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{{Ovarian cancer}}
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==Overview==
==Overview==
Historically ovarian cancer was called the “silent killer” because symptoms were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that some symptoms are much more likely to occur in women with ovarian cancer than women in the general population.
Historically [[ovarian cancer]] was called the “silent killer” because [[symptoms]] were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that some [[symptoms]] are much more likely to occur in women with [[ovarian cancer]] than women in the general [[population]].
==History and Symptoms==
*The majority of patients with [disease name] are asymptomatic.
OR
*The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
*Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. 
===History===
Patients with [disease name]] may have a positive history of:
*[History finding 1]
*[History finding 2]
*[History finding 3]
===Common Symptoms===
Common symptoms of [disease] include:
*[Symptom 1]
*[Symptom 2]
*[Symptom 3]


===Less Common Symptoms===
Less common symptoms of [disease name] include
*[Symptom 1]
*[Symptom 2]
*[Symptom 3]
==Symptoms==
==Symptoms==
===Studies on the accuracy of symptoms===
Two [[case-control]] studies, both subject to results being inflated by [[spectrum bias]], have been reported. The first found that women with ovarian cancer had symptoms of increased abdominal size, bloating, urge to pass urine and pelvic pain.<ref name="pmid15187051">{{cite journal |author=Goff BA, Mandel LS, Melancon CH, Muntz HG |title=Frequency of symptoms of ovarian cancer in women presenting to primary care clinics |journal=JAMA |volume=291 |issue=22 |pages=2705-12 |year=2004 |pmid=15187051 |doi=10.1001/jama.291.22.2705}}</ref> The smaller, second study found that women with ovarian cancer had pelvic/abdominal pain, increased abdominal size/bloating, and difficulty eating/feeling full.<ref name="pmid17154394">{{cite journal |author=Goff BA, Mandel LS, Drescher CW, ''et al'' |title=Development of an ovarian cancer symptom index: possibilities for earlier detection |journal=Cancer |volume=109 |issue=2 |pages=221-7 |year=2007 |pmid=17154394 |doi=10.1002/cncr.22371}}</ref> The latter study created a symptom index that was considered positive if any of the 6 symptoms "occurred >12 times per month but were present for <1 year".They reported a [[sensitivity (tests)|sensitivity]] of 57% for early-stage disease and [[specificity (tests)|specificity]] 87% to 90%.


