The Symptoms of Early-Stage Ovarian Cancer

This transcript has been edited for clarity.

Ovarian cancer represents the most lethal gynecologic malignancy in US women. During training, I was taught that ovarian cancer is a silent killer. Indeed, most cases are diagnosed in women in their 50s or 60s who have advanced disease, and to date, screening for this uncommon but dreaded disease has not been found to reduce ovarian cancer mortality.

Prior studies conducted to assess whether symptoms are present in women with ovarian cancer have focused on patients with late-stage disease.

The lead article in the February issue of American College of Obstetricians and Gynecologists' (ACOG's) Green Journal (Obstetrics & Gynecology) addressed the prevalence of symptoms in women with early-stage ovarian cancer. Investigators used data collected at the time of enrollment in a trial that assessed different chemotherapy strategies for women with stage I or II disease.

Among 419 patients evaluated, some three fourths presented with one or more symptoms. Of these, approximately one half had one symptom and one third had multiple symptoms. The most common symptoms were abdominal or pelvic pain, followed by fullness or increased abdominal girth. Other symptoms included abnormal bleeding as well as urinary and gastrointestinal complaints.

An important limitation of this report is that participants in the trial had already been diagnosed with ovarian cancer. We know that patients already diagnosed with disease are more likely to report prior symptoms than before disease diagnosis. Given this potential for recall bias, the study likely overestimated symptom prevalence in women with early-stage ovarian cancer.

Nonetheless, we should counsel women in their 50s or older to contact us if they experience persistent abdominal or pelvic pain, increased abdominal fullness or girth, or abnormal uterine bleeding. When such symptoms are identified, arranging for a vaginal ultrasound represents a prudent next step.

I am Andrew Kaunitz. Please take care of yourself and each other.

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Cite this: Andrew M. Kaunitz. Not as Silent as We Thought: The Symptoms of Early-Stage Ovarian Cancer - Medscape - Feb 08, 2022.

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