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This question was answered on Wed 19, Mar 2008 09:16pm by Dr Heinrik M, MD

Ovarian cancer - Bloated and thoracic back pain with pain in pelvis



    
Asked by Unregistered ; 5109 ) on Wed 19, Mar 2008 10:26am

I am 22 years old and on birth control. I have had abnormal pap smears for the past 3 years and have had a cervical coloscopy twice and a biopsy was taken. I also had a pelvic ultrasound done two or three years ago. Lately I have not been able to finish my meals, I am exhausted all the time no matter how much sleep, I have been having a lot of thoracic back pain and I am so bloated I cannot fit into any of my jeans. Lately I have had a lot of pelvic pain near where my uterus would be located. I am going to have a pelvic ultrasound this afternoon, but no one will really tell me if they think I might have cancer. I am not pregnant.

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Answer by Dr Heinrik M, MD (doctor) on Wed 19, Mar 2008 09:16pm:

Hi, Cancer incidence increases with increasing age, and hence it is not likely that any doctor will consider cancer among the first things. If you have back pain, at your age the investigation would look at your activities, symptoms below the area of pain. And based on the presence of absence of anything else – would the subsequent tests be determined. Poor appetite but apparent increase in abdominal girth does raise suspicion for fluid within the abdomen, if there is a definite change in weight then this is more so. The ultrasound is indeed a first step. Whether this represents cancer, there is too little evidence to say so. It is within the realm of possibility but not probable. At the very least, the back pain may only be postural, an anatomic problem like mild scoliosis. The pelvic pain may be benign problems with the endometrium (how are your menses anyway? any irregularities?) or the more probable urinary tract infection. Your concerns are pretty valid, because there seems to be so many symptoms that you would consider a single problem (and in this regard cancer is suspect because of how it can metastasize and how it affects even appetite, but this is not unique for cancer. There are also slow growing infections that do present with similar non-specific symptoms) – but the existence of multiple fairly common problems may actually be more probable. Unfortunately this is all I can say about this. If the pelvic ultrasound shows anything – it may only be endometriosis. If there is a mass on the ovary, your age group would raise suspicion for germ cell tumors. While these are cancer, they have a good chance for cure, so I think there is a lot to keep positive.

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