===''Ovarian Cancer Symptoms Consensus Statement''===
*[[Ovarian cancer]] can be diagnosed based on the clinical presentation, [[Staging (pathology)|stage]] of the disease, the condition of the patient, and the presence of [[Peritoneal carcinomatosis|peritoneal carcinoma]] <ref name="pmid16087828">{{cite journal| author=White RH, Chew HK, Zhou H, Parikh-Patel A, Harris D, Harvey D et al.| title=Incidence of venous thromboembolism in the year before the diagnosis of cancer in 528,693 adults. | journal=Arch Intern Med | year= 2005 | volume= 165 | issue= 15 | pages= 1782-7 | pmid=16087828 | doi=10.1001/archinte.165.15.1782 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16087828  }} </ref><ref name="pmid11117976">{{cite journal| author=Sørensen HT, Mellemkjaer L, Olsen JH, Baron JA| title=Prognosis of cancers associated with venous thromboembolism. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 25 | pages= 1846-50 | pmid=11117976 | doi=10.1056/NEJM200012213432504 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11117976  }} </ref><ref name="pmid9611053">{{cite journal| author=Friedrich M, Villena-Heinsen C, Schweizer J, Holländer M, Stieber M, Schmidt W| title=Primary tubal carcinoma: a retrospective analysis of four cases with a literature review. | journal=Eur J Gynaecol Oncol | year= 1998 | volume= 19 | issue= 2 | pages= 138-43 | pmid=9611053 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9611053  }} </ref><ref name="pmid22217630">{{cite journal| author=Hippisley-Cox J, Coupland C| title=Identifying women with suspected ovarian cancer in primary care: derivation and validation of algorithm. | journal=BMJ | year= 2011 | volume= 344 | issue=  | pages= d8009 | pmid=22217630 | doi=10.1136/bmj.d8009 | pmc=3251328 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22217630  }} </ref><ref name="pmid19706933">{{cite journal| author=Hamilton W, Peters TJ, Bankhead C, Sharp D| title=Risk of ovarian cancer in women with symptoms in primary care: population based case-control study. | journal=BMJ | year= 2009 | volume= 339 | issue=  | pages= b2998 | pmid=19706933 | doi=10.1136/bmj.b2998 | pmc=2731836 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706933  }} </ref><ref name="pmid14447118">{{cite journal| author=SINHA AC| title=Hydrops tubae profluens as a presenting symptom in primary carcinoma of the fallopian tube: report of two cases and review of literature. | journal=Br Med J | year= 1959 | volume= 2 | issue= 5158 | pages= 996-1001 | pmid=14447118 | doi=10.1136/bmj.2.5158.996 | pmc=1990718 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14447118  }} </ref><ref name="pmid21791297">{{cite journal| author=Ou YC, Huang HY, Huang CC, Changchien CC, Tseng CW, Lin H| title=Primary fallopian tube carcinoma: clinicopathological analysis of 12 cases. | journal=Taiwan J Obstet Gynecol | year= 2011 | volume= 50 | issue= 2 | pages= 141-4 | pmid=21791297 | doi=10.1016/j.tjog.2011.01.031 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21791297  }} </ref>
In 2007, the Gynecologic Cancer Foundation, Society of Gynecologic Oncologists and American Cancer Society originated the following consensus statement regarding the symptoms of ovarian cancer.<ref>{{cite web |url=http://www.sgo.org/publications/OvarianCancerSymptoms.pdf |title=Ovarian Cancer Symptoms Consensus Statement |accessdate=2007-07-19 |format=pdf |work=}}</ref>
*If [[symptoms]] suggestive of [[epithelial ovarian cancer]], pelvic exam and [[pelvic]] [[imaging]] should be done to look for [[Adnexal|adnexal mass]]
*Because [[ovarian cancer]] is diagnosed [[histologically]], [[surgical]] [[exploration]] is the main approach for the definitive [[diagnosis]] of [[ovarian cancer]]
*[[Symptoms]] can vary based on the advancement of the disease:
*Women with advanced disease presents with acute [[symptoms]] such as:
**[[Shortness of breath]]: due to [[malignant]] [[pleural effusion]]
**[[Nausea]] and [[vomiting]]: due to [[bowel obstruction]]
**[[Symptoms]] of [[venous thromboembolism]] ([[VTE]]) depending on the site of the [[thrombus]] and its extent such as: 
*** Severe [[pain]] and [[swelling]] in the [[lower limb]]
***[[Shortness of breath]] with [[pulmonary emboli]]
*Women with early, late or advanced disease presents with [[subacute]] [[symptoms]] such as:
**[[Gastrointestinal]] [[symptoms]]: due to [[ascites]], [[metastasis]], [[bowel obstruction]] or [[distention]] of the ovarian tube
***[[Abdominal pain]]
***[[Bloating|Abdominal bloating]]
***[[Abdominal distention]]
***[[Constipation]]
***[[Early satiety]]
***[[Nausea and vomiting]]
**[[Urinary symptoms]]:
*** Increase [[frequency]]
*** Increase [[urgency]]
**[[Symptoms]] related to [[adnexal]] mass
***[[Pelvic pain]]
*** Pelvic pressure
*** Palpable [[abdominal]] or [[pelvic]] mass
** Constitutional [[symptoms]]:
***[[Fatigue]]
***[[Weight loss]]
** Other [[symptoms]]
*** Abnormal [[vaginal bleeding]]
***[[Rectal bleeding]]
***[[Painful intercourse]]


