Ovarian Cancer Is Not Always a 'Silent Killer'

Study finds that women sometimes report symptoms months before diagnosis

28 aug 2009- Despite the fact that ovarian cancer is dubbed the "silent killer," patients usually have symptoms that are noticeable, sometimes months before their diagnosis, according to a study published online Aug. 25 in BMJ.

William Hamilton, M.D., and colleagues at the University of Bristol in the United Kingdom analyzed medical records for 212 women over 40 years of age who were diagnosed with primary ovarian cancer, as well as 1,060 matched controls. Researchers blinded to the status of each patient assessed them for evidence of a range of reported symptoms.

There were seven symptoms reported by women that were associated with a subsequent diagnosis of ovarian cancer: abdominal distention, postmenopausal bleeding, loss of appetite, increased urinary frequency, abdominal pain, rectal bleeding and abdominal bloating, the researchers found. In 85 percent of the cases and 15 percent of the controls, at least one of these symptoms was reported to a primary care physician before diagnosis. After the symptoms reported within 180 days before diagnosis were excluded, abdominal distension, urinary frequency and abdominal pain were still independently associated with an ovarian cancer diagnosis.

"Currently, the only realistic proposition for expediting the diagnosis of ovarian cancer rests with identification of cancer in women with symptoms. Symptoms are common and often reported, even in early, and potentially curable, cancers. In that respect, our results are encouraging: there is some chance of identifying early ovarian cancer by using symptoms," the authors write. "Ovarian cancer is not silent; rather its sound is going unheard."

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