Your Health

RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. Good morning. I'm Renee Montagne.

In Your Health today, we look at the deadliest female malignancy, cancer of the ovaries. This summer, 20 groups concerned with women's health urged women and their doctors to pay attention to early symptoms of what might be ovarian cancer. Experts are debating whether the group's new guidelines will cause more benefit or harm.

Here's NPR's Richard Knox.

(Soundbite of surgery)

RICHARD KNOX: Surgeons at the Massachusetts General Hospital huddle over a patient, Mrs. J.L., searching with their eyes and their fingers for tumors in her abdomen. She's one of 23,000 American women who will be diagnosed this year with ovarian cancer.

Dr. LINDA DUSKA (Oncologist, Massachusetts General Hospital): (Unintelligible) that's where the cancer was. There's still cancer there, yeah. Hold that, please.

KNOX: Surgeon Linda Duska says Mrs. L.'s cancer was widespread by the time doctors diagnosed it.

Dr. DUSKA: When we first looked at her, she had tiny spots, two or three millimeters of cancer, all throughout her entire abdomen. And there were also bigger spots of cancer on her bladder, on her colon, behind her uterus.

KNOX: That's typical. Eight out of 10 women with ovarian cancer have the same picture. For years, ovarian cancer was called a silent killer, causing no symptoms until it was too late to be cured. There's no good screening test for ovarian cancer, like Pap smear for cervical cancer.

But recently, researchers have shown that ovarian cancer patients often do have symptoms - bloating, pain in the abdomen or pelvis, loss of appetite or feeling full quickly, urinary problems.

But Duska says those symptoms are often ignored or misinterpreted while the cancer grows.

Dr. DUSKA: We all have stories of months and months of being worked up, colonoscopy, and you know, all kinds of other tests before somebody finally figured out what was going on.

KNOX: Beth Bennett, a 54-year-old New Hampshire woman, says that's her story.

Ms. BETH BENNETT (Cancer Patient): It started very slowly, where I just would have these twinge of cramps, which I didn't think too much about. But I had just had my annual checkup with my gynecologist, who I called. And they really didn't think that it was anything.

KNOX: The symptoms piled up while Bennett's doctors scratched their heads - even after an ultrasound test showed a mass the size of an orange on her left ovary. Her gynecologist thought it was a benign cyst. It took four months before her ovarian cancer was recognized for what it was.

Ms. BENNETT: I have this whole group of friends now who have ovarian cancer and they all tell me the same thing: they had no idea, not a clue. Every one of them was diagnosed late.

KNOX: The new guidelines urged women to ask their doctors about possible ovarian cancer if they have digestive, pelvic or urinary symptoms that occur almost every day for several weeks. Duska says women need to be as persistent as their symptoms.

Dr. DUSKA: They really need to push their physicians and a lot of them have told me, I've had to go back to my doctor multiple times and say something is really wrong with me and you need to figure it out.

KNOX: The American Cancer Society agrees. It signed on to the new guidelines. But Dr. Debbie Saslow says the Cancer Society is worried that many women with common symptoms might be unduly alarmed.

Dr. DEBBIE SASLOW (Breast and Gynecological Cancer Program, American Cancer Society): Unfortunately, as we had feared, there are women who have seen the media coverage of this statement and have run to their doctors because they feel bloated or they feel some pain and have been very insistent about getting tests, such as CA-125, that are inaccurate.

KNOX: CA-125 is a blood test that can indicate ovarian cancer. But it's often a false alarm. Ultrasound can help diagnose ovarian cancer, but it can be misleading too. The only sure diagnosis is by exploratory surgery called a laparoscopy. The Cancer Society is concerned about unnecessary laparoscopies, but...

Dr. SASLOW: The alternative is to not say anything and to continue having women who then later get ovarian cancer say why didn't anyone tell me about these symptoms? Or you know, I did tell my doctor about these symptoms and he or she told me not to worry about that.

KNOX: Duska, the Boston surgeon, has seen no sign women are overreacting. But she says it could be years before we know if the guidelines will make ovarian cancer as curable as breast cancer usually is.

Richard Knox, NPR News, Boston.

MONTAGNE: And you can find guidelines to help in the early detection of ovarian cancer at npr.org/yourhealth.

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