Ovarian Cancer: Diagnosis and Treatment

Lee Rowley Excerpts

Tuesday 30th October 2018 Westminster Hall

[Lee Rowley (North East Derbyshire) (Con)]

I beg to move,

That this House has considered ovarian cancer diagnosis and treatment.

It is a pleasure to serve under your chairmanship, Mr Bone. I thank the Backbench Business Committee for allowing the debate, as well as everyone who is here to support this important and timely event—both my colleagues in the Chamber, and everyone in the Public Gallery. The issue is extremely important, and I am privileged to open the debate. This will be the first time since 2014 that ovarian cancer has been debated in either Chamber.

Ovarian cancer is a quiet, invasive cancer, that robs wives, daughters, sisters, mothers and grandmothers of years of their lives, often unexpectedly and quickly, with devastating impacts on their families. Today about 25,000 women are living with the cancer and every day 20 will be diagnosed with it. Despite some progress in recent years the disease still takes away the lives of 4,000 women a year, and hundreds of thousands around the world. Because of its devastating effects its survival rate is, tragically, not as high as everyone would like, and 46% of sufferers do not survive for five years or more.

[Nick Thomas-Symonds (Torfaen) (Lab)]

I warmly congratulate the hon. Gentleman on securing the debate. To improve survival rates, we need earlier diagnosis. For many years ovarian cancer was known as the silent killer, but there are a number of signs and symptoms. Will he join me in encouraging anyone with those signs and symptoms to see their GP urgently?

[Lee Rowley]

I absolutely will. That is a timely and important point. I was on Radio Sheffield only this morning talking about the debate with someone from Target Ovarian Cancer. We spent an awfully long time talking about the symptoms, because it is important that people understand them, and are aware of them, so they can get the treatment they need if they are, unfortunately, affected.

All cancers are important. Extremely sadly—sometimes tragically—ovarian cancer tends not to receive the bulk of the attention or funding. That is partly because it does not affect as many people as other cancers, but it is also because of survival rates. The 46% rate of survival beyond five years compares unfavourably with the rate for breast cancer, which is 87%, and prostate cancer, which is 85%. There are simply fewer survivors of ovarian cancer in the UK who could highlight the importance of fighting the disease and succeeding than there are survivors of other cancers. There is a need for people to speak up about ovarian cancer. Thanks to the work of those who are doing so, it has started to receive the attention that it needs. Charities such as Target Ovarian Cancer work tirelessly every day to raise the profile of the disease, support those who have been affected, improve diagnosis and treatment, and work for a cure. I pay tribute to the work of the all-party parliamentary group on ovarian cancer, and in particular the hon. Member for Washington and Sunderland West (Mrs Hodgson), who chairs it. It has been a privilege to be involved in the work and I am grateful to be able to help in a small way.

What is it about ovarian cancer that requires a particular focus? From the work I have seen, there are four things: improving awareness of the disease, as the hon. Member for Torfaen (Nick Thomas-Symonds) mentioned, so that it can be caught earlier; speeding up the diagnosis when it is suspected that someone has the disease; improving the data available for tracking the disease and our progress in the fight against it; and improving the treatment, allowing people to recover and be disease-free more quickly.

[Nick Boles (Grantham and Stamford) (Con)]

On the point about early diagnosis, my constituent and good friend Jane Sagar had a cyst of 6.5 cm, which a specialist identified. However, its removal was not recommended, although she was later told that any cyst greater than 5 cm on her ovary should automatically have been removed, because it was likely to be cancerous. As a result she is entering her fourth year of treatment for advanced ovarian cancer.

[Lee Rowley]

My hon. Friend makes an important point. Treatment around the country needs to be made more consistent and clearer, to put a stop to the issues that many of us have heard in stories from constituents.

