For the first time, cancer experts in the U.S. are advising women of symptoms that might alert them to ovarian cancer, one of the deadliest cancers and a disease that is hard to spot early.

Suddenly experiencing weeks of bloating, the need to urinate frequently, eating changes and abdominal or pelvic pain — one of these or a combination could be a tip-off to early ovarian cancer, according to several groups of cancer experts.

The American Cancer Society and other groups released a consensus statement Wednesday listing the symptoms. Historically, doctors have believed there were no early symptoms of ovarian cancer.

It is estimated that 2,400 new cases of ovarian cancer will be diagnosed in Canada in 2007 and there will be 1,700 deaths, according to the Canadian Cancer Society.

There is no screening test for the condition and a regular pelvic examination has been considered the main way to detect the cancer early.

"Unfortunately, until now there has been no agreement on common symptoms, allowing women to go undiagnosed, despite visits to the doctor, until it was too late," said Dr. Barbara Goff, a University of Washington gynecologic oncologist, in a prepared statement.

The American Cancer Society put together the consensus statement along with the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists.

Canadian experts say women should see their doctor if they suffer, for at least two to three weeks, one or more of these symptoms daily:

• Bloating.
• Pelvic or abdominal pain.
• Difficulty eating, or feeling full quickly.
• Frequent or urgent urination.

Women who are having a menstrual period may experience some bloating or frequent urination, but it goes away in a few days, said Dr. Joan Murphy, a gynecologic oncologist and surgeon with the University Health Network in Toronto. Likewise, a woman who has bloating for years with no cause found also need not panic.

"It's a change in the way one is feeling and the persistence," Murphy said. "Both of those things are very important."

No final answer

But the guidelines are problematic, said Debbie Saslow, the cancer society's director of breast and gynecologic cancer.

Women with one or more of the symptoms are more likely to have irritable bowel syndrome than ovarian cancer, she said. Also, there are no highly accurate tests to clearly confirm ovarian cancer in women who have the symptoms, she added.

That means recognizing the symptoms may not lead to helpful tests or saved lives. Indeed, pursuing the symptoms as a harbinger of ovarian cancer may, in some cases, lead to biopsies and other treatments that will cause more harm than benefit.

"That was the frustration with this," Saslow said. But experts decided to issue the statement anyway, because important recent studies by Goff have indicated the sudden onset of the symptoms in healthy women may be an important indicator.

"We can't not tell women there are any symptoms just because we're not sure what to do" in terms of definitive diagnosis and treatment, Saslow said.

The list offers a framework to help women evaluate how they are feeling and is not a final answer, Murphy agreed, saying that given the devastation of ovarian cancer, anything that helps women get diagnosed earlier is welcome.

If ovarian cancer is detected early in stage 1 when it is confined to the ovaries, 80 per cent of women or more survive at least five years after the diagnosis, but few patients are diagnosed at that stage. The survival rate falls to 15 to 20 per cent when it is diagnosed at more advanced stages.