For Now, Recognizing Possible Warning Signs

The difficulty of treating ovarian cancer in advanced stages, when it is usually discovered, is driving research efforts to detect the disease earlier.

"What we need more than anything is a screening test for ovarian cancer that women can get routinely in the course of their normal care," said Susan Lowell Butler, executive director of the D.C. Cancer Consortium and co-founder of the Ovarian Cancer National Alliance, an advocacy group. At least two academic research teams, one at New York University and one at Yale, have been trying to devise such a test, but neither has achieved regular clinical application.

Butler, a survivor of breast and ovarian cancer, said her first indication of a problem came during a pelvic exam, when her doctor felt a mass on her ovary. But a pelvic exam does not always identify such masses, and the Pap smear -- which experts said some women assume detects all gynecologic cancers -- looks only for signs of cervical cancer.

Doctors once believed that early ovarian cancer was often silent. But recent studies have shown that many women have symptoms before the cancer spreads. Experts now encourage women to watch for and tell their doctors about any recurrent warning signs, which according to the National Cancer Institute, may include:

· general abdominal discomfort or pain (swelling, bloating, cramps, pressure or indigestion);

· nausea, constipation, frequent urination or diarrhea;

· loss of appetite; weight gain or loss; abnormal vaginal bleeding and a feeling of fullness after a light meal.

According to the American Cancer Society, women who have had breast cancer or who have a family history of ovarian cancer may be at increased risk of the disease. Others who may be at higher risk include women who started menstruating before age 12, were childless or bore a first child after age 30, or who entered menopause after age 50.

--January W. Payne