[Theresa Villiers (Chipping Barnet) (Con)]

I apologise that I shall not be able to stay for the whole of this important debate. Does my hon. Friend agree that the additional resources that the Government are devoting to the NHS are welcome, and that it is important for it to use them wisely, which includes improving early diagnosis and treatment of cancer? Early diagnosis is crucial to successful outcomes and the raising of survival rates for ovarian and other cancers.

[Lee Rowley]

My right hon. Friend is right and I hope that the Minister will recognise that. It is a matter of getting a diagnosis, and encouraging people who feel that something may not be quite right to go to the doctor, so that the pathway starts. Then, if there is an issue—most of the time there is not—there can be progress, and people can get the treatment they need earlier.

The first step in improving outcomes on ovarian cancer is improving awareness among the general public, and among GPs and in doctors’ surgeries in general. As has been mentioned, the symptoms of ovarian cancer are often easy to mistake for something else. Too often it is easy to dismiss them as inconsequential or not worth further attention. Symptoms include bloating, a need to go to the toilet more frequently, pain in the tummy or always feeling full. Recognising that those symptoms are potentially problematic is a key to survival. Those diagnosed at the earliest stage, stage 1, are almost certain to be alive a year after the diagnosis; 98% of them will be. Only half of those diagnosed at stage 4 are alive a year later.

Awareness of the symptoms among the general public remains low. For example, only 20% of women can name bloating as a symptom, and only 3% can name feeling full and loss of appetite as an issue. A regional Be Clear on Cancer pilot on ovarian cancer symptoms in 2014 was promising. There was an increase in both spontaneous and prompted awareness of the issues. There were also promising findings from a further regional pilot last year, which focused on abdominal symptoms, including bloating. Initial findings showed that the campaign led to an increase in the number of GP referrals for suspected cancer. We ask that if the Government propose to run any future public health campaigns, they should include work to make people aware of those symptoms.

The second area where there is work to be done is diagnosis, not least because 45% of women reported that it took three months or longer from first presenting to their GP with concerns to recognition that they might have an issue. Diagnosis relies on two forms of assessment—an ultrasound and a blood test called CA125. In too many areas the assessments are done sequentially rather than simultaneously, which often means vital weeks are lost. We have urged the National Institute for Health and Care Excellence and the NHS to review that process and extend the coverage of multidisciplinary diagnostic centres. Those centres prove very useful for the sort of cancers that hide behind vague, less common symptoms, which it is important to get to the bottom of as quickly as possible.

The third area is data. There are many calls on the Government from many sources to ensure that the cancer dashboard demonstrates the progress already being made on a variety of cancers. I understand the challenge, but we also hope that in time the Government may look favourably on the idea of including ovarian cancer data in the dashboard. We hope that that would be relatively simple, as much of the data is already collected and published elsewhere. Good data is vital in driving forward and improving early diagnosis. Huge strides have been made in its collection, and making it available would help with the continuing work to drive up standards.

Finally, treatment also requires further attention. As with many health issues, ovarian cancer treatment is invasive and often difficult. It centres primarily on surgery and chemotherapy. There has been much progress in recent years on drugs to treat the cancer, with the development of a number of PARP inhibitors, providing new tools and opportunities to improve the outcome. However, spending and research on ovarian cancer remain lower than for other cancers, and there is much work to focus on. Where surgery is required there is a strong case for specialist centres around the country, supported by a detailed service specification from NHS England.

To further drive up the quality of treatment, charities such as Target Ovarian Cancer and Ovarian Cancer Action, together with the British Gynaecological Cancer Society, are funding an ovarian cancer feasibility audit. Over the next two years, it will map and analyse existing data on ovarian cancer, and look at the treatment provided and the outcomes for women.

[Liz Twist (Blaydon) (Lab)]

Will the hon. Gentleman join me in congratulating Target Ovarian Cancer and other cancer charities on highlighting this issue and putting forward some very sensible recommendations for improving treatment? Does he agree that it is shocking that our survival rates in the UK are among the lowest in Europe?

