The new advice is the first official recognition that ovarian cancer, long believed to give no warning until it was far advanced, does cause symptoms at earlier stages in many women.

The symptoms to watch out for are bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly and feeling a frequent or urgent need to urinate. A woman who has any of those problems nearly every day for more than two or three weeks is advised to see a gynecologist, especially if the symptoms are new and quite different from her usual state of health.

Doctors say they hope that the recommendations will make patients and doctors aware of early symptoms, lead to earlier diagnosis and, perhaps, save lives, or at least prolong survival.

But it is too soon to tell whether the new measures will work or whether they will lead to a flood of diagnostic tests or even unnecessary operations.

Cancer experts say it is worth trying a more aggressive approach to finding ovarian cancer early. The disease is among the deadlier types of cancer, because most cases are diagnosed late, after the cancer has begun to spread....

http://www.nytimes.com/2007/06/13/health/13cancer.html?ref=todayspaper

[hippiechick]

1. Oh for God's sake ...

" ... bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly and feeling a frequent or urgent need to urinate ... "

Those are symptoms of about 500 other 'female maladies' from PMS to early labor to gonorrhea. :eyes:

[DeepModem Mom]

3. "women who have the symptoms for more than a few weeks"

I'd see a doctor with these symptoms if they continued for more than a few weeks, or if they weren't symptoms I recognized as ones I ordinarily experience. I think they're aware these symptoms are vague -- but they're just trying to help some women to an early diagnosis that might save lives.

[kestrel91316]

4. Heck, I'd think there was something wrong with me if I DIDN'T have

one or the other of these going on most of the time, lol.

[dflprincess]

5. The article I saw on this said the symptoms should have been

occuring every day for two or three weeks. This rules out any bloating that may be related to your normal cycle. It also did say the symptoms may be another condition entirely (though early labor or gonorrhea would be two good reasons to see a doctor). The trick will be to get a doctor to take them seriously and actually try figure out what's causing them.

I recently started to read an article on ovarian cancer that began "Gilda Radner should have known the symptoms of ovarian cancer.." No. Gildra Radner's doctors should have known the symptoms. As I recall, she went from doctor to doctor for over a year, believing something was wrong and kept getting told it was all in her head before she finally found a physician who took her seriously.

[DeepModem Mom]

6. A valuable post -- thanks, dflprincess! nt

[Bridget Burke]

30. For too many years, these symptoms have been written off.

"Just silly women, making complaints." I'm glad that MD's are paying more attention. Early diagnosis is really necessary in treating ovarian cancer. The fact that we have more female MD's nowadays can't hurt.

By the way--gonorrhea & early labor are also worth a doctor's attention. And severe PMS.

[pitohui]

31. yeah, these people never heard of PMS or the menstrual cycle?

this is ridiculous and will create lots of fear for millions

[me b zola]

2. Thank you for posting this

While I am glad that we are making strides in breast cancer screening, not enough attention and resources have been given to ovarian cancer which quite often has been a death sentence to a woman once she is (finally) diagnosed.

[Spacemom]

7. This makes me so mad

My mom was seeing a pain management doctor for 2 years prior to her diagnosis of ovarian cancer. She was complaining of stomach pain, vomiting daily, and lost 70 pounds in 6 months without trying. Everytime she mentioned these symptoms she was told that she's just "getting older" and she's overweight and she's "menopausal." By the time she was diagnosed in March of 2004, she was stage 3C. She died June 15, 2005. It doesn't matter if you go to the doctor with these symptoms, it's still "all in your head."

[DeepModem Mom]

8. I'm so sorry, Spacemom. And, sadly, I'm sure that same tragedy...

has been experienced in other families. Damn!

[Spacemom]

11. Thank You

:hug:

I apologize for using your thread to vent. Friday is 2 years without mom and I'm a little crazy right now.

I hope doctors will start listening when their female patients tell them something "isn't right." The symptoms are vague, but if tested and caught early so many more women could survive what is otherwise a death sentence.

[Delphinus]

10. A few years ago,

because my mom's belly (at 75) swelled up to where she looked like she would give birth at any moment, I asked the doctor, with my mom there in the room, if he would at least do the CA125 blood test. He said, "and if that comes back positive, what then?" I was struck dumb. When I recovered my composure I told him, "Well, you treat it." He then started in this long recitation of excuses and stuff - I don't think he ever ran the test.

This example, and so many more, makes me really question the medical system.

[DemBones DemBones]

17. That test is only good for determining if ovarian cancer has recurred in

women who've already had it. I don't know why he didn't tell you that -- maybe he didn't know!!! Did he do a scan?

[DemBones DemBones]

15. I'm very sorry about your mom. It's bad enough to lose your mother but when

a doctor's incompetence and insensitivity is partly to blame, it's even sadder and more infuriating. I lost my mother in 1985 in a similar scenario.

Mother went to see her internist four months in a row complaining that her chronic cough (from asthma, emphysema) had changed. Every month he just blew her off with the usual "Lose weight."

I should have sent him a picture of her dead body; he would have been pleased she had lost so much weight. :sarcasm:


She had lung cancer. It was inoperable but if he'd done a chest X-ray the first time she went in, and she'd had radiation right away, maybe she'd have lived longer and had more good quality days. She died ten months after the asshole finally diagnosed her. My dad, my brothers and I really should have sued him for malpractice.

Maybe it's not too late for your family to sue that doctor, or at least file a complaint with the state medical board. Her symptoms were much more dramatic than my mother's and should have signaled to anyone with half a brain that something was seriously wrong.


It's always "in your head" if you're a woman. Women doctors are, in my experience, no better, because they're trained alongside the men and pick up the bias.

