Thursday, September 17, 2009

Whisperings of Ovarian Cancer

Ovarian cancer is referred to as the silent killer because symptoms tend to be noticed when cancer is in an advanced stage. Despite this belief, research has demonstrated that women are experiencing identifiable symptoms up to a year before an ovarian cancer diagnosis. A statement on the National Ovarian Cancer Coalition ([NOCC], 2006) Web site says "Ovarian cancer ... it whispers, so listen!" Listening to the whispers as well as giving the whisper volume so it can be heard is essential.

Women experiencing the vague but identifiable symptoms of ovarian cancer need the voice to respond to the whispering of their bodies, collectively and individually. Listening to women and identifying their symptoms is an obvious task, but nurses also need to consider women's ways of knowing and the strength of women's voices to optimize screening, early detection, and timely care for ovarian cancer. It is a theoretical framework that can be used to emphasize the importance of listening to women as they are screened in any healthcare setting, especially for the early symptoms of ovarian cancer.

The purpose of this descriptive qualitative study is to examine personal stories of ovarian cancer within the framework of WWK to understand how women voice their whisperings of ovarian cancer and their interactions with healthcare providers. A review of the literature was conducted using the CINHAL[R] database. To begin the search, the key words, ovarian cancer, cancer screening, female, and early detection, resulted in 116 articles. The literature included discussions of evidence-based screening practices, recommended diagnostic tests, and the Ovarian Cancer Symptom Index.

Because WWK is the guiding framework for the study, the key words, ovarian cancer and women's ways of knowing and ovarian cancer and intuition were used to guide the literature search. Ovarian cancer still is elusive because no useful diagnostic test for the general population is available. Rather a combination of diagnostic tools are used to screen for ovarian cancer, but they are not used to screen all women. Because no equivalent to the mammogram or Pap smear currently exists for detecting ovarian cancer.

The accuracy of those modalities is limited and has not proven to be effective in identifying ovarian cancer in the early stages. USPSTF listed a D recommendation for routine ovarian cancer screening, which means that screening of asymptomatic women is ineffective or the harms outweigh the risks. Population-based screening for ovarian cancer is not recommended by the American College of Obstetricians and Gynecologists. More info for small lung cancer.

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