[Lee Rowley]

I absolutely do. All these things are a work in progress, but I hope that through debates such as this, through talking about it and through all the fantastic work the charities and the APPG do we can move things forward, make progress and, in time, have fewer women suffering from this and more women getting treatment more quickly than today.

The question of ovarian cancer is, however, more than a technical discussion about diagnosis, awareness, data and treatment, as important as those are. Behind each statistic is a real person who has been unexpectedly struck down by the disease and, in far too many cases, might not be around today to tell the story of their fight. As part of the preparation for this debate, the parliamentary digital team and Target Ovarian Cancer asked people to share stories of their fight and those of their family members.

I am hugely grateful to both organisations for helping with that, and to everyone who got in touch. The stories we received were heartbreaking and heartwarming in equal measure, tragic and terrific, and whatever the outcome, they were inspiring to us all. I cannot possibly do justice to everybody who got in touch or to all the stories and experiences out there, but I will share a few today to remind us of the importance of making progress on this disease.

Danielle got in touch to tell us about her mum, who was diagnosed with stage 3 ovarian cancer in September of last year. Like many other people’s, her symptoms were fuzzy: irritable bowel syndrome, feeling full, swelling and weight loss, which could have been a hundred other things. By chance, the doctor who saw Danielle’s mum also sent her for a blood test, which quickly confirmed that there was an issue. A month or so later, Danielle’s mum started chemotherapy, and in January this year she had a full hysterectomy. After a 10-hour operation, it was hoped that everything had been caught and the focus was on recovery. By June, however, the cancer had returned; sadly, a few months later, in August, Danielle’s mum lost her battle, just 10 months after diagnosis.

Forty-year-old Sarah also had symptoms such as weight loss, feeling full and ovary pain. Before the cancer was diagnosed, she tried many times to find out what the issue was, including once being told, “Well done,” for having lost weight. In Sarah’s case the blood test that often highlights an issue came back normal, which emphasises the imperfect nature of the diagnosis. A nine-hour operation and six rounds of chemotherapy later, Sarah continues to battle her cancer while looking after her two young children.

We also heard the story of the daughter of Jean, who was diagnosed in 2011 with stage 4 ovarian cancer as a result of severe bloating and loss of appetite. After major surgery and four rounds of chemotherapy, the news came through that the cancer had spread. Her battle ended early in 2013.

Emma told us about her mum, who was told she was suffering from irritable bowel syndrome; the actual issue was found too late and she lost her battle, aged 64, just six weeks after diagnosis.

Seren started feeling unwell while at university, aged just 19. Unable to get a doctor’s appointment, she came back home and was diagnosed with cancer. Her tumour was the size of a rugby ball and her operation was pushed forward as it was stopping her eating and affecting her breathing. Chemotherapy followed and today Seren is recovered and working for a cancer charity.

Christine is also one of the good news stories. She was diagnosed with stage 2 ovarian cancer aged 35, having had to visit three different GPs to resolve the problems she was suffering from, which had initially been put down to colitis and anxiety. After her diagnosis, an emergency operation and 10 chemotherapy sessions followed. That was in 1985 and Christine is still here; she has been able to share her story in the last few days.

Finally, Linda was diagnosed with ovarian cancer in September 2017, having initially felt unwell at the beginning of summer while she was on holiday. The classic symptoms were there: bloating, feeling full and knowing that something “wasn’t right”. Multiple trips to the GP followed until, finally, a blood test was taken, confirming the cancer. Linda had a full hysterectomy that same month and spent much of the next few months recovering.

I know that many hon. Members may be wondering the obvious: why am I standing here making the case about a disease that cannot and will not ever affect my body? As with so many others, although it may not have touched me personally, it has touched my family. Linda is my mum. Up until last year, she had had relatively good health and there is no history of ovarian cancer in my family. I generally try to keep my family out of politics—I was the fool who ran for Parliament, not them—but last year was a nightmare that none of us wants to experience again, and we have no wish to see anyone else experience the same. My dad, my brother and I watched my mum live through an extremely scary diagnosis, hugely invasive treatment and one of the hidden aspects of all cancers, the brush with mortality that takes time for sufferers to get to grips with.

