Ovarian Cancer: Diagnosis and Treatment

Theresa Villiers Excerpts

Tuesday 30th October 2018 Westminster Hall

[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.