Results from an Olmsted Medical Center and Mayo Clinic study analyzing symptoms recorded in the medical records of ovarian cancer patients suggest ovarian cancer, long considered asymptomatic 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, M.D., director of research at 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."
The most common symptom found in the records of the 107 ovarian cancer patients studied was crampy abdominal pain. Abdominal pain and urinary urgency, frequency or incontinence were the most commonly documented symptoms in women who had Stage I and II, the early stages, of ovarian cancer. In patients with Stages III and IV cancer, 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 study found the following factors associated with a longer time to diagnosis of patients' ovarian cancer: delays in women seeking medical care, health care system issues, competing medical conditions, physicians' failure to follow up, and women not returning for follow-up.
Brigitte Barrette, M.D., a Mayo Clinic gynecologist and study investigator, 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."