Happily for me and my family, my mum is one of the lucky ones. She is sitting at home in north Derbyshire right now, possibly watching this debate on the internet. She has had a hard year and we are extremely proud of her. Yet I know that for every family like mine who have had good news, there are more people who face a tragic outcome. My mum and Danielle’s mum were diagnosed about the same time and I know that my mum’s journey, like that of Danielle’s mum, could have been so different. I do not want anyone else to face what those of us who know and understand what this disease forces on sufferers have faced. Better treatment, diagnosis and a cure cannot wait. I am grateful for the opportunity to discuss these hugely important issues; I look forward to the debate and the Government’s response. Together, I hope we can beat ovarian cancer.

--- Later in debate ---

[Lee Rowley]

I thank all right hon. and hon. Members who have contributed to this exemplary debate. It has been one of those debates that we all aspire to have, in which we talk about the detail and leave out a lot of the politics, and in which there is unity regarding wanting the same outcome: we all want to be able to treat the disease more quickly, with better outcomes and fewer people experiencing it. I am grateful to everyone for entering into the discussion in that spirit.

I thank the hon. Member for Strangford (Jim Shannon) for attending this morning, for highlighting the importance of the issue to him, and for mentioning all the work being done in Northern Ireland—particularly for raising the point about genome testing. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for sharing his experience north of the border. He, like so many others, provided some of the most important elements of the debate—examples of constituents’ own experiences. I also thank the Front-Bench spokespeople: the hon. Member for Lanark and Hamilton East (Angela Crawley) for also sharing her experience north of the border; and my colleague on the all-party parliamentary group, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who spent so much time highlighting the group’s great work. It has been a privilege to be part of that work over the past few months; the report is a great piece of work and I hope to see improvements coming out of it.

I also thank the Minister. I am a relatively new Member, but I can often tell in debates when Ministers are going through the motions and when they actually care, and today I have heard a speech that demonstrates a genuine interest. It was great to hear about the Minister’s personal connection and about how he cares about the issue, and it was interesting to hear some of the things he highlighted. “Lots to come” is the summary I think it is fair to say we can take from the speech, with regard to the ACE centres, the potential for more public health campaigns, the genome point and the screening. I was particularly glad to hear about the dashboard, which I hope, in time, will give us an opportunity to push forward and demonstrate greater transparency.

Although they are not all still in their place, I thank my hon. Friends the Members for Grantham and Stamford (Nick Boles) and for Nuneaton (Mr Jones), my right hon. Friend the Member for Chipping Barnet (Theresa Villiers), and the hon. Members for Blaydon (Liz Twist), for Torfaen (Nick Thomas-Symonds) and for Upper Bann (David Simpson). I am incredibly grateful for their contributions. I also thank everyone in the Public Gallery, who has listened and provided support. I am aware that there are Members in the room to whom the matter means much but who, by convention, are not able to speak: my hon. Friend the Members for Erewash (Maggie Throup) and you, Mr Bone. You are undertaking a different role today, as Chair, but you were so kind in supporting me when we applied to the Backbench Business Committee for the debate. I am grateful to you and my hon. Friend for your silent but heartfelt support.

This is an important area. It has affected me personally, but it is not about the personal effects; it is about ensuring that we make progress as a country in sorting out the disease and resolving the issues, reducing the number of people out there who get a diagnosis. The debate has shown that a lot has been achieved, that a lot can be done, and that there is a lot of progress we can make, and I look forward to seeing that progress in the coming years.

[Mr Peter Bone (in the Chair)]

I thank all Members for the excellent debate.

Question put and agreed to.

Resolved,

That this House has considered ovarian cancer diagnosis and treatment.