The American Cancer Society recently joined the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists to issue the first nationwide consensus statement on ovarian cancer symptoms. This statement was created to raise awareness about symptoms most commonly associated with ovarian cancer, which include:

• bloating

• pelvic or abdominal pain

• difficulty eating or feeling full quickly

• urinary symptoms (urgency or frequency)

Because these symptoms can be vague and common, they need to be persistent and represent a change from normal to be suggestive of ovarian cancer. Women who have these symptoms daily for more than a few weeks should consult their doctor, preferably a gynecologist, for a thorough examination.

Other symptoms that have been reported by women with ovarian cancer include fatigue, indigestion, back pain, pain with intercourse, constipation, and menstrual irregularities. However, these symptoms are found in equal frequency in women in the general population and are usually associated with other causes.

"The number and frequency of symptoms also are often key factors in the diagnosis of ovarian cancer," said Dr. Debbie L. Saslow, American Cancer Society director of breast and gynecologic cancer. "When a woman visits a doctor complaining of these symptoms, and they cannot be explained by other causes, ovarian cancer should be considered."

There is no current follow-up guideline for women with these symptoms. Women who are considered high risk or who have unexplained symptoms as described above may have a bimanual pelvic examination, a trans-vaginal ultrasound, and/or a blood test for the tumor marker CA-125. However, studies have shown that these tests are too inaccurate to be used for routine screening of women at average risk of ovarian cancer. In addition, these tests have not been shown to reduce deaths caused by ovarian cancer.

Exploratory surgery may be an option to determine if ovarian cancer is present, but there is a significant risk of serious adverse effects, including death. If a pelvic examination or other tests suggest ovarian cancer, it is necessary to consult a doctor or surgeon who specializes in treating women with this type of cancer, such as a gynecologic oncologist.

Dr. Len Lichtenfeld, American Cancer Society deputy chief medical officer, acknowledged that "we are left with a less than perfect way of trying to find ovarian cancer early by relying on symptoms that can point in many different diagnostic directions."

But as researchers continue to search for an effective screening test for ovarian cancer, it is hoped that the consensus statement will increase awareness, and prompt attention to symptoms can improve the odds of early diagnosis and successful treatment.

For more information about ovarian cancer, visit www.cancer.org/ovariancancer or call 1-800-ACS-2345.