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31 December 2004
Early Warning Signs Of Ovarian Cancer Flagged 
A study by Olmsted Medical Center and the Mayo Clinic analyzing symptoms of ovarian cancer patients suggest ovarian cancer, long considered symptom-free until late-stage cancer develops, does in fact have early symptoms, including urinary incontinence and abdominal pain. "Ovarian cancer is called the silent killer," says Barbara Yawn, of the Olmsted Medical Center and the study's lead investigator. "We know now that there are symptoms, yet it appears that women ignore them and physicians don't recognize the potential urgency of evaluating the symptoms." Crampy abdominal pain and urinary urgency, frequency or incontinence were the most commonly documented symptoms in women in the early stages of ovarian cancer. In the later stages, abdominal pain and increased abdominal girth were the most commonly documented symptoms. Fewer than 25 percent of the symptoms would be considered unique to ovarian cancer or related directly to the reproductive pelvic organs: the uterus, fallopian tubes, cervix and ovaries. The investigators said that the symptom of abdominal pain most likely originates from pressure from the tumor or from fluid in the abdomen prompted by the tumor's presence. Urinary incontinence is most likely due to the tumor's pressing on the bladder and causing increased pressure within the abdomen, prompting urine loss. Study investigator Brigitte Barrette found the commonality of urinary leakage symptoms among the ovarian cancer patients particularly interesting. "My surprise with our findings was at the urinary incontinence, because it's not something that has been reported often," she says. "Sudden or marked change in urinary leakage was a symptom. So, incontinence problems that develop over a period of just a few weeks are something to pay attention to." The difficulty in differentiating symptoms of abdominal pain and urinary incontinence as ovarian cancer predictors lies in the many different diseases or conditions to which these symptoms may point. "Many of the symptoms are more common in other conditions, such as irritable bowel syndrome or colon cancer," says Dr. Yawn. Looking for ovarian cancer is a bit like looking for a zebra in a field of horses. "Someone can go to the doctor with bloating, and usually the physician will investigate for the common things," says Dr. Barrette. "It's like when someone goes to the emergency room with a headache. Most of the time, it's not a stroke. But, that should be considered." Drs. Yawn and Barrette suggest that women and their doctors be particularly alert to incontinence and abdominal pain that do not improve with treatment. "Ovarian cancer must be considered. If the symptoms persist and there is not a clear reason, you need to look further," said Dr.Yawn At a minimum, the investigators said the symptoms require a pelvic examination with an ultrasound and a blood test for ovarian cancer if they do not resolve within weeks - not months. "We know if ovarian cancer is detected at an earlier stage, the survival is about 90 percent; we know that an early stage can make a difference," said Dr. Yawn.
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