In 2003, after many visits to several different physicians while having difficulty becoming pregnant, I learned I had a disease that I never expected: a rare form of ovarian cancer. I was 29 years old. The disbelief and shock I felt lasted for quite some time. Even as a PA, I had never considered that ovarian cancer could be causing my health problems. Today, after having made it through multiple surgeries and chemotherapy and having been blessed with a beautiful daughter, I want to look at a different way of making a difference as a PA and survivor.
In 2008, I joined Chatham University's PA program and met my colleague and friend, Heidi Felix. She was working in gynecologic oncology, and we found ourselves discussing my history and her experiences in clinical practice with patients with ovarian cancer. She had seen numerous patients with vague symptoms who were referred from physician to physician, and by the time they saw an oncologist, their disease had progressed to a late stage. There was a common underlying theme: these patients had never talked with their physician—nor had their physician ever talked with them—about ovarian cancer.
Heidi and I were concerned about the lack of awareness of ovarian cancer and wondered how we could make a difference. Could we educate undergraduates and our own PA students about the sometimes subtle symptoms of ovarian cancer? Heidi developed a research project designed to discover the level of awareness on our small campus of female-only undergraduates and coed graduate students, and we began to work on the project. We based it on a similar project that had been described in 2009 in the American Journal of Nursing.1 For that study, the authors surveyed 1,211 women older than 40 years and discovered that roughly 60% of the women were not familiar with the symptoms of ovarian cancer, 67% believed that a Pap smear could detect ovarian cancer, and 54% felt that ovarian cancer was not important because their practitioner had not discussed it with them. Finally, 80% of the women had never discussed ovarian cancer with their physician, whereas 60% had discussed breast cancer.1
As faculty members at Chatham, we began to survey our students with respect to their demographics (age, gender, undergraduate or graduate student, and field of study) and awareness of ovarian cancer (color representing ovarian cancer awareness, month observed for awareness, signs/symptoms, risk factors, etc). Our population consisted of 171 students, the majority of whom were female and 18 to 24 years old; 38% were PA students. We found several misperceptions regarding the diagnosis, symptoms, detection, and prevention of ovarian cancer. Half the students believed that ovarian cancer is detectable by a Pap smear and that a preventive vaccine is available, while 36% believed that ovarian cancer is caused by human papillomavirus (HPV) infection. In addition, 70% did not know that bloating, abdominal pain, and urinary symptoms are signs of possible ovarian cancer. Students majoring in one of the health sciences (physician assistant, physical therapy, occupational therapy) did not have better awareness compared to the general population we surveyed; 39% believed HPV was responsible for ovarian cancer, and 54% believed a Pap smear detects ovarian cancer. The major difference was that half the health sciences students were aware of the possible symptoms of ovarian cancer. Although this is only one small study, we believe that the results highlight the general lack of ovarian cancer awareness.
These results can help practicing PAs to improve survival rates and quality of life for women with ovarian cancer. This disease has survival rates greater than 90% when caught early but 45%2 or less when detected in the later stages—which means that a PA's well known attention to detail in history taking can have a huge impact on survival rates. We must provide patients with concise and relevant information about ovarian cancer. We hope that in the future, the color teal will be as well known as the color pink. JAAPA
The authors are assistant professors in the Chatham University PA program, Pittsburgh, Pennsylvania.
REFERENCES
1. Lockwood-Rayermann S, Donovan HS, Rambo D, Kuo CJ. Women's awareness of ovarian cancer risks and symptoms. Amer J Nurs. 2009;109(9):36-45.
2. American Cancer Society. Ovarian cancer. http://www.cancer.org/cancer/ovariancancer/index. Accessed August 8, 2011.