Ovarian Cancer

Stuart Andrew Excerpts

Wednesday 12th October 2011 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. It has been a good many years since I last did so, when I was chairman of the Welsh Young Conservatives and you were chairman of the national Young Conservatives. I am grateful for the opportunity to raise this important subject. I am conscious that many hon. Members wish to contribute, many of whom have personal and constituency experience of the disease. It is important to hear from as many of them as possible, so I shall make my opening comments as brief as I can.

My personal experience of the effects of ovarian cancer occurred some 40 years ago, and it meant that I never knew my grandmother. In her 50s, she suffered from the disease, which sadly took her life in my first year of life. She was buried on my first birthday. Clearly, at that age I was too young to know, but she was, by all accounts, a truly wonderful lady and, due to the cruel nature of the disease, her death was a loss that impacted on my family for many years.

Some 40 years on, I was elected a Member of Parliament in 2010, and like all new MPs, I am sure, I felt somewhat overwhelmed when I came to this place. What staggered me more than anything was the volume of invitations that I received from many different charities. One stood out—that from Target Ovarian Cancer. It stood out because it informed me that a constituent would be attending a reception, and because of the impact that the disease had had on my family.

I worked in the charity sector for 16 years and, as I was involved in politics, I thought I knew how to get to Members of Parliament, but I realised how wrong I was when I saw the volume of correspondence that I received. I thought it clever of Target Ovarian Cancer to make its invitation personal by bringing a constituent down here. In June, I attended that reception and had the opportunity to meet my constituent, Chris Shagouri. She is one of those people with whom one instantly clicks; she is inspirational. I listened to her speak about how late diagnosis of the cancer had impacted on her, her husband and her family. She talked about her ongoing battle to keep the disease at bay, and it is clear that she has great determination, but it was easy to wonder how much easier it might have been had the diagnosis been made earlier.

As the reception continued, I heard, time and again, moving stories from other women about their experiences. That and Chris’s persuasive manner convinced me to support the all-party group on ovarian cancer, which was being set up.

Sadly, diary clashes have restricted the number of meetings that I have been able to attend, but it is impressive that they are regularly attended by women who reinforce over and again the message that early diagnosis is necessary. At the most recent meeting, we heard again from women from throughout the UK about their experiences. At the most recent reception, four women gave personal accounts of their problems, which motivated me to bid for this debate. I am grateful to have been given that opportunity.

Ovarian cancer is not rare. It is the fourth most common cause of cancer death in women after breast, lung and bowel cancers. Every year, some 6,500 women are diagnosed and, staggeringly, 4,400 die every year. Just 36% of women who are diagnosed survive for a further five years. Those figures are staggering, compared with more than 80% for those who suffer breast cancer. It is also staggering that in three quarters of women who are diagnosed, the cancer has already started to spread. Those figures are scary.

The holding of this debate prompted someone to contact me this week. They wrote:

“My mother died aged 67 in 2009 with Ovarian Cancer. By the time she was diagnosed, the cancer wasn’t in the early stages and she was given only a 2% chance of living for 5 years. She fought all the way with various treatments and lived for 7 years after diagnosis.”

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising the issue. As he rightly said, every one of us can relate to a constituent or family member with the disease, and most people are aware that the cancer is hereditary or genetic. Does he believe that whenever someone is diagnosed with ovarian cancer there should be immediate checks on other family members—sisters, nieces, and daughters—to ensure that the hereditary effect is not passed on? Does he believe that that should be done quickly after diagnosis?

[Stuart Andrew]

I am grateful for that intervention. I agree absolutely that anything we can do to ensure early diagnosis of conditions can only help. In the long term, it is better for the individual concerned, and certainly better for the rest of the family, who go through equal concern.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Gentleman on securing the debate. Not long ago in my constituency, we ran an event to raise money for ovarian cancer treatment. An astounding finding was the number of young women aged 18 to 25 who are affected. I was astonished, because my impression had been that the disease affected older women, but it seems to be on the rise among younger women and is known as the silent killer. Does the hon. Gentleman agree that early intervention is vital? That could be done with blood tests, which some GPs have called for, and perhaps in schools, to identify this tragic killer of women.

[Stuart Andrew]

The hon. Gentleman makes an important point. I will talk about early diagnosis, which is crucial, as is awareness—making people aware of the symptoms. That is crucial in the campaign to fight this terrible disease.

I return to the letter that I was quoting from, which is relevant to the point that the hon. Gentleman made:

“I really hope the message regarding this disease can increase, as I wouldn’t want anyone else to suffer as my mother did. If she had gone to her GP straight away when she presented with symptoms and the GP acted straight away, then she may still be with her family, who miss her so much.”

That is a powerful testament to the problem that the disease causes.

According to figures from the National Cancer Intelligence Network, only pancreatic cancer involves a higher proportion of people diagnosed with the late stage of the disease. but with ovarian cancer, unlike pancreatic cancer, we know what the symptoms are. That was not always the case. The hon. Gentleman referred to it as the silent killer, which is often how it is referred to, but in most cases the symptoms go unrecognised for some time by the women or their GPs. It is alarming that Target Ovarian Cancer has found that one third of women waited six months or more after visiting their GP for a correct diagnosis. That is staggering.

The National Institute for Health and Clinical Excellence has published guidance on the recognition and initial management of ovarian cancer, and listed symptoms such as persistent bloating or increased abdominal size, abdominal or pelvic pain, difficulty eating and feeling full quickly, and the need to urinate more frequently. If women experience such symptoms frequently, particularly more than 12 times a month, they should undergo tests.

