Cancer is the leading cause of death in the UK with over 168,000 people dying each year. While the statistics show that mortality from cancer is reducing, one of the main causes of death remains delayed diagnosis, and therefore treatment, of cancer. Ruth Powell, Head of Clinical Negligence and Ramune Mickeviciute, Solicitor in our Clinical Negligence team explore how to spot the signs and symptoms of ovarian cancer and what to do if diagnosis or treatment goes wrong.
Common signs and symptoms
Some cancers are easier to diagnose and treat than others. This is because some cancers have more specific symptoms and slow growth rates. Complications arise if cancer has more generalised symptoms, especially at the start, following which early diagnosis becomes more difficult. This is usually the issue with female reproductive system cancers.
Ovarian cancer is the sixth most common diagnosed cancer with more than 7,000 women diagnosed in the UK each year. Despite this, the disease is often missed and late diagnoses are still more common than they should be.
Misdiagnosis of ovarian cancer
Ovarian cancer presents in a way that is often confused with symptoms of other less severe illnesses which leads to frequent misdiagnosis. That means some patients are only identified in the advanced stages of the disease when it becomes more difficult to treat.
Symptoms of ovarian cancer include:
- Pelvic or abdominal pain, discomfort or bloating.
- Changes in eating habits, getting full early and loss of appetite.
- Vaginal discharge or abnormal bleeding, especially if the bleeding occurs outside of the typical menstrual cycle or after the woman has gone through menopause.
- Bowel changes, such as diarrhoea or constipation.
- An increase in the size of the woman’s abdomen.
- Peeing more often (frequent urination).
Common misconceptions
The most common misconception is that the patient is suffering from gastrointestinal issues, particularly in cases where there is previous history of these types of illnesses.
In addition to the symptoms highlighted above, it is important to take a note of other factors that can increase the risk of ovarian cancer:
- Older age. The risk of ovarian cancer increases as women age. It is most often diagnosed in older adults.
- Family history. A small percentage of ovarian cancers are caused by genes changes which are inherited. The genes that increase the risk of ovarian cancer include BRCA1 and BRCA2. These genes also increase the risk of breast cancer.
- Being overweight or obese.
- Postmenopausal hormone replacement therapy.
- Endometriosis.
- Age when menstruation started and ended. Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer.
- Never having been pregnant.
Prevention and early diagnosis
If there is any suspicion of ovarian cancer, the woman will usually be offered a blood test and an ultrasound scan to start with.
The best way to diagnose ovarian cancer, particularly in early stages, is by transvaginal ultrasound scan. If the blood test and ultrasound scan suggest ovarian cancer, further tests will be done to help to confirm the diagnosis, and confirm the type and staging of the cancer.
However, due to generic symptoms that might present at the start, it is common for the medical practitioner to order an abdominal ultrasound scan or CT scan instead of a transvaginal scan. These are not very sensitive in picking up tumours around female reproductive system organs and can result in false negative results.
