Posts Tagged ‘ovarian cancer symptoms’

Ovarian Cancer – five tips to make sure you get the medical care you need

Wednesday, May 11th, 2011

Did you know that more than 21,000 women are diagnosed with ovarian cancer in the U.S. each year? An astonishing 15,000 women die from ovarian cancer each year. Despite numerous advances in healthcare, the mortality rate for ovarian cancer has not improved in the last 30 years. Simply put, ovarian cancer is the deadliest of all gynecologic cancers. If the cancer is diagnosed in its early stages (i.e. before it spreads to other organs), the five-year survival rate is about 93.8%. However, if it the cancer is diagnosed in its later stages, the five-year survival rate is about 28.2%.

There is no question that ovarian cancer is quite deadly and that early diagnosis and treatment is key for survival. There is an abundance of information about ovarian cancer online and in other written sources. Simply put, take the time to familiarize yourself with the symptoms of this terrible disease. Let’s share with you some information, which I believe can make a difference. Call it a male lawyer’s perspective, if you will. I’ve seen what happens when early detection should have happened, but tragically did not.

1. Examine Your Medical History

Whenever the possibility for ovarian cancer exists, consider your medical history as you discuss your symptoms with your physician. If you are having symptoms consistent with ovarian cancer, take the initiative and discuss your symptoms and history with a gynecologist as opposed to your primary care physician. Make sure to tell your physician if you have any cancer history. Don’t forget to include information about any family history of cancer (parents, siblings, etc.). Of particular importance is any history of breast or ovarian cancer, although any cancer history is relevant. Unfortunately, women with a personal or family history of ovarian cancer or breast cancer are at a higher risk.

2. Understand and Appreciate Your Symptoms

Although your physician is likely to talk to you about ovarian cancer, it is always a good idea to familiarizer yourself with the signs and symptoms of ovarian cancer before your doctor’s appointment. Many of the symptoms of ovarian cancer overlap with the symptoms of cervical cancer. Therefore, if you are experiencing symptoms of cervical cancer, you and your physician should also discuss the possibility of ovarian cancer. We have seen cases were a physician will consider one or the other but not the possibility of both cancers. Here are some of the more common symptoms of ovarian cancer:

-          Irregular uterine bleeding

-          Abdominal  and/or pelvic pain

-          Abdominal fullness or bloating

-          Fatigue

-          Unexpected weight loss

-          Fatigue

-          Headaches

-          Frequent urination

-          Low back pain

Watch this video for more information about symptoms of ovarian cancer:

httpv://www.youtube.com/watch?v=fH9N4auMblE

 

Watch this video for more information about symptoms of cervical cancer:

httpv://www.youtube.com/watch?v=HHA_0HsjeBI&feature=related

3. Is it a solid mass?

If your radiographic studies reveal a mass, make sure that you get a clear answer as to whether the mass is solid or fluid-filled.  A fluid filled mass will typically turn out to be a cyst. It could also be a blocked fallopian tube (i.e., hydrosalpinx, hematosalpinx, pyosalpinx). Generally speaking, a fluid filled mass is less likely to be malignant. However, if your radiographic studies reveal a solid mass, especially one that arises from an ovary, the possibility of ovarian cancer must be seriously considered. If you are found to have a solid mass, talk to your gynecologist or primary care physician about consulting with a surgical oncologist.

4. Should you have a CA 125 blood test?

CA 125 is a protein. It is a tumor marker or biomarker for ovarian cancer because it is more prominent in ovarian cancer cells. The CA 125 test is a test designed to test the levels of CA 125 in a patient’s blood. Elevated CA 125 levels can be indicative of ovarian cancer. If your CA 125 levels are elevated, you and your physician should seriously consider the possibility of ovarian cancer. An elevated CA125 should prompt your physician to order additional radiographic studies, including a CT of the abdomen and pelvis, an ultrasound of abdomen and pelvis, a PET scan or even a CT pyelogram. You should also consider consulting an oncologist or a surgical oncologist. If you are found to have a solid mass and your CA 125 level is elevated, time is of the essence for further investigation and surgical intervention.  Ask your doctor about other tumor markers that can be tested.

5. Who is reading your ultrasound?

Many patients who present to their gynecologist with symptoms of ovarian cancer will initially undergo an ultrasound. A great number of gynecologists will themselves perform and interpret the ultrasound. Here is the problem. With all due respect to gynecologists, they are not trained ultrasonographers or even radiologists! Ultrasounds can be particularly difficult to read. This can be due to the patient’s position and, more frequently, the size of the patient. In heavier patients, a pelvic ultrasound can be quite limited if one is trying to visualize the ovaries, discern the presence of mass, or determine whether the mass is solid or fluid-filled. So, if your gynecologist is the only person to read your ultrasound, the result is potentially quite devastating. The mass could remain undiagnosed, and you may be told to come back if your symptoms get worse. The ultrasound may be interpreted as limited, and, for whatever reason, your gynecologist may simply neglect to order a more sensitive study (i.e. a CT scan). Instead, he or she may choose to monitor you for any further deterioration of symptoms.

