Symptoms and diagnostic delay in ovarian cancer: A summary of the literature

Victoria Jayde
Faculty of Nursing and Midwifery, University of Sydney, Sydney NSW

Katherine M White
University of Sydney; Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney NSW

Penny Blomfield
University of Tasmania, Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart TAS

PP: 055 - 065

Abstract

Ovarian cancer is the most common cause of death due to gynaecological cancers in developed countries. The symptoms of ovarian cancer are common female complaints, are non-specific and do not fit any easily recognisable pattern. This frequently leads to a delay in diagnosis.

Until an effective screening test becomes available for this disease, increasing the education of women and clinicians regarding the symptoms of ovarian cancer must be seen as a priority. Nurses are ideally placed to disseminate information about the symptoms of ovarian cancer to the community and have a responsibility to do so. It is crucial that nurses are aware of the common symptoms and the usual diagnostic pathway in order to provide empathetic, informed nursing care.

This paper draws on the results of a narrative systematic review to describe current knowledge of symptoms of ovarian cancer and describes delays women commonly experience in obtaining a diagnosis.

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Keywords

ovarian cancer, symptoms, diagnosis, nursing, experience, women


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References

American College of Obstetricians and Gynecologists (ACOG), Committee on Gynecologic Practice (2002) The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Gynecologic Oncology 87(3), 237-239.

Andersen M, Goff B, Lowe K, Scholler N, Bergan L, Dresher C, et al (2008) Combining a symptoms index with CA125 to improve detection of ovarian cancer. American Cancer Society 484-485.

Attanucci C, Ball H, Zweizig S and Chen A (2004) Differences in symptoms between patients with benign and malignant ovarian neoplasms. American Journal of Obstetrics and Gynecology 190(5), 1435-1437.

Australian Cancer Network (ACN) and National Breast Cancer Centre (NBCC) (2004) Clinical practice guidelines for the management of women with epithelial ovarian cancer. Camperdown: NBCC.

Australian Institute of Health and Welfare (AIHW) (2008) Australia's health 2008, Cat. No. AUS 99. Canberra: AIHW.

Australian Institute of Health and Welfare (AIHW) and Australasian Association of Cancer Registries (AACR) (2008) Cancer in Australia: An overview, 2008. Cancer series no. 46. Cat. No. CAN 42. Canberra: AIHW.

Australian Institute of Health and Welfare (AIHW) and Cancer Australia and Australasian Association of Cancer Registries (AACR) (2008) Cancer survival and prevalence in Australia: Cancers diagnosed from 1982 to 2004. Cancer Series no. 42. Cat. No. CAN 38. Canberra: AIHW.

Australian Nursing and Midwifery Council (ANMC) (2006) National competency standards for the registered nurse. ANMC. Retrieved March 23 2009 from http://www.anmc.org.au/professional_standards/index.php

Australian Nursing and Midwifery Council (ANMC) (2008) Code of professional conduct for nurses in Australia. ANMC. Retrieved March 23 2009 from http://www.anmc.org.au/professional_standards/index.php

Australian Nursing and Midwifery Council (ANMC) and Royal College of Nursing, Australia (RCNA) and Australian Nursing Federation (ANF) (2008) Code of ethics for nurses in Australia. ANMC. Retrieved March 23 2009 from http://www.anmc.org.au/professional_standards/index.php

Bankhead C, Collins C, Stokes-Lampard H, Rose P, Wilson S, Clements A, et al (2008) Identifying symptoms of ovarian cancer: A qualitative and quantitative study. BJOG: An International Journal of Obstetrics and Gynaecology 115(8), 1008-1014.

Bankhead C, Kehoe S and Austoker J (2005) Symptoms associated with diagnosis of ovarian cancer: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology 112(7), 857-865.

Behtash N, Ghayouri A and Fakhrejani F (2008) Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study. European Journal of Cancer Care 17(5), 483-487.

Bell-Syer S, Foxlee R and Cullum N (2007) The Cochrane Wounds Group: Systematically reviewing the wound care literature. Advances in Skin and Wound Care 20(5), 283-287.

Bhoola S and Hoskins W (2006) Diagnosis and management of epithelial ovarian cancer. Obstetrics and Gynecology 107(6), 1399-1410.

Cannistra S (2004) Cancer of the ovary. New England Journal of Medicine 351(24), 2519-2529.

Chan K and Selman T (2006) Testing for ovarian cancer. Best Practice and Research Clinical Obstetrics and Gynaecology 20(6), 977-983.

Chan Y, Ng T, Lee P, Ngan H and Wong L (2003) Symptoms, coping strategies, and timing of presentations in patients with newly diagnosed ovarian cancer. Gynecologic Oncology 90(3), 651-656.

Chu C and Rubin S (2006) Screening for ovarian cancer in the general population. Best Practice and Research Clinical Obstetrics and Gynaecology 20(2), 307-320.

Dawson T (1993) Ovarian cancer: The experiences of women after treatment. Journal of Cancer Care 2(1), 39-44.

