Ovarian Cancer Treatment and Diagnosis During COVID-19

According to Dr. Kris Zanotti, a gynecologic oncologist at University Hospitals in Cleveland, in the absence of much data about the novel coronavirus, experts turned to past diseases for guidance. "All the data is abstracted from other viral outbreaks that we have historically been exposed to," says Dr. Zanotti, "but for COVID specifically and its unique transmission, we are going without data."

Doctors must do their best to make recommendations based on how similar diseases behaved in the past, modifying those recommendations as new information becomes available. They are constantly learning more about how contagious this virus is, how it spreads, how many people carry the virus without showing symptoms, and how many people who are exposed to the virus eventually develop symptoms and become sick. And, of course, they have to make decisions about how best to treat ovarian cancer patients while not exposing them to infection with COVID.

When Fear Makes You Wait

One factor that experts must take into account when developing COVID-19 policies at hospitals and medical centers during the pandemic is how to ensure that patients feel comfortable seeking preventive care, screening tests, and treatments for illness and alarming symptoms.

At the beginning of social distancing guidelines, the number of people who visited hospitals and clinics with symptoms of cancer noticeably dropped.

"It's clear that some patients who did have symptoms of ovarian cancer were not presenting for care, either because of their fear of going to urgent care centers or emergency rooms, or because their primary care physician was limiting visits during that early COVID pandemic," says Dr. Zanotti.  "Since then, at least in Cleveland, those restrictions have been lifted and patients have been more liberally presenting for their care."

The initial drop in patient numbers has now led to a change in the opposite direction. Since social distancing restrictions have lifted, Dr. Zanotti and her colleagues have seen an uptick in the number of new patients diagnosed with ovarian cancer, suggesting that many had been holding off on seeking care.

Recognizing the Symptoms

If you are experiencing symptoms of ovarian cancer, it’s important to seek help as soon as possible since early diagnosis has been linked to significantly better outcomes. Noticing the symptoms, however, can be challenging. Ovarian cancer is sometimes called "the silent killer," because early symptoms are vague, and more obvious symptoms usually don't appear until the disease is advanced.

According to Dr. Zanotti, "Initial symptoms of ovarian cancer can overlap with common symptoms that most of the population would have in their everyday life." Those symptoms include:

• Bloating
• Fatigue
• Constipation
• Back pain
• Feeling full quickly
• Weight loss

Because many people experience these symptoms at one time or another, women might not recognize them as indicators of the early stage of ovarian cancer.  "Many times patients who are diagnosed with ovarian cancer can recall weeks or months of fairly vague symptoms, increasing in intensity, until ultimately they present for their care and diagnosis," says Dr. Zanotti.

Learning to recognize the symptoms, and seeking help if they don’t go away, can make a big difference in how quickly cancer can be diagnosed and how successfully it can be treated. If you have concerns over the safety of visiting a medical office, hospital, or cancer center because of COVID-19, discuss them with your primary care doctor, and find out what they are doing to keep their patients safe.

Learn more about SurvivorNet's rigorous medical review process.

---