Heavy toll of silent killer Ovarian cancer is known as the silent killer, says a leading specialist. Gynaecological oncologist and surgeon, Raj Naik, of Gateshead's Queen Elizabeth Hospital, warned symptoms are difficult to spot. He said: "There may be some discomfort in the stomach, a little bit of nausea, some bowel disturbance or extra pressure on the bladder. "But not really anything specific and often those initial symptoms are ignored by the patient and it is difficult for the GP to make a diagnosis. Many women will have gone to their doctor two or three times before they have an ultrasound scan." As a result, two thirds of women diagnosed have very advanced cancer, significantly lowering survival chances. "Most women will have a major operation at the very beginning," says Mr Naik. "It's called a debulking procedure where we remove both ovaries, the womb, the cervix and the fatty piece of tissue which lies by the bowel called the omentum. In some incidences we may remove the bowel as well. "The common outcome is that the patient will respond very well to the treatment, but the cancer will recur. We are quite radical with our treatment. If women recur with the disease after all their primary treatment, we will then treat the recurrence, usually with more surgery and more chemotherapy. "It's to try and keep the disease at bay. It may not cure the patient, but we are controlling the disease and giving her longer periods of quality of life." The QE is a centre for excellence for gynaecological cancers and enjoys an international reputation. Mr Raik hopes that Ovarian Cancer Awareness Month will help raise the profile of the disease. "We are part of a national research programme looking at ovarian cancer screening," he said. "I'd eventually like to see a screening programme rolled out nationwide. "The more information people have, the more they are able to look after their health. There is a huge awareness of breast cancer and as a result, there have been huge advances in the types of treatment becoming available. "If any ovarian cancer symptoms, no matter how vague, are persisting, women must go and see their GP. And it's important the GP take a detailed history and examine the abdomen. Usually ovarian cancer affects women 60 to 65, but we have treated patients as young as 20." Sadly, there is little women can do to stop the development of ovarian cancer and around 10% of cases are believed to be hereditary. "The contraceptive pill has been shown to reduce the risk, as has sterilisation," explained Mr Naik. "But outside of that there is nothing a woman can do. Exercise, diet and stopping smoking won't make any difference. That makes it all the more important for a screening programme." *********** Disease facts There are 7,000 new cases of ovarian cancer every year. More than half the cases are in over 65s. Ovarian cancer is the fourth most common women's cancer after breast, bowel and lung. Many women die because they're not aware they have the disease until it has progressed too far to be treated effectively. Diagnosis is difficult as symptoms are often similar to common, mild and benign ailments. Symptoms are vague, but look out for prolonged swelling of the abdomen, pain in the abdomen, digestive problems, weight loss. Of all diagnosed with cancer of the ovary 50% will be alive five years later. If the cancer spreads outside the ovary, only 20% of women will survive more than three years. All tumours are surgically removed. If tumours are malignant or cancerous, the ovaries, womb and fallopian tubes may also be removed A family history of breast, ovarian and/or colon cancer can be associated with an increased risk. | 
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