[Ian Paisley (North Antrim) (DUP)]

Under NICE guidelines, the first thing that should be done is a CA 125 test. Is the hon. Gentleman concerned that there are apparently restrictions on a GP’s ability to obtain that test for their patients, and importantly that there have been attempts block those tests from being carried through to pathology laboratories? The CA 125 test is the one thing that can spot the disease and increase the possibility of early diagnosis and greater chances of success.

[Stuart Andrew]

I am grateful for that intervention, which proves the need for the debate. I hope that we can take forward many of the issues raised today to try to tackle the disease. The hon. Gentleman’s point is incredibly valid and important.

NICE’s information is a step forward because it offers women, and importantly GPs, the chance to distinguish between ovarian cancer and more common but less serious conditions such as irritable bowel syndrome, which is the most common misdiagnosis. The ovarian cancer awareness measure, which is an accredited tool used by Target Ovarian Cancer in its pathfinder study, showed that only 4% of women felt confident of spotting the symptoms of the disease, and just 9% were aware that persistent bloating is the most common symptom of ovarian cancer. Compare that with 76% of women who recognise that a lump is the most common symptom of breast cancer.

[Kevin Brennan (Cardiff West) (Lab)]

Does the hon. Gentleman agree that because of the specificity of the symptoms of ovarian cancer, there is a case for a specific campaign to raise awareness of the disease, rather than relying on a generic campaign, which is the approach that the Government have tended to favour so far?

[Stuart Andrew]

The hon. Gentleman is in danger of stealing my thunder, but I am glad that he has emphasised my point before I have made it.

[Iain Stewart (Milton Keynes South) (Con)]

I congratulate my hon. Friend on bringing this important matter before the House. He is right to highlight awareness, but there is also the need for better information for women and their families following diagnosis. A close relative of mine was diagnosed with the condition, but there was a lack of knowledge of where to find more information about it. That led me and others to look online at a condition that was similar, but had a very different five-year survival rate. That caused a lot of unnecessary anguish to close family members.

[Stuart Andrew]

My hon. Friend raises a valid point. I worked in the hospice movement for about 15 years, and time and again we heard from parents of children at the hospice or patients in the adult hospice that when they were told of their disease, they almost went blank; they heard not the rest of the information, but just the dreaded diagnosis. It is crucial that people are given as much information as possible to take away and digest later.

As I said, 76% of women recognise the most common symptom of breast cancer, but there is clearly a lack of understanding about the significance of symptoms that they may experience due to ovarian cancer. Furthermore, GPs are not picking up the disease quickly enough. Just 22% of women are urgently referred to the two-week cancer referral route, and the rest are either sent away, or treated or referred inappropriately. Late diagnosis has been identified by the cancer benchmarking study, funded by the Department of Health, as a key driver for the poor ovarian cancer survival rates. That study seeks to understand the differing survival rates between countries for breast, lung, bowel and ovarian cancer. For some reason, despite the findings, ovarian cancer was the only cancer in the study not to be included in subsequent awareness campaigns. A large majority of women who are diagnosed in the later stages of the disease will experience recurrences, and many will develop resistance to chemotherapy.

My constituent, Chris Shagouri, is undergoing treatment yet again to try to slow the progress of the disease. Her strength and commitment to help to improve the lives of women who are diagnosed with ovarian cancer is amazing, especially when she could be forgiven for wanting to concentrate her efforts on herself and her close family. Chris Shagouri is representative of the many women who have attended meetings of the all-party group on ovarian cancer, and who share a determination to change the status quo. They often say that if just one woman gets a quicker diagnosis it will have been worth it, because for that woman this really is a matter of life and death. I hope that we can reach a better total than just one woman.

Treatments for ovarian cancer are highly intensive and invasive. An American study showed that, compared with women who have breast cancer, those with ovarian cancer spend nearly 10 times as long being treated in hospital in the first year after diagnosis and the last year of life. There have been no new life extending treatments for women with ovarian cancer during the past 20 years.

Why do members of the all-party group on ovarian cancer want to have this debate? Because we feel that, right now, an important opportunity to make much needed progress is being overlooked. I welcome the Government’s work, and commend them for it, with the cancer drug fund and the palliative care strategy —it was long overdue. In January, the Government published their new cancer strategy, which contained a strong commitment to improving early diagnosis and a multimillion pound investment in cancer awareness campaigns—fantastic stuff. It initially included regional breast, lung and bowel cancer campaigns, and recently we have heard that a national bowel cancer awareness programme will be rolled out next year, following the success of the pilots. New campaigns on oesophogastric cancers, and kidney or bladder cancer, will be run at a local level. The all-party group remains frustrated that ovarian cancer is not included in that admirable work.

The Government are committed to saving more than 5,000 lives a year from cancer by 2014-15, and women with ovarian cancer could represent 10% of that figure. Each year, up to 500 women lose their lives unnecessarily to ovarian cancer because we do not do as well as other European countries. The Government’s study showed that late diagnosis is a key driver of deaths from ovarian cancer in the UK, and it is curious that the condition was not included in the awareness campaigns in this country.

Why can an awareness campaign on ovarian cancer not be started now, even in pilot form? We applaud the Minister for the commitment to improve people’s chances of surviving cancer, but urge him to include ovarian cancer in the awareness work that is being done. Every day we wait, another one or two women, like my grandmother or such as Chris Shagouri, and many others who have been campaigning will lose their lives unnecessarily. As a matter of urgency, I ask the Minister whether he will consider an awareness campaign and whether he will meet with representatives from the all-party group on ovarian cancer to discuss how we can take such a campaign forward and stop other women suffering in future.