Abdominal Pain as a Symptom of Ovarian Cancer
By Olivier Uyttebrouck, Journal Staff Writer

Anna Alderete began feeling a severe pain in her left side in May 2006, but five months would pass before a doctor diagnosed her with advanced ovarian cancer.
   
The Los Lunas school bus driver felt pain during the day, but it bothered her most at night.
   
"It would get unbearable when I went to bed," Alderete, 58, said recently. "I would just cry with pain."
   
Cancer experts this month published new guidelines that identified abdominal pain as a possible symptom of ovarian cancer.
   
Other symptoms include bloating, difficulty eating or feeling full quickly and a frequent or urgent need to urinate.
   
Doctors say they hope the guidelines will lead to quicker diagnosis of ovarian cancer, long known as the "silent killer" because it often remains undiagnosed until after it spreads beyond the ovaries.
   
"Really it is not the silent killer, and we need to undo that concept," said Dr. Carolyn Muller, a University of New Mexico gynecologic oncologist and Alderete's physician.
   
Ovarian cancer's image as a silent killer works against its victims because patients and physicians often assume there is no way to recognize the disease early, Muller said.
   
Failure to suspect the disease can hinder a timely diagnosis, she said.
   
"It's easy not to think of (ovarian cancer)," Muller said. "But if it's not thought of, it will take months to sort it out."
   
Abdominal pain is a "very, very classic" symptom, she said.
   
Physicians tend to overlook the disease because it is rare.
   
A woman has one chance in 70 of developing ovarian cancer, compared with a one-in-eight chance of developing breast cancer, she said. The odds increase if a woman has a family history of ovarian or breast cancer.
   
About 20,000 new cases and about 15,000 deaths are expected in the United States this year, according to the Gynecologic Cancer Foundation.
   
Studies show that the four symptoms identified in the guidelines are experienced by women in all stages of ovarian cancer, Muller said.
   
Ovarian cancer is more survivable if discovered early. The survival rate is 90 percent if diagnosed in stage one- when the cancer is confined to the ovaries, Muller said.
   
In Alderete's case, a physician diagnosed a viral infection in May and prescribed antibiotics. She was referred to UNM's Cancer Center in September where Muller found that cancer had spread throughout Alderete's stomach.
   
Muller performed two surgeries in September to remove Alderete's ovaries and other organs. She has been in remission for about three months.
   
Muller acknowledges that women commonly experience the symptoms identified this month by the Gynecologic Cancer Foundation. The key, she says, is for women to "know thyself" well enough to recognize something abnormal.
   
If an unusual symptom lasts more than two weeks, a woman should seek a pelvic exam and ask her doctor about the possibility of ovarian cancer, Muller recommends.
   
"If (the symptom) is chronic, if it persists, if it's unusual for the woman," then ovarian cancer should be considered, she said.
   
Ovarian cancer symptoms
   
The Gynecologic Cancer Foundation has announced four symptoms of ovarian cancer:
  

• bloating
      pelvic or abdominal pain
      difficulty eating or feeling full quickly
     
• urgent or frequent need to urinate
      For more information, see the foundation's Web site at www.wcn.org