Ovarian cancer picked up too late

University of Auckland cancer researcher Dr Alicia Didsbury says by the time most women are diagnosed with ovarian cancer in New Zealand, it’s too late to save their lives.

A trustee of The Ovarian Cancer Foundation New Zealand, Didsbury helped write and present the latest State of Ovarian Cancer Report to MPs, patients and medical professionals in Wellington on 11 February.

The foundation’s report states that 60 percent of GPs said ovarian cancer diagnosis was delayed, because of difficulty accessing ultrasound scans.

If ovarian cancer is picked up at stage one or two, it’s often curable with surgery and, in some cases, chemotherapy, Didsbury says.

When picked up in these early stages, 70 to 90 percent of women survive for five years or more.

However, about 85 percent of women are not diagnosed with ovarian cancer until they are at stage three, when the cancer has spread to their lymph nodes or abdominal lining, or stage four, when the cancer has spread to other organs, such as the lungs or liver, she says.

By these late stages, the chances of survival drop dramatically, says Didsbury, from the University’s Centre for Cancer Research.

“Almost half of women with ovarian cancer are diagnosed in emergency departments in New Zealand, which is double the rate in Australia.

“When it’s picked up in emergency departments, 42 percent will die within a year.”

Didsbury says the high rate of emergency department diagnosis is a warning sign the health system is failing women.

“An emergency department diagnosis should be the exception – not the norm.”

The report calls for better access to blood tests and scans that help diagnose ovarian cancer, and funding for more research that could develop better tests and treatments.

The Ovarian Cancer Foundation surveyed 500 members of the public, as well as women with ovarian cancer and GPs.

Before they were diagnosed, 75 percent of women reported being misdiagnosed with menopause symptoms, urinary tract infections, stress, ovarian cysts, irritable bowel syndrome, constipation, needing to lose weight, and depression.

Didsbury says women need to be persistent in asking their GP for tests if they have ongoing early symptoms of ovarian cancer, such as bloating; feeling full after eating little; abdominal, pelvic or back pain; frequent or urgent urination; changes in bowel habits; fatigue; or menstrual irregularities.

While ovarian cancer mostly affects postmenopausal women, it can strike younger women, who often have rarer types of the disease that are harder to detect through blood tests.

The report found nearly two-thirds of New Zealanders incorrectly believe cervical cancer screening detects ovarian cancer, and 60 percent did not know the symptoms.

“There is no screening for ovarian cancer, so women’s awareness of symptoms is vital for early detection.

“If they have new symptoms that persist for more than four weeks, they need to ask for thorough tests to check for ovarian cancer,” she says.

The report calls for a national strategy to address ovarian cancer, which kills more than 200 women a year in New Zealand.

“Ovarian cancer is our deadliest women’s cancer,” Didsbury says.

Despite this, ovarian cancer is under-researched and underfunded in comparison to more common cancers, she says.

Didsbury’s interest in researching cell-based treatments for ovarian cancer was sparked by a family member being diagnosed tragically late with the disease in 2019.

“Like many women, she was misdiagnosed for about 18 months and by the time she had treatment, she was already terminal.”

Didsbury searched for New Zealand clinical trials that might offer hope for her sick family member.

“I was appalled to find there were none.

“We’ve got good researchers in New Zealand looking at this type of cancer, but they’re struggling to get funding.

“We need to do more clinical trials so we can build the body of knowledge and provide better care.”

Including information on the New Zealand Cancer Registry about the treatments patients received and their outcomes would be a great first step towards improving care, she says.

“There are plenty of actions we can take to make a big difference to women’s chances of survival and to improve their quality of life with ovarian cancer,” says Didsbury.