Eltabbakh G, Yadev P and Morgan A (1999) Clinical picture of women with early stage ovarian cancer. Gynecologic Oncology 75(3), 476-479.

Evans J, Ziebland S and McPherson A (2007) Minimizing delays in ovarian cancer diagnosis: An expansion of Andersen's model of 'total patient delay'. Family Practice 24(1), 48-55.

Ferrell B, Smith S, Cullinane C and Melancon C (2003) Symptom concerns of women with ovarian cancer. Journal of Pain and Symptom Management 25(6), 528-538.

Fitch M, Deane K, Howell D and Gray R (2002) Women's experiences with ovarian cancer: Reflections on being diagnosed. Canadian Oncology Nursing Journal 12(3), 152-168.

Fitch M, Gray R, DePetrillo D, Franssen E and Howell D (1999) Canadian women's perspectives on ovarian cancer. Cancer Prevention and Control 3(1), 52-60.

Fox S and Lyon D (2007) Symptom clusters and quality of life in survivors of ovarian cancer. Cancer Nursing 30(5), 354-361.

Friedman G, Skilling J, Udaltsova N and Smith L (2005) Early symptoms of ovarian cancer: A case-control study without recall bias. Family Practice 22(5), 548-553.

Gaetano C and Lichtman S (2004) Care of elderly women with ovarian cancer. Geriatric Nursing 25(6), 329-335.

Goff B, Mandel L, Drescher C, Urban N, Gough S, Schurman K, et al (2007) Development of an ovarian cancer symptom index: Possibilities for earlier detection. Cancer 109(2), 221-227.

Goff B, Mandel L, Melancon C and Muntz H (2004) Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. Journal of the American Medical Association 291(22), 2705-2712.

Goff B, Mandel L, Muntz H and Melancon C (2000) Ovarian carcinoma diagnosis. Cancer 89(10), 2068-2075.

Green S (2005) Systematic reviews and metaanalysis. Singapore Medical Journal 46(6), 270-273.

Kehoe S (2006) Treatments for gynaecological cancers. Best Practice and Research Clinical Obstetrics and Gynaecology 20(6), 985-1000.

Koldjeski D, Kirkpatrick M, Swanson M, Everett L and Brown S (2005) An ovarian cancer diagnosis-seeking process: Unraveling the diagnostic delay problem. Oncology Nursing Forum 32(5), 1036-1042.

Kurman R, Visvanathan K, Roden R, Wu T and Shih I (2008) Early detection and treatment of ovarian cancer: Shifting from early stage to minimal volume of disease based on a new model of carcinogenesis. American Journal of Obstetrics and Gynecology 198(4), 351-356.

Lataifeh I, Marsden D, Robertson G, Gebski and Hacker N (2005) Presenting symptoms of epithelial ovarian cancer. Australian & New Zealand Journal of Obstetrics & Gynaecology 45(3), 211-214.

Martin V and Cherry C (2006) Ovarian cancer. In K Dow (ed) Nursing care of women with cancer (pp.96-119). St Louis: Mosby.

National Breast Cancer Centre (NBCC) (2002) Priority actions for ovarian cancer control: A framework for a national approach. Camperdown: NBCC.

National Breast Cancer Centre (NBCC) (2005) Assessment of symptoms that may be ovarian cancer: A guide for GPs. Camperdown: NBCC.

National Breast Cancer Centre (NBCC) (2006) Ovarian cancer: The facts, [leaflet]. Camperdown: NBCC.

National Breast and Ovarian Cancer Centre (NBOCC) (2008a) Can you name any symptom of ovarian cancer? [leaflet]. Surry Hills: NBOCC.

National Breast and Ovarian Cancer Centre (NBOCC) (2008b) Epithelial ovarian cancer - Understanding your diagnosis and treatment. Surry Hills: NBOCC.

National Breast and Ovarian Cancer Centre (NBOCC) (2008c) General practitioner education series workshop kit. Surry Hills: NBOCC.

National Breast and Ovarian Cancer Centre (NBOCC) (2009) Appropriate referral of women with suspected ovarian cancer. Surry Hills: NBOCC. Retrieved April 30 2009 from http://www.nbcc.org.au/resources/resource.php?code=OCARW

National Comprehensive Cancer Network (NCCN) and American Cancer Society (ACS) (2004) Ovarian cancer - treatment guidelines for patients, version II/August 2004. Retrieved February 19 2007 from http://www.nccn.org/patients/patient_gls/_english/pdf/NCCN%20Ovarian%20Guidelines.pdf

National Health and Medical Research Council (NHMRC) (2000) How to use the evidence: Assessment and application of scientific evidence. Canberra: NHMRC.

National Ovarian Cancer Network (NOCN) (2006) Senate inquiry into gynaecological cancer in Australia, [submission]. Darling South: National Ovarian Cancer Network.

Nelson L, Ekbom A and Gerdin E (1999) Ovarian cancer in young women in Sweden, 1989-1991. Gynecologic Oncology 74(3), 472-476.

