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'You know your body': Ovarian cancer an 'elusive diagnosis,' expert says

Tribune-Democrat - 9/25/2021

Sep. 25—JOHNSTOWN, Pa. — When Marianne Spampinato was in her late 30s, she went to her gynecologist with troubling menstrual symptoms. The doctor told her it was probably just her age.

The symptoms continued, leading Spampinato to look for another opinion.

"When I turned 40, I found a nurse practitioner who wanted to get to the bottom of the issues I was having," Spampinato said this week.

After several other tests, an ultrasound study was ordered to check for endometriosis — a painful condition of the uterus. While the images did not show endometriosis, they did provide the first clue for finding the true source of her symptoms.

"I had what looked like a saddle on my ovary," Spampinato said. "They wouldn't let me leave without scheduling surgery."

She was referred to a gynecologic oncologist at UPMC Magee-Womens Hospital in Pittsburgh, where she had a hysterectomy in May 2001.

"He told me, 'You don't know how lucky you are. We found two grape-sized tumors in your left ovary,' " she said.

Following a round of chemotherapy, Spampinato has been cancer-free for 20 years.

Like Spampinato, local experts say many ovarian cancer patients have experienced delays in getting answers for their symptoms.

Dr. Thomas Krivak, a gynecologic oncologist, said the typical symptoms often persist for three to four months before ovarian cancer is confirmed.

"The problem with ovarian cancer is it can be an elusive diagnosis," Krivak said. "There is no screening test for ovarian cancer. The Pap test does not screen for ovarian cancer."

Krivak will soon be seeing patients at Conemaugh Physicians Group — Obstetrics and Gynecology, 1111 Franklin St., through an arrangement with Allegheny Health Network in Pittsburgh. His schedule in Johnstown has not been finalized.

Symptoms of ovarian cancer can also be associated with other conditions of the abdomen and pelvic area, the experts say.

"Symptoms are all very vague," said Dr. Greg Whorral, gynecologist with Windber GYN Associates. "Because the symptoms are vague, it is often found later in progression."

The American Cancer Society website lists the most common symptoms as:

—Bloating.

—Pelvic or abdominal pain.

—Trouble eating or feeling full quickly.

—Urinary symptoms such as urgency or frequency.

Although there are blood tests that can indicate ovarian cancer, Krivak said an accurate diagnosis requires a biopsy or surgical procedure. Those are usually done by a gynecologic oncologist.

Treatment typically begins with surgery, followed by chemotherapy — also by a gynecologic oncologist. Until Krivak's arrival in Johnstown, the process required several trips to Pittsburgh or another major city.

Spampinato appreciates how fortunate she was to get the early diagnosis and treatment. She encourages women experiencing any symptoms to not ignore them and be persistent in getting answers.

"I was very blessed to have found it in stage one," she said. "You know your body and what you should be feeling. If you know something doesn't feel right, go see a doctor — or doctor after doctor after doctor. Get someone to listen to you to try to help. You have to be your own advocate."

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