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Be alert not alarmed: ‘tell-tale’ symptoms may not indicate ovarian cancer

Ovarian cancer can be hard to pin down. seamesse/flickr

We are bombarded with health messages on an almost daily basis. Many of these encourage us to monitor ourselves for worrying signs that might be signals of an underlying problem.

Ovarian cancer is the latest in a long line of such concerns. It is the sixth most common cause of cancer death in Australia; and it has a poor five-year survival rate of only 42%.

Many cases of ovarian cancer are undiagnosed until an advanced stage of the disease.

Against this backdrop, a National Breast and Ovarian Cancer Centre survey has shown that one in five women can’t name a single symptom of ovarian cancer.

This has formed the basis of a public health campaign to raise awareness of the cancer and its associated symptoms.

The trouble is that the symptoms signalling an underlying cancer are vague, non-specific and, as our study has found, extremely common in the general population.

Using a computer assisted telephone interview (CATI) of 2,235 women aged between 18 and 70 years of age, we asked questions about the presence, severity and duration of symptoms associated with ovarian cancer.

Two-thirds of the healthy women in our study reported they had experienced one or more of the symptoms in the past year.

Over half of the respondents (52%) had experienced abdominal bloating - one of the symptoms the survey asked about - in the past twelve months.

Increasing abdominal size was reported by 30% of the respondents and pelvic pain by 29%. Feeling full quickly, and inability to eat normally, were reported by 18% and 15% respectively.

Only one third of our sample had not experienced any of these symptoms in the past year.

One in six women (17%) reported a combination of the three most common symptoms (abdominal pain, bloating and increased size).

This study, and earlier research, suggests the presence of three or more symptoms, that are severe and persist over time, are clear indicators of the possibility of ovarian cancer.

So, given that these ovarian cancer symptoms are so common in the community, how can we deliver a message that does not just increase women’s anxiety, lead to unnecessary consultations or even, in some cases, to unnecessary interventions and investigations?

We may end up doing more harm than good to the general population in our understandable desire to detect this so-called silent killer early enough to improve survival rates.

I am reminded of John Howard’s message about terrorism in our midst (an even less likely occurrence than what we are discussing here). At the time, we were exhorted to be alert not alarmed.

The trouble now, as then, is to identify what we may detect through our alertness. In the case of ovarian cancer, there’s no easy or simple message to convey.

Clearly our public heath messages need to be refined to emphasise that, while these signs and symptoms are common in the general population, a combination of signs, their duration and particularly their severity are the important triggers to seek advice from your general practitioner.

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