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Common, frequent early symptoms

October 20, 2008|Susan Brink | Times Staff Writer

Laurie Gray's mother died of ovarian cancer at the age of 41, more than 30 years ago. For Gray, a Brentwood attorney, a cloud of concern lingered over her own health. She's 52 now, and a few years ago, she tested positive for the BRCA1 gene. Shortly afterward, she had her breasts and ovaries removed as a precaution.

For women with the gene, the risk of ovarian cancer spikes from a 1 in 70 chance to as high as a 6 in 10 chance. "Their risk goes up hugely," says Dr. Carmel J. Cohen, co-chairman of the Ovarian Cancer Research Fund. "Those women ought to have their ovaries removed."

But most women don't have the BRCA1 or BRCA2 genes known to increase risk, and ovarian cancer can still swoop in out of the blue. Fortunately, researchers are looking more closely at the vague symptoms commonly felt by women who later were diagnosed with ovarian cancer. And they have found some subtle differences that may help women know when they should press doctors for a closer medical look.

In a 2004 report in the Journal of the American Medical Assn., responses by women with ovarian cancer were compared with those from women without cancer who visited primary care clinics. Oddly, gynecological symptoms, such as menstrual irregularities, were less likely to be reported by women with ovarian cancer.

Instead, the most frequent early symptoms connected to ovarian cancer were: back pain, fatigue, indigestion, urinary problems, constipation, abdominal pain, bloating and increased abdominal size. And some 43% of the women had three of these symptoms -- bloating, increased abdominal size and urinary tract problems -- simultaneously.

The women with ovarian cancer complained of having several symptoms every day, compared with the control group of women, who complained of one or two symptoms several times a month.

When women who have not experienced these early symptoms are suddenly being troubled by combinations of two or three of them, several times a month, it adds up to the best early-warning signal available so far, says Dr. Robert Morgan, oncologist and researcher at the City of Hope National Medical Center in Duarte.

"It used to be felt that women with early-stage disease did not have symptoms. Now, it's looking like up to 90% of women have early symptoms," Morgan says.

Adds Cohen, "It's very important that women be told that when they go to their provider with these symptoms, they must tell the provider, 'Prove to me that I don't have ovarian cancer.' "


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