Ovarian Cancer

Sarah Wollaston Excerpts

Wednesday 12th October 2011 Westminster Hall

[Fiona Mactaggart (Slough) (Lab)]

I should start this speech by telling the House that I should be dead, because only two out of every five women with ovarian cancer survive beyond four years and my cancer was diagnosed eight years ago, at the start of 2003. I remember the dates well. Throughout that autumn term, I had been on a very serious diet. As hon. Members know, I need to do that, and I was completely unaware that the loss of appetite that was caused by my cancer was being helpful to my dieting. At the end of that autumn term, I went to see my GP about symptoms that actually were irrelevant to the cancer, but she is a very insightful woman. She took a very careful history from me and did a CA 125 test. This was about December. She referred me and I did the CA 125 test. I remember the dates fairly well because it was just before I went away for a Christmas holiday. The level was elevated. Of course, I had no idea how significant that was. I cannot remember what it was at that point—45 or something like that. I said, “Is that serious?” She said, “Well, yes.” I did not quite work out how serious it was, but she had referred me to a specialist. I came back from my Christmas holiday and had an intravaginal ultrasound in January. I went to see the doctor about the results and was told on, I think, 15 January that I was going to have a hysterectomy in an operation that might be related to cancer on 14 February—not a date one forgets.

Although I was late detecting the symptoms and, indeed, the symptoms that I went to see my GP about were not symptoms caused by my cancer, it was a very short time before I had an intervention. In fact, it was quicker than that. It was this time of day on a Wednesday. The day before, we had lost, by just three votes, a cross-party vote on an 80% elected House of Lords. Those three votes were hon. Gentlemen who had had too good a dinner. I was trying to do press and so on about the House of Lords vote. I was trying to get across the point that a majority of the House of Commons thought that we should have an 80% elected House of Lords, but some hon. Members went in the wrong door because they cannot manage when they do not have Whips telling them where to go. Those calls were interrupted by a telephone call from St Thomas’ hospital, which said, “We have a cancellation. Can you come in today?” I burst into tears. Then I went to the Army & Navy Stores and bought a nightie and a pair of slippers and set off to St Thomas’ hospital.

As can be imagined, I arrived at the hospital not with my head in the place where a cancer patient needs it to be, but still trying to sort everything out, because although I had known that I was to have the operation, it was originally to take place about two weeks after the House of Lords vote that I was working towards. So I arrived all shouty and dictating things, putting out press releases, bellowing into a phone and so on. I was put in my bed and was still shouting down the phone, but then this woman came up to me, took my hand and put it in a bowl. I was on the phone and I said to her, “What are you doing?” She said, “I’m giving you a manicure.” I said, “Why?” She said, “I’m a volunteer. I come into the women’s ward in St Thomas’ hospital on a Wednesday and give women manicures.” I have told the Minister that story because that volunteer helped me through the experience, as I stopped being an MP and started facing being a patient. I strongly urge the Minister to recognise how powerful such roles, which do not look clinically essential, are in the care of people. That is my first message.

My second message is that my story tells us how good the NHS can be—how fast it can respond. In my case, it was eight to 10 weeks between first going to the GP—and not reporting the right symptoms—and having an operation. One cannot ask for better than that. I know that a big reason for it was the targets that we had set, because when I was told when my operation would take place, the consultant said to me, “Oh, I’m bumping up against the date.” I therefore urge the Minister both to look after the role of volunteers and voluntary organisations and to retain those targets that put pressure on the system to help people like me to live.

[Dr Sarah Wollaston (Totnes) (Con)]

I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on initiating this important debate. Does the hon. Member for Slough (Fiona Mactaggart) agree that although it is wonderful that she had such rapid access to treatment, such access to diagnosis is not uniformly available throughout the country? My experience is that it is difficult for general practitioners to gain rapid access to ultrasound scans, which was a crucial factor in the hon. Lady’s diagnosis. Equally, access to CA 125 measurements, although included in the NICE draft guidelines, which is welcome, is not uniformly available to GPs throughout the country.

[Fiona Mactaggart]

The fact that those things are not accessible is condemning women to die. It is very simple, and they are not complicated tests. I have had an awful lot of CA 125 tests because women have a lot before and a lot afterwards to see what is happening to the markers in their blood. It is a very simple test and certainly should be available in primary care so that GPs can do it quickly and reassure themselves and their patients. It was thanks to Ovacome that I began to realise how important knowing one’s CA 125 level is. Until I started reading the educative materials produced by voluntary organisations, I did not know that.

I want to say one thing about all the voluntary help available to people with cancer. It is very confusing. People never really know who does the thing that they need—who provides the help. Today, the question might be, “Should I wear a wig, or are they all horrible and uncomfortable?” The answer is yes, by the way. It might be, “Do I need someone to hold my hand and explain what’s wrong with me?” People do not know these things. I wish that somehow all the wonderful charities could get together and have one doorway through which the patient goes and can say, “This is what my life’s like. I can’t afford to park at the hospital” or “The wig that I got is itching” or “Is my reaction to chemotherapy appropriate? Do other people have it?” Who are the right people to help? People in this situation never know who the right people are, so one thing that I wish the Department of Health would do is find some way of resourcing those organisations to provide a better entry to their services for people with cancer.

However, I want to focus on diagnosis and helping people to detect their symptoms early. I did not detect mine particularly early; indeed, it was my GP who detected them, not me. Many hon. Members have written to the Minister, and at the annual general meeting of the all-party group in July we considered the response that he had sent us. Frankly, to me, it seems that the message is not getting through. The work being done to improve early diagnosis of cancer, particularly awareness, will not make a difference to the women who have ovarian cancer. I am very glad to receive an account of the work being done on breast, lung and bowel cancer, but frankly it is a bit insensitive. Someone who is concerned about ovarian cancer will see all those wonderful information campaigns on other cancers, but none of them applies to the symptoms of ovarian cancer. That will not do, and it particularly will not do when ovarian cancer is such a killer.

In the letter to the all-party group, the Minister said that

“future activity will depend on the success of the Be Clear on Cancer campaigns”.

His Department has since announced that following the success of the regional pilot campaign for bowel cancer, it will be rolled out nationally. Now that we know that those awareness campaigns work, when will we have a commitment to work on ovarian cancer? We have extended the work to include stomach, oesophageal, bladder and kidney cancer. Why not ovarian cancer? It was not until long after I had had a hysterectomy, chemotherapy and so on that I realised which of the symptoms that I had had were clues to my cancer. We really must help people to know that they are at risk. Ovarian cancer is the fourth most common cause of cancer death in women. Is it just because it affects women that we are not seeing action? If men had it too, we might be doing better, although, of course, we have a good history on breast cancer.

I worry that ovarian cancer is being put in the “too difficult” box, and it is not acceptable to do that with the most fatal gynaecological cancer. Ovarian cancer kills four times as many women as cervical cancer, for which we have a national screening programme. Is it not time that we put in place a national screening programme for ovarian cancer and gave GPs and others proper access to diagnostic tests that will save thousands of women’s lives? It is not acceptable that so many women die of this cancer when we know how to stop it, and I urge the Minister quickly to put in train action to deal with this issue.