The Case for Early Palliative Care in the Treatment of Ovarian Cancer

© 2014 Harborside Press® Once referred to as a silent killer but more recently as “the disease that whispers,” ovarian cancer’s early-stage symptoms are often vague and mimic other gastrointestinal or genitourinary illnesses. Although the median age at time of diagnosis is 63 years old, most women attribute the nonspecific nature of symptoms to menopause or stress (National Cancer Institute [NCI], 2014). Over time, tumor growth produces the hallmark clinical findings of pelvic ascites, abdominal distension, and pain, leading the patient to seek out evaluation and eventual diagnosis and treatment. The majority of women (61%) who present for evaluation will already be in the advanced stages of the disease (NCI, 2014). According to the NCI, there will be an estimated 22,240 new cases of ovarian cancer in the United States this year, as well as a resultant 14,030 deaths (NCI, 2014). It is the deadliest of all gynecologic cancers. Though this disease accounts for only 3% of all cancer cases in women, it is the fifth leading cause of cancer-related death (Martin, 2011; NCI, 2014). There has been no improvement in the mortality rate in the past 40 years. Advanced ovarian cancer runs a chronic course, often with variable phases of latency. In three quarters of patients, tumor recurrence will occur. Long-term survival of greater than 5 years for those with advanced disease will only be achieved in approximately 25% of patients (NCI, 2014; Ozols, 2005).