Finding ovarian cancer fast may not help survival
NEW YORK (Reuters Health) - Once a woman begins experiencing symptoms of ovarian cancer, getting diagnosed and treated quickly may not help her survive longer, according to a new study of Australian women.
The finding is discouraging, researchers said, especially because doctors have believed that catching more cases of ovarian cancer early may help extend how long women live after diagnosis.
Ovarian cancer kills the majority of women with the disease within 5 years.
The results, published in the Journal of Clinical Oncology, "do not mean that women who have persistent symptoms that might be due to ovarian cancer should not seek immediate medical attention," Christina Nagle, the study's lead author from the Queensland Institute of Medical Research in Australia, told Reuters Health.
"Presenting promptly will help ensure that they are appropriately referred and can then make informed choices about their treatment," she said in an email.
Nagle and her colleagues followed almost 1,500 Australian women who were diagnosed with ovarian cancer between 2002 and 2005. The researchers interviewed the women about their symptoms and when they first went to the doctor and were diagnosed with cancer, then continued to track the participants for the next 5 years.
Most of the women had symptoms before they were diagnosed - in the others, cancer was caught at a routine check-up or during surgery for a different condition.
In women with symptoms, about 40 percent went to their doctors and were examined and diagnosed with ovarian cancer within 2 months of when the symptoms started. Within 3 months, about 60 percent of women had been diagnosed, and 6 months after symptoms began, 80 percent had been diagnosed.
Women whose cancer was picked up before symptoms started survived longer than those who had symptoms. For example, in all women with late-stage cancer, those without symptoms lived an average of 4 years after their diagnosis, compared to 3 years in women with symptoms.
But among those who did have invasive, symptomatic cancer, survival did not depend on how soon they saw their doctor.
Fifty-two percent of women who were diagnosed within 1 month of their first symptoms survived for the next 5 years, compared to 53 percent of women who took more than a year to be diagnosed.
Nagle said that her team suspects that once cancer is advanced enough to cause symptoms, it may be too late for treatment to help most patients live longer.
However, women may still get symptoms - such as daily stomach or pelvic pain, pelvic bloating or fullness, or difficulty eating - from early-stage cancer, and for them, it's possible that a quick diagnosis could improve outcomes, said M. Robyn Andersen, who studies ovarian cancer at the University of Washington in Seattle and was not involved in the current research.
Women who have new and persistent symptoms, she said, should still see their doctors.
And even if there is no ultimate change in how long women with ovarian cancer survive, early diagnosis and treatment is still important, Andersen said.
"Getting somebody quickly and promptly to the correct treatments helps them feel better about working with their physician team, helps them start their battle with cancer in a much better place," she told Reuters Health. "It is a quality of life issue for a cancer patient to be diagnosed promptly."
According to the National Cancer Institute, about 22,000 new cases of ovarian cancer were diagnosed last year.
Tumors or abnormal growths may first be detected during a normal pelvic exam, or through ultrasound imaging. A blood test to detect a substance called CA 125, which may be a sign of certain cancers, is still being studied as a diagnostic tool, according to the National Cancer Institute.
Because the disease is relatively rare and the benefits of early detection unclear, the U.S. Preventive Services Task Force, a federal expert panel, does not recommend that women be regularly screened for ovarian cancer.
SOURCE: bit.ly/ky2Ojr Journal of Clinical Oncology, online May 2, 2011.
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