Ovarian cancer is known as a “silent killer,” since by the time symptoms arise the disease has often already spread.

But in certain cases of aggressive ovarian cancer, symptoms do arise in the tumor’s early stages. In those instances, doctors on the alert can act quickly, offering patients a much better prognosis, a new study finds.

This “symptom-triggered testing” approach led to surgeries that successfully removed almost all visible cancerous tissue in three-quarters of patients diagnosed in this way, British researchers report.

They believe the study counters the notion that ovarian cancers are always too advanced once symptoms arise.

Instead, “our findings emphasize the importance of increasing an awareness of ovarian cancer symptoms to facilitate earlier diagnosis,” said study senior author Dr. Sudha Sundar. She is professor of gynecological cancer at the University of Birmingham in England.

The findings were published Aug.13 in the International Journal of Gynaecological Cancer.

The U.K. adopted symptom-triggered testing for ovarian cancer as a standard protocol in 2011.

Under the protocol, if a woman experiences symptoms such as pain, abdominal bloating/swelling and feeling full soon after starting to eat, they are referred to further testing.

That screening involves a blood test looking at levels of a protein called CA125, a biomarker for the possible presence of ovarian cancer, plus an abdominal ultrasound.

If positive results are found, the patient is fast-tracked for referral to hospital review (overseen by a gynecologist) within the next two weeks.

The new study included data on 1,741 women with ovarian cancer treated at 24 British hospitals.

Of those women, 119 (7%) were diagnosed with high-grade serous ovarian cancer — the most common, aggressive and lethal type of ovarian tumor. Patients averaged 63 years of age and 90% were postmenopausal.

Sundar’s team noted that, even though symptoms arose, the cancer didn’t interfere with the activities of daily living for 94% of the women.

But paying attention to symptoms paid off: 1 in every 4 of the diagnosed patients were still in stage 1 or 2 disease, the study found.

In 43 of the 119 patients (36%), the tumor was still localized to the pelvic area. Moderate spread (to the lower abdomen) was found in 29% of patients, and high spread (to organs such as the liver or spleen) was noted in 27% of women.

Three-quarters of patients were sent to surgeries to remove as much of the tumor as possible.

In only 8% of cases was the tumor so advanced as to be considered inoperable, the Birmingham team noted, and in 73 of the 119 patients all visible cancerous tissue was successfully removed.

Near-complete removal of visible cancerous tissue was achieved in another 15 patients, they added.

In most cases, chemotherapy was also given, either before or following surgery.

“Our figures demonstrate that in a real-world setting, symptom-based testing can potentially lead to diagnosis of high-grade serous ovarian cancer with low disease spread and results in a high proportion of complete surgical removal of the cancer,” Sundar said in a university news release.

“These findings challenge the assumption that the disease should always be considered to be in its advanced stages in women once they develop symptoms,” she added.

More information

Find out more about ovarian cancer at the American Cancer Society.

SOURCE: University of Birmingham, news release, Aug. 13, 2024

Source: HealthDay

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