Mr John Butler, Consultant Gynaecological Oncology Surgeon at The Royal Marsden Private Care, joins Dr Toby Dean of Sloane Street Surgery to discuss ovarian cancer, including the symptoms women should be aware of, when to seek medical advice, how ovarian cancer is investigated and the advances being made in diagnosis and treatment.
00:50 – How common is ovarian cancer?
Dr Toby Dean: Ovarian cancer is something we are very mindful of in primary care, particularly because it can present later. How likely is a woman to develop it?
Mr John Butler: Ovarian cancer is an uncommon cancer. Around 4,000–5,000 women are diagnosed with it each year in the UK, and it is more common in women who are post-menopausal. A woman’s lifetime risk is around one to two in 100.
It used to be described as a ‘silent killer’, but that doesn’t reflect the whole picture. Many women are successfully treated, and we continue to see improvements in both diagnosis and treatment.
01:27 – What are the symptoms of ovarian cancer?
Dr Toby Dean: What symptoms should women be aware of?
Mr John Butler: Most women with ovarian cancer do experience symptoms. The difficulty is that many of them are very common and can have numerous other causes.
Symptoms can include feeling full more quickly than usual, bloating, pelvic pain, a change in bowel habits, needing to pass urine more frequently, or noticing a lump.
The important thing is persistence. If these are new symptoms and continue for several weeks – typically four to six weeks – it’s worth getting them checked.
In the vast majority of cases, they won’t be caused by ovarian cancer. But persistent symptoms shouldn’t simply be ignored.
When should you see your GP about possible ovarian cancer symptoms?
Dr Toby Dean: People can sometimes worry that they’re wasting their doctor’s time, particularly when the symptoms seem relatively ordinary. What would you say to them?
Mr John Butler: Listen to your body. If you’re experiencing new symptoms that aren’t going away, see your doctor.
I often meet patients who have had symptoms for months but either haven’t felt listened to or have been frightened to seek further investigation.
Friends and family can be important too. If somebody you know mentions an ache or another symptom that has been going on for some time, encourage them to have it checked. It’s probably nothing serious, but occasionally it can be – and finding out what is going on is important.
03:23 – How is ovarian cancer investigated?
Dr Toby Dean: If someone comes to their GP with persistent symptoms, what might happen next?
Mr John Butler: The first steps can be relatively straightforward. Your doctor will take a history and may arrange blood tests and an ultrasound scan, as well as any appropriate examination.
If something abnormal is identified, we now have access to very sophisticated diagnostic tests, including MRI and PET scans.
Ultimately, a cancer diagnosis requires tissue to be examined. Depending on what investigations show, that could involve a biopsy or surgery to remove an abnormal cyst or other tissue.
The important thing is to gather the right information so that we understand exactly what we’re dealing with.
Is ovarian cancer one disease?
Dr Toby Dean: If ovarian cancer is diagnosed, what happens next?
Mr John Butler: Cancer isn’t one single disease, and ovarian cancer itself includes a number of different subtypes.
Once we have a diagnosis, we look at the particular type of ovarian cancer and its stage – in other words, how advanced it is. That information helps us determine the most appropriate treatment for that individual patient.
03:55 – How has ovarian cancer treatment changed?
Dr Toby Dean: Is this an area where treatment is improving?
Mr John Butler: Absolutely. I’ve been a consultant for 12 years and the developments I’ve seen during that time have been remarkable.
Both surgery and chemotherapy have advanced significantly, and we now also have newer drug treatments that weren’t available when I first became a consultant.
Although ovarian cancer has historically had a difficult reputation, I’m optimistic. We’re seeing better outcomes and continued advances in treatment.
When should I seek advice about possible ovarian cancer symptoms?
Symptoms such as persistent bloating, feeling full more quickly, pelvic pain, changes in bowel habits or needing to pass urine more frequently are common and can have many different causes.
However, if you develop new symptoms that persist for several weeks or aren’t normal for you, it’s important to seek medical advice rather than simply putting up with them.
At Sloane Street Surgery, our GPs can assess your symptoms and, where appropriate, arrange further investigations or referral to a specialist.
Appointments can be booked online here or by calling the surgery on 020 7245 9333.
About the guest
Mr John Butler
Consultant Gynaecological Oncology Surgeon
Mr John Butler is a Consultant Gynaecological Oncology Surgeon at The Royal Marsden Private Care. He trained in London, including specialist oncology training at The Royal Marsden and St Bartholomew’s Hospital, and is certified in both gynaecology and sub-specialist gynaecological oncology by the Royal College of Obstetricians and Gynaecologists. He has an active research portfolio and has published extensively on gynaecological cancer, cancer survival and cancer policy.
About the author
BA (Hons) MB BSMRCGP
“The most fulfilling part of this job is making a real difference to patients with timely diagnoses and supporting them going through a difficult time”.
I enjoy the full variety of General Practice and recognise the benefits in both continuity and time that private care affords. I have a particular interest in disease prevention, chronic disease management and paediatrics.
The key to our success is maintaining and improving our patients’ health, managing chronic disease meticulously and working alongside the best specialists when needed.
