#6: Target Ovarian Cancer

Simply Hormones Podcast

The Silent Killer! A recent phenomenon, in medical terms, and it’s up to YOU to find out about it – it could save your life. Look no further, here you will find symptoms and treatment options and ‘where to go next’ inforamtion. It has been a pleasure to interview Dr Sharon Tate. Raising awareness of this deadly disease can only help to improve the low survival rate.

It’s such a recent phenomena, in medical terms, but symptoms can now be identified enabling women to take charge of their own health

Trasncript of Interview with Dr Sharon Tate, Target Ovarian Cancer and Kathryn Colas, http://www.simplyhormones.com

Kathryn Colas: Hello, good morning, it's kathryn Colas here from SimplyHormones.com and I'm here today talking to Dr Sharon Tate of Target Ovarian Cancer. Target Ovarian Cancer is a charity dedicated to achieving a long and good life for every woman diagnosed with ovarian cancer in the United Kingdom, and working to improve diagnosis and treatment of this disease. This silent disease..

They have a challenge. Ovarian cancer in the UK today is characterised by low survival. We have the lowest survival rates in Europe. Low awareness, though lack of understanding. Chronic underfunding, that means they're not getting the investment. Fragmentation, means it's a piecemeal approach to research and patient care and there is no national platform, as such, just yet, so there's no research grant for them.

To me, that looks quite grim! And it seems to me that whatever stats I look at for whatever degenerative disease, the over 50's seem to be prime candidates and I feel that by helping to raise awareness of ovarian cancer and the challenges to overcome it we can reduce the incidence of this dreadful disease, particularly in the most vulnerable age group, which just happens to be mine!

KC: Good morning Dr Tate

ST: Good morning

KC: Morning. So, let's get some answers for the listeners about ovarian cancer. How familiar do you think people are with the symptoms?

ST: Well, Kathryn, awareness of ovarian cancer and, in particular, its symptoms is very low amongst women and we know, from a big piece of research that we did last year called the ‘Target Ovarian Cancer Pathfinder Study' that only about 4% of women are confident in naming a symptom of ovarian cancer.

KC: Right. That's very low, isn't it?

ST: It is. This tends to be the case for women of all age groups. Women who are slightly younger, say in the age group 16 – 34 are a little less confident in naming symptoms than women who are more mature, say, age 55 or over but overall, awareness across all the age groups is poor.

KC: It's, poor, yes. Can you tell us about the most common symptoms and are they the same across the board in the different age groups.

ST: Well, the symptoms most commonly experienced by women of all ages who are diagnosed with ovarian cancer include: an increase in abdominal size or persistent bloating, so this is not the kind of bloating that tends to come and go and fluctuate like women experience around a period or if they have food intolerances. It's not like that. They also experience persistent pelvic or abdominal pain in the tummy or below and many of them experience difficulty eating or feeling full quickly and those three tend to be the major symptoms. However, occasionally, women do experience urinary symptoms so this may mean that they need to pass water more urgently or, perhaps, more often than usual. Many women experience changes in bowel habits so this may include ongoing diarrhoea or constipation and also extreme fatigue and back pain are symptoms that women do experience. And it's important to bear in mind, as well, that the list I have just reeled off, is not a check list, per se, so women don't have to be able to go down it and say, yes I've got that got that, got that one…

KC: Yes. If I just interject there, because some of those symptoms you've mentioned cross over into menopausal symptoms, as well.

ST: That's right. They do. And that is one of the challenges of ovarian cancer that that list of symptoms is common to many conditions that are not caused by cancer and what we advise women is that they seek advice from their GP; in particular if the symptoms are new to them, so they've never experienced this type of symptom before and also if they experience them on most days and also if the symptoms are getting worse over the days or weeks. So, the symptoms, once they start, won't tend to fluctuate they will tend to progressively get worse and be there continuously.

KC: And, there is a terribly low survival rate with this disease. Why is that? And how can we improve recovery?

