Symptoms of 'Silent Killer' Not So Quiet

Ovarian cancer, called the silent killer because it often goes undetected, does have pronounced symptoms if doctors and patients would only heed them, researchers said.

A bloated abdomen, pelvic pain and an urgent need to urinate, which some associate with menstruation, may signal an ovarian tumor especially if the symptoms are severe, frequent and simultaneous, they said.

The importance of early diagnosis is illustrated in five-year survival rates that approach 90 percent if the disease is caught early versus 20 percent if diagnosed after it has progressed, a study published in the Journal of the American Medical Association said.

Comparing women who turned out to have malignant tumors and cancer-free women who visited a health clinic during the same six-month period in 2001, those with cancer were much more likely to have a combination of increased abdominal size, bloating, pelvic pain and a frequent and urgent need to urinate. Back pain, constipation and fatigue were commonly reported symptoms, but were not associated with cancer.

"The important difference is that (vague) symptoms (reported by noncancerous women) are less severe and less frequent when compared with women with ovarian cancer," wrote study author Barbara Goff of the University of Washington School of Medicine, Seattle.

"In addition, women with ovarian cancer typically have symptoms of recent onset and have multiple symptoms that coexist," she wrote. "This study adds further evidence that ovarian cancer is not a silent disease."

Ovarian cancer is the fifth-leading cause of cancer death among U.S. women after cancers of the lung, breast, colon, and pancreas. About 23,000 women are diagnosed with the disease each year, and 14,000 die from it -- a relatively high fatality rate caused by the failure to catch many cases early.

Strategies to screen for ovarian cancer have proven to be elusive but this study demonstrated what to look for, an editorial accompanying the study said.

"The importance of this study is not the validation of a symptom cluster as a precise way to diagnose ovarian cancer, but rather the reinforcement of the need for an ongoing process of communication between patients and their physicians," Mary Daly and Robert Ozols of the Fox Chase Cancer Center in Philadelphia wrote.

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