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Awareness of ovarian cancer needed by both women and GPs

Medical negligence solicitor Gemma Castrofilippo voices her concern following a new report from Target Ovarian Cancer which shows women unaware of most common symptom of Ovarian Cancer and highlights rates of misdiagnosis by GPs

Gemma is an experienced clinical negligence solicitor who has specialised in this area since qualifying in 2008.  Gemma handles a wide range of cases, with a particular interest in obstetric cases, brain injury cases, mental health issues and cytogenetic work. You can follow Gemma on Twitter on @LD_Gemma
Shockingly, research recently released by the charity Target Ovarian Cancer (Pathfinder2016) shows only 20% of women in the general population are able to name the most common symptom of ovarian cancer: persistent bloating.  Of the other three main symptoms: 20% could name pelvic or abdominal pain, 3% feeling full/loss of appetite and 2% increased urinary urgency/frequency.

Also revealed by the charity’s research, and even more worrying, is the finding that almost half of women with ovarian cancer are initially misdiagnosed by their GPs.  Of the women interviewed 41% visited their GP on three or more occasions before being referred for ovarian cancer tests; having been referred initially for something other than ovarian cancer.

It is clear from the research that urgent action is needed to promote awareness of ovarian cancer and its symptoms to both GPs and women.  

There is a clear gap in the knowledge of ovarian cancer; a gap which needs to be plugged to ensure the current delay in diagnosing and treating the disease does not continue.

What should women/GPs be looking out for?

The common symptoms* of ovarian cancer are:
  • A swollen/bloated abdomen
  • Lower tummy (abdominal) pain
  • Feeling of fullness or loss of appetite
  • Passing urine more often than usual
  • Unexplained weight loss
  • Unexplained fatigue
  • Unexplained changes in bowel habit (constipation/loose stools)
  • Irregular periods or vaginal bleeding after menopause
  • Back pain
  • Pain during sex

Cancer Research UK states ovarian cancer is the sixth most common cancer for females in the UK, and that one in 52 women will be diagnosed with this form of cancer in their lifetime. Every year 7,300 women are diagnosed with the disease and 4,100 die. Despite this, the apparent lack of awareness among doctors and women of the symptoms of ovarian cancer coupled with the symptoms being attributed to other issues such as Irritable Bowel Syndrome (IBS) and stress, means ovarian cancer can be overlooked or disregarded as a potential diagnosis.  In fact, Cancer Research UK says most ovarian cancer cases are diagnosed at a late stage.  

If diagnosed at the earliest stage (Stage I), the survival rate for up to 90% of women is five years or more, though at present nearly two thirds of women are diagnosed when the cancer has spread (Stages II-IV).

What are the common misconceptions?

While GPs knowledge is improving compared to previous research by Target Ovarian Cancer, of the 504 GPs who took part in the most recent research, 44% wrongly believed that symptoms only present in the later stages of the disease and 77% mistakenly believed the disease is a ‘silent killer’.  

How can we educate?

Target Ovarian Cancer proposes a two pronged approach to improve early diagnosis:

Firstly by promoting national awareness campaigns to ensure women are aware of the symptoms to look out for by and the importance of visiting their GP.

Empowered with the knowledge of the symptoms to look out for, women can increase their chances of being diagnosed earlier by being more likely to visit their GP sooner, and also raising the possibility of ovarian cancer as a potential diagnosis when their GP may not at that stage have been considering this.

Secondly by educating GPs with accredited training on ovarian cancer and supporting them to refer women promptly.

It is worrying that such a large amount of women suffering from ovarian cancer are misdiagnosed by their GPs.  The fact that ovarian cancer can be difficult to diagnose due to it presenting in the same way as other more common conditions, such as digestion problems, menopause or stress, should mean that education and awareness of this type of cancer among both doctors and women should be given greater priority than at present.  When a woman attends her GP complaining of symptoms that fall within the bracket of those associated with ovarian cancer, this should be an automatic red flag signalling further investigation is warranted to ensure that before a diagnosis is reached, ovarian cancer is either ruled out or identified at a much earlier stage than present.  

Moving forward…

The delay in diagnosing and treating ovarian cancer needs to be addressed; early diagnosis gives the best chance of survival.

As the old adage says, knowledge is power; and in the case of ovarian cancer, the power to potentially prolong the lives of those affected.

* Symptoms taken from the websites for Target Ovarian Cancer and Cancer Research UK

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