I’m delighted to be asked to be a lay member of the GP Advisory Board. I qualified as a doctor in 1982 and as a GP in 1987. Since then I’ve worked as a part time inner city GP, mostly in the North Midlands, jugging family, sanity and a very rewarding but demanding job. I was lucky to have had excellent health and loads of energy all my life.
A very important part of a GP’s work is referring suspected cancers as quickly as possible, supporting people and their families once diagnosed, and caring for people who are terminally ill at home. However, nothing could have prepared me for a personal diagnosis of advanced ovarian cancer.
Like many of us, my symptoms were vague and nonspecific. I was able to work through them and 'too busy' to make time to see my own GP. When I did make time, I was fortunate that they arranged for me to have an urgent scan and then an appointment at the gynae-oncology clinic. I am very aware this is tragically often not the case for many women with ovarian cancer and diagnoses are made late.
I know how difficult it can be as a GP to diagnose ovarian cancer, but this is no excuse. In a surgery session you may see many people who have abdominal pain, feel bloated or need to wee more often than usual. What is important is that any of these symptoms raise alarm bells for the GP, and that they actually consider ovarian cancer as a possible diagnosis to be excluded in female patients. This has become clearer since the National Institute for Health and Care Excellence guidelines were published for diagnosing ovarian cancer in 2011.
GP awareness has also been raised by Target Ovarian Cancer’s excellent e-learning modules. Over 25 per cent of GPs have brushed up on their knowledge of ovarian cancer by completing a module. I wonder if it should become a mandatory training module for all GPs. This would be difficult to enforce, but maybe not impossible.
The challenge for GPs
As always the most important thing for GPs to do in order to make a timely and correct diagnosis, is to know enough about every possible medical condition that a patient may bring to you (this aspect gives most GPs nightmares). They need to listen hard to what the patient is really telling you to find out what their underlying concern is and then act on it with appropriate tests and referrals. This can be really challenging in a 10 minute appointment. The Government needs to be pressured to support GPs more with their ever increasing workload and to increase the GP workforce.
Ultimately, the key to ovarian cancer survival is early diagnosis – and this will be helped by women being aware of what the symptoms of ovarian cancer are and seeing their GP as soon as they have a concern. We can all help with the awareness raising done by Target Ovarian Cancer and other charities (and now the 'Be Clear on Cancer’ campaign) by telling friends, colleagues and family what to look out for. We can all work to get more diagnoses to be made quickly.
In my working lifetime of 30 years I have seen wonderful improvements in the treatment and survival of women with breast cancer. I can see this is also starting to improve with ovarian cancer, but sadly we’re still around 10-15 years behind breast cancer. However I feel hopeful that this will change considerably in the future.