In yet another instance, if the ultrasound is limited, a solid mass may be confused for a fluid-filled mass. Under these circumstances, you may be asked to follow-up in six months. The problem with all of these permutations is delay, and you cannot afford delay with ovarian cancer. Make sure that your radiographic studies, whatever they may be, are read by a skilled specialist in the interpretation of whatever study you undergo.

As we always say, be your own patient advocate and be an informed patient. Be an active participant in your medical care by being informed and by demanding the care you require. Having an understating of the types of mistakes that can be made during medical treatment is simply prudent.

Please share your familiarity or experience with ovarian cancer treatment. What do you think women should watch out for should they find themselves afflicted by this terrible disease?

For more information, see our other blogs:

Ovarian Cancer – Early Intervention is Key, What You Must Know…

New study links gene to ovarian cancer and may assist in early detection 

Ovarian Cancer – The Smear Test Won’t Tell You Much

 

Image from cancersyptomspage.com

Ovarian Cancer – Early Intervention is Key, What You Must Know…

Monday, January 3rd, 2011

According to the American Cancer Society, about 22, 000 women are diagnosed with ovarian cancer in the U.S. each year; about 14,000 of these patients will die as result of their cancer.  It is most noteworthy that the five-year survival rate is 90% when ovarian cancer is diagnosed before it has spread beyond the ovaries.  Yet, only about 20% of ovarian cancers are detected in the early stages.

Screening, more screening, monitoring and an understanding of the signs and symptoms of ovarian cancer are key to early detection.  A myth that must be dispelled is that cervical cancer is the same as ovarian cancer.  Just because a patient has a normal pap smear, does not exclude the possibility of ovarian cancer. Simply put, the pap smear test has nothing to do with the diagnosis of ovarian cancer. Unfortunately, recent studies suggest that many women rely on their normal pap smear result to conclude that they do not have an ovarian problem.

It must also be understood that what some doctors loosely characterize as an ovarian cyst does not necessarily exclude the possibility of ovarian cancer. If your doctor tells you that you have an ovarian cyst because of a mass identified on ultrasound, make sure to inquire about the basis for the conclusion that the mass is”just a cyst.” Sometimes the ultrasound is the only study performed to identify the mass.  As great as ultrasounds are, they are not always the most accurate studies.  This is particularly true for patients who are obese or overweight. Radiologists will often read ultrasounds in such patients as limited because of “body habitus” (the physique of the patient). Keep in mind that most of these ultrasounds are performed in clinics, and they are read by obstetricians, who are not trained radiologists. You must ask your physician if the mass is a solid mass or a mass filled with fluid. If it is a solid mass or your physician cannot answer the question, you may want to consider further studies. Don’t let your physician simply guess that the mass must be a cyst because of its size or because of some general statistical probability. In any event, both cysts and solid masses require further monitoring.

The symptoms of ovarian cancer include but are not limited to:

  • Swollen abdomen
  • Unusual or excessive vaginal bleeding
  • Pelvic and/or abdominal pain and/or heaviness
  • Back pain
  • Unexpected weight gain or loss
  • Increased urinary frequency or urgency
  • Lethargy
  • Constipation
  • Indigestion
  • Nausea and vomiting

If you and your physician suspect ovarian cancer, the following are useful diagnostic modalities:

  • Alpha fetoprotein
  • Blood chemistry
  • CA125 (may be done if ovarian cancer is strongly suspected or has been diagnosed, and to follow the cancer during or after treatment)
  • CBC
  • Quantitative serum HCG (blood pregnancy test)
  • Urinalysis
  • Abdominal CT scan or MRI of abdomen
  • GI series
  • Ultrasound
  • Pelvic laparoscopy
  • Exploratory laparotomy

If you are experiencing these symptoms, you may want to address the possibility of ovarian cancer with your physician.  Some physicians will generally perform an ultrasound. If they are not impressed with the ultrasound, they may not pursue any other diagnostic modalities.  If the ultrasound reveals a mass, some physicians may elect to wait and perform a follow-up ultrasound in a few months.

Notwithstanding how aggressive your physician is to rule out ovarian cancer, remember that physicians rely on your feedback, and you alone truly know the extent and severity of your symptoms.  Depending on your clinical presentation, waiting for 3 or 6 months for a repeat ultrasound may be unacceptable. Ovarian cancer can spread quickly within a matter of a few months from a stage I cancer to a stage IV cancer.  Take the initiative to fully explore all available diagnostic modalities with your physician. Don’t be uncomfortable asking your doctor for additional diagnostic tests or more frequent monitoring.  The worst thing you can do is become a passive participant in a complex and stressful process guided by a physician, who may not fully appreciate the extent and severity of your symptoms.

If you are an ovarian cancer patient, share your story with our readers. How long did it take for you to find out you had ovarian cancer? In retrospect, what would you have done differently as a patient?

Related Blogs:

New study links gene to ovarian cancer and may assist in early detection
Ovarian Cancer – The Smear Test Won’t Tell You Much