When ‘gastric problems’ hide something more serious

A woman experiences bloating and discomfort after consuming a minimal meal. She might attribute these symptoms to indigestion, constipation, or general abdominal discomfort. However, if these feelings persist or worsen over time, they could signal something more serious than typical gastric issues. Ovarian cancer, a disease often challenging to detect in its early stages, may present with vague symptoms that mirror those of common gastrointestinal and urinary problems.

In 2022, the International Agency for Research on Cancer reported that 324,600 women worldwide were diagnosed with ovarian cancer, and 207,000 succumbed to the disease. More than half of these cases and deaths occurred in Asia, highlighting the need for heightened awareness in affected regions.

Women should be vigilant about persistent abdominal bloating or an increasing abdominal size, pelvic or abdominal pain, a sensation of fullness more quickly than usual, changes in bowel habits, urinary urgency or frequency, unexplained weight loss, reduced appetite, or persistent fatigue. While these symptoms do not automatically indicate ovarian cancer, their recurrence or persistence warrants further investigation.

This message is particularly pertinent in Bangladesh, where digestive problems are frequently self-treated or allowed to linger before seeking professional help. The country already grapples with a substantial cancer burden, with an estimated 167,256 new cancer cases and 116,598 cancer deaths in 2022, according to GLOBOCAN.

Age and a family history of ovarian or breast cancer also heighten the risk. Inherited mutations like BRCA1 and BRCA2 can significantly elevate the likelihood of developing both ovarian and breast cancer, making genetic counselling advisable for certain women. It is crucial to dispel the misconception that ovarian cancer lacks a routine screening test for average-risk women without symptoms.

While CA-125 testing and transvaginal ultrasonography can be beneficial tools when symptoms or specific risk factors are present, an annual CA-125 test should not be considered an effective population screening method.

When ovarian cancer is suspected, evaluation typically involves a clinical examination, ultrasound, CA-125, and additional tests. Treatment options may include surgery, chemotherapy, and, in select patients, targeted or maintenance therapies. The World Health Organization (WHO) emphasizes that cancers identified at an earlier stage generally offer better treatment prospects, lower morbidity, and reduced costs of care.

The focus should not be on instilling fear in every instance of indigestion but rather on avoiding the normalization of persistent symptoms. If "gastric trouble" keeps recurring, it is essential to listen to what one's body may be communicating. Awareness should cultivate vigilance, leading to timely consultation that can make a significant difference in the outcome.

The writer, President of the Medical Oncology Society of Bangladesh and Chief Consultant of Shanti Cancer Foundation, underscores the importance of vigilance without inducing unnecessary fear.