[fortyfeetunder]

18. Sharing your sorrow and anger

I have a dim view of the medical profession especially when it comes to women's health. Reading about your mom validates the situation.

[fortyfeetunder]

21. I share your anger

there has got to be a fundamental change in MD attitude...not sure how to get this community to get a clue. If a person has a problem that medication and/or a lifestyle change cannot correct, then that should be a clue a diagnostic is in order.... :grr:

[avrdream]

28. Easy there,

I'm one of those gynecologists with so called "attitude" and I assure you I listen very carefully to patient complaints. We aren't all bad, you know.

And FYI, my mom died from metastatic endometrial cancer....and I can find all sorts of fault in her medical workup as well.

[fortyfeetunder]

29. Agree --- fundamental change?

I am glad you listen, and hope you can influence the others in your profession to listen to their patients instead of making assumptions.

It seems to me, just from reading this thread and others, there is a lack of listening to patients' concerns among a population of MD's and I perceive it's due to something lacking in patient relationship education.

Wouldn't you agree there has to be change in this area???

[nashville_brook]

23. a post worth nominating -- so true

[ComerPerro]

9. I think things are gonna get really bad with ailments like this,

mostly because they are treatable if caught early on, but if they progress uncaught then they are very difficult to recover from.

The sick thing is, a lot of times they aren't caught in early stages. Sometimes it is because people do not have access to preventative care.

This story is almost laughable, in a dark humor sort of way.

A woman who has any of those problems nearly every day for more than two or three weeks is advised to see a gynecologist, especially if the symptoms are new and quite different from her usual state of health.

How the hell is someone without access to adequate health coverage supposed to see a doctor for these symptoms? And even if it gets brought up at their visit to the OBGYN, how can we expect them to pay for all the treatment?

[spacelady]

12. I have been to the doctor with these symptoms and was then

sent for an ultrasound. My question is - what would be the definitive test(s) to diagnose ovarian cancer? The next steps a doctor should order in other words, besides the special blood test which I understand is merely an indicator rather than a definite diagnostic tool.

[DeepModem Mom]

13. I don't know the answer, spacelady...

and I think DU rules prevent anyone here from giving medical advice. I hope you find an answer to your question -- and good for you for having yourself checked out. Best to you.

[spacelady]

14. Thanks, not really medical advice, I am just wondering if

a definite diagnosis comes from a certain test, like a pet scan, ultrasound, etc. because there is a definite cost difference and I don't think the blood test can be considered diagnostic without a follow-up test of some kind.

[DemBones DemBones]

16. Did you know you can get ovarian cancer even if your ovaries have been removed?

I can't think of what it's called right now but it is the same type of cancer but growing somewhere else since the ovaries are gone.

I hate to be the bearer of bad news like this but I think it's very important that women who have no ovaries know about this.


Some hopeful news:

My gynecologist told me last month that there is a blood test for ovarian cancer in the works. The trials have looked good on it so far and it could be available within two years.

(Some of you have probably seen the letter about ovarian cancer without ovaries which says there is a blood test that everyone should get. It's been going around online for years. The truth is that the blood test it's referring to is for women who've had ovarian cancer, with or without ovaries. The test determines if the cancer has returned. It won't detect ovarian cancer.)

Oh, my GYN also said that when women have vague symptoms that could be due to ovarian cancer, he always advises them to have a scan done. I like doctors like him, doctors who listen to their patients. Since the symptoms are usually vague or nonexistent until Stage 4 with ovarian cancer, extra caution is called for.

[fortyfeetunder]

19. Blood testing, I hope so!

After all, the BPH for prostate cancer has been around for awhile....

[Sgent]

20. Are you referring to PSA?

If so -- its almost useless except to detect a recurrent prostate cancer, the false positives are way too high.

[DemBones DemBones]

22. Got a reference for that? The PSA seems to be

widely supported in the medical community and I've never heard of "false positives" with this test.

It measures the antigen levels so I don't even know what a "false positive" would be. Falsely high levels?

[FloridaJudy]

24. Yup. PSA can be elevated by conditions other than cancer

Affecting the prostate. The other problem is it doesn't distinguish between aggressive prostate cancer, which is thankfully rather rare, and the more common "indolent" prostate cancer that takes decades to become dangerous. The vast majority of men with prostate cancer will die with the disease, not of the disease. Since prostate cancer treatment can cause such nasty side effects as impotence and incontinence, there's a real danger to over-diagnosing it.

The PSA may be valuable as a screening test, determining which men deserve further testing, but it's not a diagnostic test.

http://www.cancer.gov/cancertopics/factsheet/Detection/PSA

Edited to add link

[Sgent]

26. Sure, see this

From the US Preventative Services Task Force:

* The U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against routine screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination (DRE).

Rating: I recommendation.
Rationale The USPSTF found good evidence that PSA screening can detect early-stage prostate cancer but mixed and inconclusive evidence that early detection improves health outcomes. Screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health. The USPSTF concludes that evidence is insufficient to determine whether the benefits outweigh the harms for a screened population.

USPSTF Recommendation on PSA Screening

[DemBones DemBones]

27. Thanks for that and I must say your tag line is

a favorite lyric of mine and also very appropriate to this situation.

I have done some reading and learned that the biopsies done on the prostate are also inconclusive. They can't tell from the biopsies if the cancer is an aggressive one or a slow-growing one -- and worse yet, the biopsied tissue may show no cancer but the man may actually have cancer.

Some argue against screening at all because of the bad side effects from surgery or radiation used to treat prostate cancer.

Autopsies show that a large percentage of men over 50 had undiagnosed prostate cancer that had nothing to do with their death, was still in situ.

[truedelphi]

25. Good info - Thanks for posting n/t