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    Wednesday, June 09, 2004

    Forever on Guard: Is there a symptom complex for ovarian cancer that points to the diagnosis early in the disease? Press reports and an author of a new study say yes:

    "Women with ovarian cancer and comparatively large but benign tumors of the ovaries, they are symptomatic and they're symptomatic even in early-stage disease,' said Dr. Howard G. Muntz, a gynecologic oncologist at Virginia Mason and a study author. 'Ovarian cancer is not a silent disease."

    But his study says otherwise. For women without ovarian tumors:

    Of the women who presented for primary care, 95% reported at least 1 symptom in the past year... The median number of reported symptoms was 4. The median severity of all symptoms was between 2 and 3. In 72% of cases, women had symptoms that occurred at least once per month....The median number of recurring symptoms was 2 and the median severity for all recurring symptoms was between 2 and 3.

    For women with benign ovarian tumors:

    In the women with benign disease, the median age was 55 years and 95% of the women reported symptoms in the prior year; 67% reported recurring symptoms; 8% reported having symptoms for 6 to 12 months; and 19% reported having symptoms for more than 1 year before seeing a clinician. The median number of symptoms was 4 and the median number of recurring symptoms was 2 (n = 84).

    For women with ovarian cancer:

    In the group with malignancy, the median age was 55 years and 94% of the women reported symptoms in the prior year with 67% having recurring symptoms. The median number of symptoms was 8 and the median number of recurring symptoms was 4 (n = 44)... When asked the duration of symptoms before seeking medical attention, 36% had symptoms for 2 months or less; 24%, 2 to 3 months; 3%, 5 to 6 months; 8%, 7 to 12 months; and 14%, more than 1 year.

    So, the same percentage of women in all three groups reported symptoms in the prior year, and about the same number had recurring symptoms, although recurring symptoms were a little more frequent in the women without ovarian tumors. And most notably, the ovarian cancer patients had their symptoms for the shortest duration before seeking care, which means that there was probably something about their symptoms which told them things weren't right and drove them to the doctor's office. That something was likely the frequency and severity. This isn't exactly ground-breaking work. Most doctors base their diagnosis decisions at least in part on the severity and frequency of symptoms. An occasional bout of constipation or bloating that lasts a day or two and goes away doesn't set off the alarm bells that daily, worsening constipation and bloating do. Even if the daily, worsening symptoms have only lasted a couple of weeks.

    And then, there's the matter of whether early ovarian cancer presents with these symptoms, or whether they only manifest themselves when the cancer has grown large enough to press on surrounding organs and cause the symptoms. The data are ambiguous. For one thing, the sample size is extremely small. Only eleven women had early stage cancer, while 33 had late stage ovarian cancer. It was more likely due to good fortune that those eleven women had symptoms early in the course of their disease rather than later. Ovarian cancer still remains a silent disease that more often than not manifests itself late in the game. The study doesn't shed any new light on diagnosing it sooner.

    posted by Sydney on 6/09/2004 08:31:00 AM 0 comments


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