ST: Well, ovarian cancer is an extremely challenging disease to diagnose and also treat and many cancers do contribute to keeping the survival rates low. However, a lack of awareness of symptoms amongst women and also medical professionals is now recognised to be a very key issue. And we do know that women often experience mis-diagnosis and by the time they are actually diagnosed, their disease has spread well beyond the ovary, making it more challenging to treat and tive them the most successful outcome. But opn a more positive note, what we do know also is that among the women who are diagnosed when the procedure is confined to the ovary, the survival rate is significantly improved. So that would be our goal, really, trying to diagnose women when their cancers are at a stage where it hasn't started to spread beyond the ovary.

KC: So it's really up to women, not so much to be vigilant but to be persistent when they, if they really feel and I think women really know their bodies and if they feel that there is something causing them problems, even if the doctor says, ‘no, it's this and it's that, there's nothing to worry about', if women could be more persistent themselves and say ‘look, I'm not happy, I really think it's something more serious, who can I see' and maybe they'll get a bit more attention.

ST: Absolutely. We dol speak to women all the time that face these sorts of challenges who aren't being listened to and we would advise them, where possible to get a second opinion and if it's at all possible for them, if they can't get that within their local NHS services, if it's at all feasible then perhaps to seek, say a private consultation because it might expediate their diagnosis.

KC: Yes. And just movbing on a bit – most of us are familiar with cervical smears and can ovarian cancer be detected through smear tests like this?

ST: It's a very common misconception that a smear test can detect ovarian cancer. About 50% of women believe this to be the case. However, it's not. The smear test is just designed to detect abnormalites in the cervix. Importantly the smear test is designed to detect abnormalities before they even become cancerous. At a stage when they are easily treatable before they can progress on and become cancerous. At the moment there is no national screening programme available for ovarian cancer as there is for breast and cervical cancer. So as we've just discussed really the best thing women can do is to understand their own bodies and know what is normal for them and obviously there are changes as you go through life and obviously what was normal for a women prior to menopause isn't necessarily the same as after the menopause but they will get use to what is their current state of ‘normal' as we like to call it and if anything deviates from that, then we really encourage them to report potential symptoms to theier GP as soon as they can.

KC: It might be a nice idea, some time in the future when money is more available for women over 50, like they're invited in to have a mammography, that they could also be invited in for the cervikcal smears the ovarian cancer tests, whatever and get them all over because it's that age group, isn't it?

ST: Absolutely. I mean at the moment, in the UK, there are two clinical trials ongoing to assess the efficacy of the tests that we have for ovarian cancer, to see if it is feasible to roll the tests out as part of a national screening programme. But we won't know those results for at least another five years. In the meantime vigilance and symptom awareness is absolutely key.

KC: Yes, yes. And going back to diagnosis… we expect our GP's to know so much, don't we and perhaps that's why there's mis-diagnosis. Do they get trained in recognising symptoms for ovarian cancer|?

ST: Well as I mentioned earlier on, it's only be in recent years that we've had any evidence to show that women with ovarian cancers do experience symptoms and so, unfortunately, at the moment, in the UK what has happened is that most GP are unaware of the recent developments in research and they wouldn't recognise the symptoms that I spoke of just now as being potentially caused by ovarian cancer and so although, as an organisation we are working very hard to update GP knowledge, we do encourage all women to know the symptoms and if they are worried, in particular to ask their GP to rule out ovarian cancer. Say those words; get them on their radar and we also advise women to take along a copy of our symptoms leaflet which they can obtain from us, to help them explain their concerns, really.

KC: Yes. If they've got it written down, it's so much more helpful, isn't it?

And, going into a scenario – if a woman recognises these symptoms and goes to her GP, what's the next stage, what happens next?

