Page last updated at 00:16 GMT, Sunday, 7 December 2008

Ovarian cancer - not a 'silent killer'

By Jane Elliott
Health reporter, BBC News

Shehnaz Khan
Shehnaz knew her body was warning her

Ovarian cancer is often referred to as a "silent killer" as women are generally unaware they have it until it has spread.

But health experts have warned that if women pay attention to their symptoms their chances of survival could be dramatically improved.

Survival rates are poor, with only 30% of those diagnosed surviving for more than five years.

However identifying the disease before it has spread can mean nine in 10 women make the five-year mark.

"The symptoms shout out at you, but you have to listen to your body and act," said 52-year-old Shehnaz Khan, from Middlesex.

She first found out she had ovarian cancer 20 years ago after suffering for some time with constant dull aching abdominal pain and frequent tiredness.

Initially Ms Khan, an actress at the time, put the problems down to work stress, but doctors diagnosed ovarian cancer.

It is the type of cancer that can get any woman
Shehnaz Khan

She was told it had spread and had to have radical surgery, including a hysterectomy.

"In some ways I wish I had known what the symptoms were so that I could have acted sooner, but then I have been extremely fortunate that the treatment I received at the time has given me a long life and I am able to talk about it now and share my experience," she said.

"For me the biggest shock was that I was going to lose my fertility and my chance to have children biologically.

"I had never heard of ovarian cancer before."

Following her treatment, Ms Khan, now a designer, redoubled her efforts to maintain a healthy lifestyle, eating carefully and exercising.

In 2006, however, she started getting constant diarrhoea and feeling tired, she had period-type pain and started losing weight.

Persistent pelvic/abdominal pain
Persistent bloating
Difficulty eating
Feeling full quickly

Initially, she suspected her high fibre diet was the cause.

But when the problem persisted and she started feeling faint, she went to her GP who advised a blood test called a CA125 to check for ovarian cancer.

This showed there were problems so she had further tests, which confirmed the disease had returned.

She said: "The tests said I had a big mass growing in the pelvic area and that it was ovarian cancer, which was hard for me to understand as I had no ovaries, but they said a cell must have remained and continued to grow and over the period had grown into this mass."

She also had two small lesions in the upper abdomen.

Following chemo the tumour began to shrink and the lesions calcified, but she is now undergoing more treatment after they increased again.

An ovarian cancer cell dividing. Pic caption:David McCarthy/SPL
Survival rates for Ovarian cancer are poor

Ms Khan said she would probably need regular chemo as the tumours were unlikely to completely disappear.

"But the prognosis is that the treatments will help to kick back that tumour again and start to reduce it and bring back my quality of life," she said.

"I think the shocking thing as regards survival rates is that there have not been any changes in 20 years and that is so frightening.

"If you can catch it early you can get help and treatment.

"It is the type of cancer that can get any woman and because you can't see it or feel it is hard.

"You have to rely on listening to your body."

The Department of Health and cancer charity Ovarian Cancer Action (OCA) have issued the key symptoms to be aware of - persistent pain, persistent bloating, difficulty eating and feeling full quickly.

Peter Reynolds, of OCA, said: "We think awareness is really low.

"It was traditionally seen as a 'silent killer', but some women have the symptoms for a year before their cancer is diagnosed.

"It is important to say that if women have these symptoms they are unlikely to be ovarian cancer, but they should get them checked out.

'Hardly improved'

"Survival rates for ovarian cancer in this country have hardly improved for the last 20 to 30 years and the mortality rates are shockingly high."

OCA has recently doubled the funding it gives to the Ovarian Cancer Action Research Centre, based at Hammersmith Hospital in London.

The centre's researchers have been working to discover why the cancer quickly becomes resistant to chemotherapy and the role of ovarian cancer stem cells in the process.

Professor Hani Gabra, director of research, said they were developing new drugs and would soon be starting clinical trials.

"We are developing drugs that can re-sensitise the cancer again so it will respond again to chemotherapy," he said.

"It probably would build up another resistance.

"But we are looking at ways of keeping people alive and improving their quality of life."

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