Women's "Silent" Cancers

Pushing for Change

In December 2006 actress Fran Drescher went to Washington. But unlike Frank Capra's wide-eyed junior senator, Mr. Smith, Drescher was no babe in the woods. As the author of Cancer Schmancer, her 2002 book about the fact that it took eight doctors and two years for her to get a diagnosis of what proved to be stage-1 uterine cancer, she came to town on "a very dedicated lobbying effort," she says. Her agenda was to use her celebrity to push for passage of the Gynecologic Cancer Education and Awareness Act, also known as Johanna's Law, after Johanna Silver Gordon, who died from ovarian cancer in 2000. Drescher's efforts proved fruitful. In January 2007 President Bush signed the bipartisan bill, which authorized the launch of a national campaign to educate American women and healthcare providers about the symptoms of gynecologic cancers.

In fact, ovarian-cancer patients had been pushing to get their illness on the national radar for some time. In 1997 seven grassroots organizations had come together to form the Ovarian Cancer National Alliance (OCNA). Among their goals were lobbying for more federal funding and bringing much-needed public attention to the disease's risks and symptoms.

This nascent advocacy hopefully will help change what has been a tragic reality for decades: Research into gynecologic cancers -- ovarian, uterine, and cervical -- has been underfunded. Counted together, these are the third-most-common cancers in American women; more than 72,000 were diagnosed in 2007. While more women get breast cancer (there were 178,000 new cases last year), a higher proportion of women with cancers of the reproductive tract die. In 2007 the National Cancer Institute (NCI) reported spending of nearly $600 million for breast-cancer research and $296 million for prostate cancer. By contrast, only $97 million was earmarked for research into ovarian cancer -- the most dangerous of these cancers though one of the rarest: More than 20,000 new cases are diagnosed and 15,000 women die of the disease each year. And funding for uterine and cervical cancers combined was a mere $98 million.

While the overall five-year survival rate for women with breast cancer is 89 percent, it's just 46 percent for those with ovarian cancer (cervical is about 72 percent and uterine is 83 percent). What's more, 80 percent of ovarian cancers and 25 percent of uterine cancers are found at stage 3 or 4, when they have already spread and are less curable. Today, thanks to mammograms, 61 percent of breast cancers are found at stage 1.

The delay in diagnosis has many causes. For starters, even for women who see a gynecologist annually, the standard physical exam usually doesn't pick up early-stage uterine or ovarian cancer. And while there is a universally accepted screening test for cervical cancer -- the Pap smear -- there is no reliable screener for ovarian or uterine cancer.

In fact, when women report symptoms that should send up a red flag for gynecologic cancer, many physicians routinely attribute these complaints to other conditions, such as perimenopause, stress, or indigestion. Result? Women don't receive the tests that could distinguish between something benign, such as indigestion, and cancer.

Much needs to change, but perhaps the most critical step of all is for women to become more proactive about their reproductive health. The following pages will arm you with the information you need.