ST: Well in the first instance the GP would order some tests. The two tests that are considered the gold standard for helping to diagnose ovarian cancer are a blood test, called CA125 and levels of CA125 in the blood can be increased by ovarian cancer and also a test called the trans-vaginal ultrasound or TVU, this is an internal scan which is used, basically, to create a picture of the ovaries and then this picture can then be examined basically for any abnormalities that may exist. If these tests are positive then the woman would be referred to the hospital to see a gynaecologist for further tests because in themselves, these tests are, I suppose a ‘steer' telling the doctor what to do next. It wouldn't necessarily mean that the test's positive, you wouldn't necessarily have ovarian cancer but it's a good ‘steer'.

KC: Yes. There's some questionable cells there. And, … I've forgotten what I was going to say there. Oh, yes… And would then that ultimately result in a hysterectomy?

ST: Unfortunately, yes. For most women because, as I mentioned just now, by the time they are diagnosed the cancer has spread well beyond the ovary and so what is required in most cases is very radical surgery which includes removal of both ovaries, both fallopian tubes, the uterus and also often the cervix; very extensive surgery.

KC: Total hysterectomy. That's quite drastic isn't it? Obviously to save a life.

I'd just like to move on a bit and briefly touch on the subject of funding. How can ordinary women help to raise funds for your research|?

ST: Well there are many things women can do if they'd like to support our work. I mean, it may be something like making a donation which could be in the form of a one-off gift or a monthly contribution. They may also like to take part in a challenge event, so for example, Target Ovarian Cancer will have a team of runners which will include staff, supporters and trustees, taking part in the Adidas 5K challenge in Hyde Park or they may like to run their own fund raising event and if they would like more ideas on what they could potentially do or support, or materials to help facilitate that, then they might like to visit our website and, or, contact our fundraising team who would be more than happy to support them with their fundraising.

KC: i SEE ON I notice on your website that you have a super poster on there, haven't you, that people can print off and put in their place of work or gym, or wherever, can't they?

ST: That's right, we have a range of awareness materials, including that particular poster and the symptoms leaflet which are available as you say to download from our website or they can order them direct from us, free of charge and they'll get a nice glossy version of it. And, yes, they can often people will approach, say their local library or community centre or any sort of social network that they're involved in and create a display or, people have been into their local pharmacy and have asked them to display them in store. We also have a booklet available, called ‘Let's talk' which is full of hints and tips for raising awareness and we also run a course which accompanies that ‘Let's Talk' booklet which really aims to give people practical skills and advice on how they can go out there and raise awareness if that's the sort of thing they are motivated to do and we run these courses throughout the year at venues across the country, so anybody who's interested in attending can contact us and we will let them know when there's an event in their area.

KC: So there's lots of scope for everybody to do absolutely anything, really, isn't there?

ST: Absolutely. And I think, in a way, that for some people, raising awareness is a new concept. People are very familiar with the concept of raising money but, actually, these two activities very much go hand in hand. If you're fund raising then, what does it hurt to give somebody a leaflet, so we see them very much as a partnership but to some people it might be a little bit more unusual to think about raising awareness.

KC: Yes. That's excellent. I think we've covered a lot there in our quite short conversation and I could probably talk to you ad infinitum about everything but thank you so much for the opportunity of talking with you and explaining everything clearly and I'd just like to tell the listeners that your charity details and website information will be listed at the end of the transcript which always accompanies my podcasts and, thank you, once again and I'll say goodbye.

ST: Well thank you and goodbye, Kathryn

KC: Thank you, goodbye.

TARGET OVARIAN CANCER – Contact Details: Target Ovarian Cancer, 30 Angel Gate, London EC1V2PT. tel [phone]. Full of information describing symptoms and how you can help raise awareness, get posters/leaflets for your workplace, etc. Web: www.targetovarian.org.uk Email: [e-mail]

Kathryn Colas: You'll find lots of information on menopause, including my own personal journey at http://www.simplyhormones.com and do watch ‘Menopause: The Movie' highlighting how relationships are affected at menopause; here's the link: http://www.simplyhormones.com/video.asp and do join me on my blog for my own views on what's going on in the world: http://www.simplyhormonespodcast.com and feel free to comment on my ramblings and podcasts. Last but not least, you can contact me: [e-mail] .

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