Symptoms of ovarian cancer can be similar to those of other conditions and hard to diagnose. Now the NHS is planning better diagnosis for women over 50.
The plans are being welcomed by cancer charities.
Around 6,500 women are diagnosed with ovarian cancer in the UK each year and around 4,400 women die from the disease.
Symptoms of ovarian cancer
Ovarian cancer symptoms are usually not very specific and could be due to many different conditions. Cancer is not usually the first thing considered in a woman having these symptoms. Symptoms include:
*Persistent pelvic or abdominal pain
*Increased abdominal size/persistent bloating
*Difficulty eating or feeling full quickly
*Needing to pass urine more urgently or more often than usual
*Symptoms similar to irritable bowel syndrome (IBS)
Ovarian cancer is more common in women over 50. Symptoms often do not occur until late in the disease, when the tumour has grown large enough to apply pressure to other organs in the abdomen, or the cancer has spread to other organs.
New NHS quality standard for ovarian cancer
The National Institute for Health and Clinical Excellence (NICE) has drawn up what it calls a new quality standard for ovarian cancer.
It says women aged 50 or over reporting one or more symptoms which occur persistently or frequently should be offered a CA125 blood test.
CA125 is a protein produced by some ovarian cancer cells and a raised level may indicate ovarian cancer. However, many women with early stage ovarian cancer have a normal CA125 level and a raised level doesn’t give a definite ovarian cancer diagnosis.
The new NHS plan says women with raised CA125 should have an ultrasound of their abdomen and pelvis within two weeks of receiving test results.
Further tests, such as an MRI scan, may be needed to investigate any mass, growth or lump in the pelvis or next to the uterus. This investigation will help determine whether they are not life-threatening (benign) or whether they are cancerous (malignant).
In a statement, Dr Gillian Leng, deputy chief executive and director of health and social care at NICE says: “We know that the poor survival rates of ovarian cancer may be linked to late diagnosis, which is often because of a lack of awareness of the early symptoms, which include abdominal bloating or pain and difficulty eating.
“The disease is more prevalent in women over 50, who often mistake its symptoms for the menopause. Therefore, it is important that there are clear, measureable standards that can help drive improvements in the diagnosis, care and treatment of this disease.”
The Eve Appeal gynaecological cancer research charity has welcomed the plans from NICE. In a statement CEO Robert Marsh says: “Although 4,400 women die from this disease in the UK each year, GPs may only see one case in five years, so this is a major step towards moving ovarian cancer up the primary care agenda. By encouraging GPs to act on these symptoms in post-menopausal women early, we hope this practice will lead to diagnoses of the disease at an earlier stage, when we know treatment can be more successful and help save lives.”
The charity is funding research into national ovarian cancer screening trials which are due to report in 2015. “Until then our advice to women is to be aware of the signs and symptoms and to visit your GP if you have any concerns,” Mr Marsh says.
Also welcoming the new NHS plan in a statement, Gilda Witte, CEO of Ovarian Cancer Action, says: “It sets out what women with ovarian cancer should receive. Prompt referrals for diagnostic tests are essential. All commissioners of care must follow the Quality Standard recommendations in order to save women’s lives.
Although 85% of cases involve women aged 50 or more, Gilda Witte points out: “Women under 50 get ovarian cancer too. The Quality Standard acknowledges this but GPs must ensure that they don’t hold back from putting younger women forward for tests – particularly those with a family history of breast or ovarian cancer. The Quality Standard’s emphasis on older women detracts from this message.”