Ovarian cancer is often considered a "silent killer" with no readily identifiable symptoms, but new research challenges this view in the hopes of finding more of the deadly malignancies early.

Because there is no effective screening test to identify early-stage ovarian cancer, roughly three out of four patients are diagnosed with late-stage disease, when the chance for a cure is greatly diminished.

Many patients are misdiagnosed before their cancer is found, with vague symptoms such as pelvic pain and abdominal bloating attributed to other causes.

In their latest study, researchers at the University of Washington School of Medicine identified the six symptoms most closely associated with ovarian cancer by comparing the clinical histories of women with the disease to those of high-risk women without cancer.

The most common complaints among the cancer patients included:

--pelvic pain

--abdominal pain

--increased abdominal size

--abdominal bloating

--difficulty eating

--feeling full quickly

When any of these symptoms had been present for less than a year and occurred more than 12 days a month, they were considered independently predictive of ovarian cancer risk.

“These are very common symptoms that everyone has from time to time,” researcher Barbara Goff, MD, tells WebMD. “The purpose is not to scare women and make everyone think they have ovarian cancer. It is to alert women and their physicians that there may be cause for concern if these symptoms come on quickly and occur with frequency.”

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Potential Screening Tool percen

Five-year survival rates among women with advanced ovarian cancer range from 20 percent to 30 percent, but women diagnosed when their cancer is still confined to the ovary have a 70 percent to 90 percent survival rate.

Goff and colleagues developed a symptom index, based on their latest research, which they hope will prove to be a useful screening tool for ovarian cancer.

They found that having any of the six symptoms for less than a year and more than 12 days per month was helpful to identify women at risk.

The research is published in the Jan. 15, 2007, issue of the journal Cancer.

“This is not a perfect screening tool, and it is not going to be the solution to the early diagnosis of ovarian cancer,” Goff says. “But it is certainly a step in the right direction. It is something that we can use to help women right now in 2006.”

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Misdiagnosis Is Common

While other researchers are working to develop a more sensitive screening test for early-stage ovarian cancer, all agree that such a test is years away.

Ovarian cancer survivor Sherry Salway Black tells WebMD that greater awareness of symptoms is critical because patients who have early-stage disease are still routinely misdiagnosed.

“Many women end up seeing gastroenterologists who often diagnose irritable bowel,” she says.

Black, who is executive director of the Ovarian Cancer National Alliance, was luckier than most patients. Her ovarian cancer was diagnosed early, but even she was initially told her symptoms were nothing to be concerned about.

“I was 48 when I was diagnosed, and I was told at first that my symptoms were probably related to menopause,” she says. “[The symptoms] went away and then came back again, and I knew it wasn’t normal.”

She says all women need to know the symptoms of ovarian cancer and their own specific risk factors. They also have to be vigilant about seeking an accurate diagnosis when they feel something is wrong.

If a pelvic examination, imaging test, or other test suggests ovarian cancer, it is time to see a specialist, Black says.

Women with late-stage ovarian cancer are surviving longer than ever because of treatment advances pioneered by gynecologic oncologists.

“We are seeing better outcomes in women treated by specialists,” she says.

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By Salynn Boyles, reviewed by Louise Chang, MD

SOURCES: Goff, B.A. Cancer, Jan. 15, 2007; vol 109: online edition. Barbara A. Goff, MD, department of obstetrics and gynecology, University of Washington School of Medicine, Seattle. Sherry Salway Black, executive director, Ovarian Cancer National Alliance, Washington, D.C.