Why ovarian cancer is called the 'silent killer' and what can change that

Ovarian cancer (OC) is characterized by silent progression and late-stage diagnosis. It is critical to detect and accurately diagnose the disease early to improve survival rates. It is estimated that in 2020, there were 21,750 new cases and 13,940 deaths related to OC1. Given that survival rates for stage I and II disease are 70% to 90%, compared with 10% to 30% for stage III and IV, and that 60% to 70% of ovarian cancers are diagnosed in late stages, any strategy that allows for diagnosis in early stages would likely show a survival benefit2. Knowing the intricacies of ovarian cancer, its prevalence, and the early detection strategy is key to altering this fatal narrative.

The Silent Symptoms

The ovarian cancer resides in its usually subtle and non-specific symptoms. These are quite easily brushed off as normal body processes or blamed on some other common complaint. Some of the most reported symptoms are persistent bloating, pelvic or abdominal pain, problem eating or being full too fast, frequent urination, alterations in bowel habits, and fatigue.

Diagnosis usually involves a combination of

Evidence from surveys shows that more than 90% of women with early-stage ovarian cancer reported having symptoms prior to diagnosis. Given that survival rates for stage I and II disease are 70% to 90%, compared with 10% to 30% for stages III and IV, and that 60% to 70% of ovarian cancers are diagnosed in late stages, any strategy that allows for diagnosis in early stages would likely show a survival benefit. Key to early diagnosis is for clinicians and primary-care providers to listen to their patients closely.

If some of the symptoms sync with an ovarian cancer diagnosis, then providers should order diagnostic tests like a pelvic ultrasound or a blood test, CA125, and either confirm or rule out ovarian cancer. Some common diagnostic measures include

•Pelvic exam: A physical check-up of the reproductive organs.
• Imaging tests: Ultrasound, CT scans, or MRI scans to see the ovaries and the tissues around them.
• Blood tests: Testing for levels of CA-125, a protein that may be higher in some women with ovarian cancer.
• Biopsy: Taking out a sample of tissue for microscopic review to determine if cancer cells are present.

Shifting the narrative: Awareness and action

Many women report symptoms early on, which are often dismissed by providers. To fight the "silent killer," we must put first:
•Increased awareness: Educating women on the signs of ovarian cancer and urging them to report to the doctor early.
•Improved diagnostic tools: Funding research to create more precise and efficient screening tests for early detection.
•Enhanced access to treatment: Providing all women, irrespective of their socioeconomic status, with access to quality cancer care.
•Research and innovation: Continuing to research new and innovative treatments to enhance survival rates.

Many healthcare professionals are seemingly unaware of the symptoms typically associated with ovarian cancer, so misdiagnosis remains common. The more clinicians and primary-care providers recognize the early signs, instead of “blowing them off” as just gastrointestinal problems or nerves, the more lives will be saved. Both patients and healthcare professionals should be educated about these symptoms. Preventing ovarian cancer is always better than having to treat it.

(Article Courtesy: Dr Anil Thakwani, Senior Consultant, Clinical Oncology, Sharda Care Healthcity, Greater Noida)

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