Ovarian Cancer Awareness

Ovarian cancer is the seventh most common cancer in women globally, and one of the leading causes of cancer-related deaths in women. It does, however, suffer from a lack of awareness and therefore timely diagnosis in comparison to other cancers.

The key to any cancer treatment is usually catching the disease early. Most people recognise that universal truth, but it is easier for some cancers than others. There is no standard screening programme for ovarian cancer, as there is for cervical or breast cancer. Being aware of the symptoms, and then doing something about it, is vital.

The NHS list of symptoms

Symptoms of ovarian cancer include frequently (roughly 12 or more times a month) having:

• a swollen tummy or feeling bloated
• pain or tenderness in your tummy or the area between the hips (pelvis)
• no appetite or feeling full quickly after eating
• an urgent need to pee or needing to pee more often

Other symptoms of ovarian cancer can include:

• indigestion
• constipation or diarrhoea
• back pain
• feeling tired all the time
• losing weight without trying
• bleeding from the vagina after the menopause

The problem is that this is a very broad set of symptoms, and any of them can be caused by something completely unrelated. The key is to pay attention to your body, and know what is normal for you. If you have such symptoms, and they are not going away, see a doctor.

The most common issue that we in the legal profession encounter is delay, and delay can come from both patient and doctor. Typically, we are told of symptoms being a problem for several months, or worse, before a doctor is consulted. There is nothing that a doctor can do for you if you have not consulted them. Delay can only make it worse. There is no cancer that gets better with time. There is no sense being worried about a problem and doing nothing about it.

A doctor who does nothing after being consulted, of course, is a very different story, and likely to be hearing from us. We would prefer it if this were not necessary, and if delay could be erased from the process. You can control your own half of this partnership, so knowing your own body and taking charge by getting yourself in front of a doctor is vital.

Getting seen is not the end of it, however. There are a number of flaws in the system after that point, and you can help yourself by being persistent. You are entitled to answers. If you know that something is wrong, and you want it investigated, do not be diverted from your question. Do not get waved off without a definitive diagnosis of what is actually wrong. Most of that list of symptoms above has another explanation, and you may well be told that it’s “probably” something else. It probably is, but a lot of problems that we see arise from cases where that is as far as the investigation goes. The patient is reassured that it is probably not a problem, and is either then not told or doesn’t hear the next part. What happens next is important, however:

1. Is that diagnosis definite?
2. Are there any tests to be done to confirm it?
3. Is there any follow-up to be done, are you expecting to come back?
4. If so, when and why? What are the triggers to make you do so?
5. Is someone else going to arrange any follow up? If so, who, and when can you expect to hear from them? What if you don’t? Do not get lost to poor administration. The NHS has a very real problem in getting letters to the right people at the right time!
6. What if you’re not happy that this explanation is correct?
7. What if you want testing for cancer anyway?

Your doctor should be able to give you all the answers to that list, indeed most of them should be covered in any standard advice at almost any appointment for almost any medical complaint, but a lot get skipped over in the course of what might well be a very fast appointment in front of a harassed doctor with too much to do today. Your job is not to let that happen.

The NHS is actually generally very good indeed at cancer detection and treatment. The key is to get into the system to be diagnosed. There is a difficult balance between pressing the panic button for minor complaints that are extremely unlikely to be a serious problem, and overdoing it, such that the doctor is not investigating those that are. The standard advice to go away and come back if it doesn’t get better is crude, but an effective method for filtering out those with nothing much wrong. Where this falls down is that people simply give up. If you’ve been told twice that it’s nothing, you might be forgiven for not going back to the same doctor again. That doesn’t help you, however, if you still have a problem. If you don’t go back, nothing is being done, the NHS thinks you got better.

If tests or examinations are planned, or to be arranged, be clear about what happens next. If it doesn’t happen, chase it up. Do not make the mistake of thinking that after you have seen a doctor that the NHS is now taking care of you and you need do nothing more. Nobody is doing anything for you if there is no plan for the next step in the process. If something more is supposed to be happening, and isn’t, then you need to know what. Do not get lost in follow-up. Administrative errors happen all the time, and the reality is that you will be more effective at catching them than the NHS is. You only have one patient to think about, you will notice if they are not being looked after. The NHS has millions, they miss things. Don’t be the one that is missed.

Your bargain with the NHS is that if you give them the correct information, they will look after you. For a serious condition with non-specific symptoms, which is unfortunately exactly what ovarian cancer is, this is vital. You know when something is not right, and a doctor will always take it seriously if a patient reports a change that could be an early sign of something serious.

The message is simple, therefore, and it is to do something. If you have symptoms that worry you, see a doctor. If you’re told to come back if they persist, do it. If there are further tests to be done, make sure you know where and when, and chase it up if it’s not happening. And then actually attend. You are not making a nuisance of yourself, you are upholding your side of the deal.

The NHS has very useful guidance regarding ovarian cancer, which can be found here: https://www.nhs.uk/conditions/ovarian-cancer/