Ovarian cancer – knowledge is power

Posted: 09/03/2022

Tennis star, Chris Evert, has talked publicly about her diagnosis of stage 1 ovarian cancer, the importance of being aware of family history of the disease, and how using that knowledge can enable an early diagnosis and successful treatment. Evert is 67 years old and lost her younger sister, Jeanne Evert Dubin, who was also a professional tennis player, to ovarian cancer in 2020. Jeanne was 62. Her cancer spread before it was diagnosed, as she had no noticeable symptoms.

When ovarian cancer first develops there might not be obvious symptoms, and any that do occur can often be mistakenly attributed to other, more common and less life threatening conditions. As a result,  the disease can go undetected and be allowed to spread. The symptoms of ovarian cancer may include abdominal bloating or swelling, quickly feeling full when eating, weight loss, pelvic pain or discomfort, fatigue, back pain and changes in bowel habits, such as constipation.

Tragically, some 70 to 80% of ovarian cancers are already at stage 3 or 4 when diagnosed, meaning they have already spread, and treatment options are limited. Dr Cardenas, the treating consultant surgeon, commented that had Evert’s ovarian cancer not been diagnosed for another three months, the likelihood is that her tumour would have been at stage 3 or 4 and spread to her abdomen by then.

Stage 1 ovarian cancer is where the cancer is still localised to the ovaries and has not spread. Once the cancer spreads to other organs in the woman’s pelvic region, it is graded as stage 2. The cancer will then spread to the abdomen, at which point it is graded as stage 3. Stage 4 ovarian cancer is one that has spread more widely throughout the body. The early diagnosis, therefore, very probably saved Evert’s life. She is undergoing chemotherapy and expects positive results.

Up to 15% of cases of ovarian cancer are due to the woman having an inherited faulty gene. Inherited genes that increase the risk of ovarian cancer include faulty versions of BRCA1 and BRCA2. These also increase the risk of breast cancer. Having relatives with ovarian cancer does not necessarily mean that there is a faulty inherited gene in the family, as the cancers could have happened by chance. However, women who have a mother or sister with ovarian cancer are around three times more likely to develop it themselves, when compared to women without a family history of the condition.

Dr Cardenas has said: “Ovarian cancer is rare, however if a patient has a family history, we encourage genetic testing and counselling.”

Women also have an increased risk of ovarian cancer when they have had breast cancer in the past. The risk is higher for women with breast cancer at a younger age, and for those with oestrogen receptor negative (ER negative) breast cancer. Women who have had bowel cancer at a young age also face an increased risk of ovarian cancer compared to the general population.  

Cancer Research UK estimates that approximately 1 in 50 women in the UK will be diagnosed with ovarian cancer in their lifetime. Ovarian cancer is the leading cause of death from gynaecological cancer in the UK, partly because many women are either misdiagnosed or diagnosed too late for treatment to be successful. The charity estimates that around 10% of ovarian cancers are misdiagnosed.

Alison Johnson, partner at Penningtons Manches Cooper, represents women in investigating claims arising from potentially negligent delayed diagnoses of cancer, including ovarian cancer. She has been able to work with many women to establish whether their medical care was of a good standard and whether an opportunity may have been missed for an earlier diagnosis and treatment. That may have been an opportunity arising from a GP consultation, or from hospital investigations, either NHS or in the private sector. It can also involve a medical professional not considering the relevance of the woman’s own medical history, potentially of breast or bowel cancer, or her family history pointing at the possibility that she has an inherited faulty gene.

When a claim can be established, Alison is able to secure compensation in reflection of the impact of the negligent treatment, in terms of covering the cost of future medical treatment, the cost of fertility treatment if required, compensation for lost earnings or income, compensation for the cost of professional care and compensation for the physical injury, pain, emotional distress and loss of amenity. The financial value of the claim very much depends on the woman’s individual circumstances, and how the delayed diagnosis has impacted her life and her survival prospects.

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