Historically ovarian cancer was called the “silent killer” because symptoms were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that the following symptoms are much more likely to occur in women with ovarian cancer than women in the general population. These symptoms include:
*Bloating
*Pelvic or abdominal pain
*Difficulty eating or feeling full quickly
*Urinary symptoms (urgency or frequency)
Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms.
Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved prognosis.
Several other symptoms have been commonly reported by women with ovarian cancer.
These symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities. However, these other symptoms are not as useful in identifying ovarian cancer because they are also found in equal frequency in women in the general population who do not have ovarian cancer.
A sign is something that can be observed and recognized by a doctor or healthcare professional (for example, a rash). A symptom is something that only the person experiencing it can feel and know (for example, pain or tiredness). Ovarian cancer may not cause any signs or symptoms in its early stages. Symptoms appear once the tumour grows into surrounding tissues and organs.
The signs and symptoms of ovarian cancer can also be caused by other health conditions. It is important to have any unusual symptoms checked by a doctor.
Signs and symptoms of ovarian cancer include:
abnormal vaginal bleeding
a lump that can be felt (palpable) in the pelvic or abdominal area
need to urinate often (frequency)
intense need to urinate (urgency)
constipation
changes to digestion (such as difficulty eating, feeling full after a small meal, heartburn, gas , indigestion or nausea)
feeling of pressure in the pelvic or abdominal area
fatigue
pain in the legs, lower back, pelvis or abdomen
bloating (swelling of the abdomen)
painful intercourse
Other signs and symptoms may also occur with some types of ovarian cancer. Symptoms of stromal tumours include:
early puberty
breast enlargement or tenderness
menstrual irregularity in premenopausal women
vaginal spotting in post-menopausal women
hardening of the tissues of the vagina in post-menopausal women
secondary male sex characteristics (such as increased growth of body and facial hair, deepened voice, male-pattern baldness or enlargement of the clitoris)
Symptoms of germ cell tumours include:
early puberty
fever
Late signs and symptoms
Late signs and symptoms occur as the cancer grows larger or spreads to other parts of the body, including other organs.
buildup of fluid in the abdomen (ascites)
buildup of fluid around the lungs (pleural effusion)
weight loss
bowel obstruction
buildup of lymph fluid (lymphedema) in the legs
Read more: http://www.cancer.ca/en/cancer-information/cancer-type/ovarian/signs-and-symptoms/?region=on#ixzz3tl6wxAGo
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 18:39, 12 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Overview

Historically ovarian cancer was called the “silent killer” because symptoms were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that some symptoms are much more likely to occur in women with ovarian cancer than women in the general population.

History and Symptoms

  • The majority of patients with [disease name] are asymptomatic.

OR

  • The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
  • Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. 

History

Patients with [disease name]] may have a positive history of:

  • [History finding 1]
  • [History finding 2]
  • [History finding 3]

Common Symptoms

Common symptoms of [disease] include:

  • [Symptom 1]
  • [Symptom 2]
  • [Symptom 3]

Less Common Symptoms

Less common symptoms of [disease name] include

  • [Symptom 1]
  • [Symptom 2]
  • [Symptom 3]

Symptoms

References

  1. ↑ White RH, Chew HK, Zhou H, Parikh-Patel A, Harris D, Harvey D; et al. (2005). "Incidence of venous thromboembolism in the year before the diagnosis of cancer in 528,693 adults". Arch Intern Med. 165 (15): 1782–7. doi:10.1001/archinte.165.15.1782. PMID 16087828.
  2. ↑ Sørensen HT, Mellemkjaer L, Olsen JH, Baron JA (2000). "Prognosis of cancers associated with venous thromboembolism". N Engl J Med. 343 (25): 1846–50. doi:10.1056/NEJM200012213432504. PMID 11117976.
  3. ↑ Friedrich M, Villena-Heinsen C, Schweizer J, Holländer M, Stieber M, Schmidt W (1998). "Primary tubal carcinoma: a retrospective analysis of four cases with a literature review". Eur J Gynaecol Oncol. 19 (2): 138–43. PMID 9611053.
  4. ↑ Hippisley-Cox J, Coupland C (2011). "Identifying women with suspected ovarian cancer in primary care: derivation and validation of algorithm". BMJ. 344: d8009. doi:10.1136/bmj.d8009. PMC 3251328. PMID 22217630.
  5. ↑ Hamilton W, Peters TJ, Bankhead C, Sharp D (2009). "Risk of ovarian cancer in women with symptoms in primary care: population based case-control study". BMJ. 339: b2998. doi:10.1136/bmj.b2998. PMC 2731836. PMID 19706933.
  6. ↑ SINHA AC (1959). "Hydrops tubae profluens as a presenting symptom in primary carcinoma of the fallopian tube: report of two cases and review of literature". Br Med J. 2 (5158): 996–1001. doi:10.1136/bmj.2.5158.996. PMC 1990718. PMID 14447118.
  7. ↑ Ou YC, Huang HY, Huang CC, Changchien CC, Tseng CW, Lin H (2011). "Primary fallopian tube carcinoma: clinicopathological analysis of 12 cases". Taiwan J Obstet Gynecol. 50 (2): 141–4. doi:10.1016/j.tjog.2011.01.031. PMID 21791297.


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