Doc: No good early screening test for ovarian cancer
Dear Dr. Roach: In a recent column on screening tools, you made a brief statement about ovarian cancer. As a cancer survivor with metastasis to the ovary I was hoping to have read something within the response on screening for ovarian cancer. What is your response to someone in regard to screening for ovarian cancer if she presents with symptoms?
Dear M.L.: Ovarian cancer, like pancreatic cancer, is a dangerous and deadly cancer because it spreads early in its course, and its early symptoms are vague and often not recognized by the patient or are dismissed by her physician.
Screening, by definition, is looking for cancer or its precursor before there are symptoms. Although many have tried (including several types of blood tests), there still are not yet any generally accepted screening tests for ovarian or pancreatic cancer. For this reason, patients and physicians need to be aware of the symptoms, as vague as they are, and be ready to evaluate those symptoms promptly in order to have a chance of finding the disease at an early enough stage to have a good chance at cure.
For ovarian cancer, those early symptoms include abdominal bloating, distention or nausea; loss of appetite; fatigue; and pelvic and back pressure. Women who notice an increase in waist size despite poor appetite should be particularly concerned and should tell their doctors of their specific concern for ovarian cancer. Many times, a careful exam and history will be enough to make the diagnosis very unlikely, but other times a sonogram or CT scan may be necessary, especially in women at higher-than-average risk of the disease (older age, history of high-dose estrogen use and family history).
For pancreatic cancer, upper abdomen pain radiating to the back, unexplained weight loss and fatigue are common early symptoms. Jaundice (yellowing of the body, usually first seen in the mouth or eyes) without abdominal pain often is the first clear sign, and the cancer is, unfortunately, often quite advanced at that time.
As soon as a proven screening test is ready, I’ll write about it.
Dear Dr. Roach: Why do we sigh?
Dear C.G.: First, it’s a mechanism to help open, and keep open, the air cells called alveoli in our lungs. Only a very deep breath will open them fully. The second is emotional sighing, which is a form of communication, as well as a response to difficult tasks.
Email questions to ToYourGoodHealth@med.cornell.edu.