Hospital's new tests combat silent killer

Trials at a Gateshead Hospital could pave the way for a national ovarian cancer screening programme.

Trials at a Gateshead Hospital could pave the way for a national ovarian cancer screening programme. Health reporter JANE PICKEN finds out how it could save countless lives from a disease known as the silent killer.

THE first – and biggest – of its kind in the world, the pioneering UK CTOCS trials could herald a new way to save thousands of women from ovarian cancer each year.

By using different methods of screening, medics at centres across the country – including Gateshead’s Queen Elizabeth Hospital – are trying to establish if there an effective way of testing women for signs of cancer.

At the moment ovarian cancer is difficult to detect, but medics can get an idea of the nature of the illness through ultrasound scans or blood tests for the chemical CA125, which can increase with the presence of cancer.

And by testing these methods for their effectiveness, medics are hoping to produce supporting evidence for one particular method, which could be used in a national NHS screening programme.

The trials are well under way in Gateshead.

A staggering 17,323 post-menopausal women between the ages of 50 and 74 have been recruited to take part.

For some, the trials have been life-changing – finding tumours in the ovaries which otherwise could have gone unnoticed until it was too late.

Norma Drew is recovering after undergoing surgery to remove cancer.

Mum-of-two Norma Drew owes her life to her decision to take part in the trial three years ago. She was diagnosed with ovarian cancer earlier this year.

“A letter arrived out of the blue inviting me to take part. I was quite happy to do it,” explained Norma, 62, a retired nursery nurse.

“I went along to the Queen Elizabeth Hospital and I was chosen to take part in the blood test trials.

“I had one last September, and a week later they sent me a letter.

“My CA125 blood levels were raised and I needed to go back in three months.

“I also noticed I was getting pains low down in my right side.

“When I went back for the test, the CA125 levels had gone up drastically from 16 to 648. I was horrified.”

The diagnosis came like a bolt out of the blue for Norma, who was proud of her healthy lifestyle. She even took part in the Great North Run in 2005.

Every year around 280 women are diagnosed with ovarian cancer in the North East. Nationally, 4,440 die from the disease every year.

“In February they removed my ovaries, womb, appendix and part of the bowel.

“I’ve since had six rounds of chemotherapy,” said Norma, who lives with husband Geoff, 61, in Tynemouth.

“Now I’m fine, and the doctors are very pleased with my progress. I think it’s great they’re doing these trials. I might not have known I was ill. Ovarian cancer is a killer if it is not discovered early enough.”

The 10-year UKCTOCS project was launched in 2001 and results are expected in 2010.

If they show one method of screening can be used to effectively detect ovarian cancer before the need to operate, the results will be presented to the Department of Health. They could even influence national policy.

The trial will investigate two different screening tests, a blood test and ultrasound examination – and which is better at detecting early stages of ovarian cancer.

The tests are carried out over 10 years, on 200,000 women invited to take part.

At the moment, only women with a strong family history are regularly monitored for early signs of the disease.

If a GP initially suspects ovarian cancer, they would refer the patient for an ultrasound scan.

“The basis of this trial is to pick up ovarian cancer at the earliest possible stage.

“I hope it will lead to a national screening programme,” said consultant gynaecological oncologist at the Queen Elizabeth Hospital, Raj Naik, who is leading the project there.

“With the blood test, there is evidence to show that women who have ovarian cancer have raised CA125 levels. However, a rise could also be due to other reasons.

“With the ultrasound scans, we are looking for changes in size.

“An enlarged ovary means there could be a cyst growing.

“Looking at the nature of the cyst will give us an idea of whether it is benign or cancerous.”

But scans cannot tell ultimately if an ovarian cyst is cancerous. The only way medics know for sure is to operate.

“We have one group undergoing scans, another the blood tests and a third group of women who do not have either,” added Mr Naik.

“Eventually we will compare all three areas and see how many cancers we identified in each group.

“We will also look at survival rates for each of the groups. If we are successful at detecting the cancer in its early stages, and the results are in favour of screening, it could help the Department of Health.

“But we still have to be aware of the adverse effects of screening.

“Even if a blood test shows a raised level and a scan shows an enlarged ovary, there is a chance the cyst could be benign.

“They would still go through a major operation when it turns out not to be cancer.”


Know the range of symptoms

OFTEN referred to as the silent killer, ovarian cancer is difficult to diagnose as the symptoms are vague and subtle.

Early symptoms may include pain in the lower abdomen or side, and a full bloated feeling in the abdomen.

Later symptoms of ovarian cancer may include a persistently swollen abdomen, pain in the lower abdomen or back, digestive problems, like indigestion, bloating, constipation, nausea and lack of appetite, passing urine more often than usual, abnormal bleeding from the vagina (this is uncommon, but should always be reported to your GP), weight loss, increasing tiredness, shortness of breath, and pain during sex.

Queen Elizabeth Hospital consultant gynaecologist and oncologist Keith Godfrey said: “The symptoms are not obvious as they include indigestion and tummy swelling which can be mistaken for irritable bowel.

“GPs need to be aware of this and carry out an ultrasound scan or, ideally, a pelvic examination.

“A carrier of the ovarian cancer gene is 50% more likely to contract the disease. But people are aware that the disease is insidious so they are much more prepared to investigate even vague symptoms to see if it is ovarian cancer.”


Reasons to celebrate success

SCREENING trial UKCTOCS is the world’s largest ovarian cancer screening trial and is taking place at 11 centres across the country.

Nationwide 200,000 women have been recruited to take part in the trial, which is being funded by ovarian cancer research charity The Eve Appeal.

Ovarian cancer currently kills more than 70% of women who develop it, but if diagnosed in the early stages more than 90% will survive.

Research sister Geraldine Thompson, who works on the screening trial said: “In the Gateshead region, we have more reason than most to celebrate as we’ve recruited 17,300 women on to the programme, which was way above our target figure.

“This is great news for the health of women in our area.”

Alex Ford, chief executive of The Eve Appeal, said: “Now 200,000 British women have signed up to this programme to make sure that the question that has dogged us for decades will be answered.

“It is a hugely-exciting time for everyone involved with ovarian cancer, largely because of the progress within this programme and the support of so many women.”

To make a contribution to The Eve Appeal or to find out more, call 020 7380 6900 or visit .

For more information about the trial, visit Cancer Help UK at .


David Whetstone
Culture Editor
Graeme Whitfield
Business Editor
Mark Douglas
Newcastle United Editor
Stuart Rayner
Sports Writer