Nossov V, Amneus M, Su F, Lang J, Janco J, Reddy S, et al (2008) The early detection of ovarian cancer: From traditional methods to proteomics. Can we really do better than serum CA-125? American Journal of Obstetrics and Gynecology 199(3), 215-216.

Olaitan A and McCormack M (2007) Centralisation of services for the management of ovarian cancer: Arguments for. BJOG: An International Journal of Obstetrics and Gynaecology 111, 1188-1190.

Olson S, Mignone L, Nakraseive C, Caputo T, Barakat R and Harlap S (2001) Symptoms of ovarian cancer. Obstetrics and Gynecology 98(2), 212-217.

Ovarian Cancer Australia (2008) Symptom Diary, Ovarian Cancer Australia. Retrieved March 25 2009 from http://www.ovariancancer.net.au/awareness/symptoms_ovarian_cancer

Partridge E and Barnes M (1999) Epithelial ovarian cancer: Prevention, diagnosis, and treatment. CA - A Cancer Journal for Clinicians 49(5), 297-320.

Paulsen T, Kaern J, Kjaerheim K, Trope C and Tretli S (2005) Symptoms and referral of women with epithelial ovarian tumors. International Journal of Gynaecology and Obstetrics 88(1), 31-37.

Portenoy R, Kornblith A, Wong G, Vlamis V, Lepore J, Loseth D, et al (1994) Pain in ovarian cancer patients. Prevalence, characteristics, and associated symptoms. Cancer 74(3), 907-915.

Power J, Brown L and Ritvo P (2008) A qualitative study examining psychosocial distress, coping, and social support across the stages and phases of epithelial ovarian cancer. Health Care for Women International 29(4), 366-383.

Reynolds E and Moller K (2006) A review and an update on the screening of epithelial ovarian cancer. Current Problems in Cancer, 30(5), 203-232.

Rufford B, Jacobs I and Menon U (2007) Feasibility of screening for ovarian cancer using symptoms as selection criteria. BJOG: An International Journal of Obstetrics and Gynaecology 114(1), 59-64.

Ryerson A, Eheman C, Burton J, McCall N, Blackman D, Subramanian S, et al (2007) Symptoms, diagnoses, and time to key diagnostic procedures among older US women with ovarian cancer. Obstetrics and Gynecology 109(5), 1053-1061.

Salzberg M, Thurlimann B, Bonnefois H, Fink D, Rochlitz C, Moos R, et al (2005) Current concepts of treatment strategies in advanced or recurrent ovarian cancer. Oncology 68, 293-298.

Schaefer K, Ladd E, Lammers S and Echenberg R (1999) In your skin you are different: Women living with ovarian cancer during childbearing years. Qualitative Health Research 9(2), 227-242.

Scottish Intercollegiate Guidelines Network (SIGN) (2003) Epithelial ovarian cancer - A national clinical guideline. Guideline No. 75, SIGN. Retrieved March 25 2009 from http://www.sign.ac.uk/guidelines/fulltext/75/index.html

Smith L, Morris C, Yasmeen S, Pairkh-Patel A, Cress R and Romano P (2005) Ovarian cancer: Can we make the clinical diagnosis earlier? Cancer 104(7), 1398-1407.

Teneriello M and Park R (1995) Early detection of ovarian cancer. CA - A Cancer Journal for Clinicians 45(2), 71-87.

Thulesius H, Lindgren A, Olsson H and Hakansson A (2004) Diagnosis and prognosis of breast and ovarian cancer. Acta Oncologica 43(2), 175-181.

Vine M, Calingaert B, Berchuck A and Schildkraut J (2003) Characterization of prediagnostic symptoms among primary epithelial ovarian cancer cases and controls. Gynecologic Oncology 90(1), 75-82.

Vine M, Ness R, Calingaert B, Schildkraut J and Berchuck A (2001) Types and duration of symptoms prior to diagnosis of invasive or borderline ovarian tumor. Gynecologic Oncology 83(3), 466-471.

Webb P, Purdie D, Grover S, Jordan S, Dick M and Green A (2004) Symptoms and diagnosis of borderline, early and advanced epithelial ovarian cancer. Gynecologic Oncology 92(1), 232-239.

Wikborn C, Pettersson F and Moberg P (1996) Delay in diagnosis of epithelial ovarian cancer. International Journal of Gynaecology and Obstetrics 52(3), 263-267.

Wikborn C, Pettersson F, Silfversward C and Moberg P (1993) Symptoms and diagnostic difficulties in ovarian epithelial cancer. International Journal of Gynecology and Obstetrics 42(3), 261-264.

Wynn M, Chang S and Peipins L (2007) Temporal patterns of conditions and symptoms potentially associated with ovarian cancer. Journal of Women's Health, 16(7) 971-986.

Yawn B, Wollan P, Klee M and Barrette B (2001) Ovarian carcinoma: Care and survival in a community-based population. Clinical Therapeutics 23(1), 146-159.



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