Health Notes, February 28th 2010, by Sarah Stacey

When to take tummy troubles to your doctor

In autumn 2006, mother of two Loretta Oliver, now 47, started losing weight.  ‘When my sister commented, I said “I know, isn’t it brilliant?” ‘.  Then she became aware of other symptoms: ‘continuous bloating that I ‘d never had before, plus diarrhoea every morning first thing, and sometimes I was so tired I had to go to bed.  I thought it was probably irritable bowel syndrome or maybe a wheat allergy – but I come from a family where you just don’t get ill and, like most mothers, I didn’t have much time to think about myself.’   

When nothing improved, she went to her GP.  A stool test was fine but he sent a referral letter to the gastrology department at St Mary’s Hospital, Paddington.  The letter was lost.  Hearing nothing, Loretta assumed all was fine.  ‘Six months later, I went back to the GP because my symptoms were getting worse.  I was sent to the gastrologist immediately, he did a blood test plus an abdominal scan - then drained nine litres of fluid off my stomach.’  Loretta was diagnosed with advanced (stage 3) ovarian cancer.  ‘Ironically a recent smear test had been clear so I thought I was free of all gynae cancers – but of course a smear only applies to cervical cancer.’ 

Her treatment consisted of a radical hysterectomy (removing womb and ovaries) plus chemotherapy.  Today, although not clear of the disease Loretta is well enough to look after her family, work as a marketing consultant three days a week – and spend a fourth talking to women on behalf of Ovarian Cancer Action, making them aware of the symptoms: ‘If ovarian cancer is diagnosed early [at stage 1], the five year survival rate is up to 90 per cent.  Mostly, however, women don’t go to their doctors until much later and if they do, GPs may mistake their symptoms for a gastro-intestinal (GI)problem and not refer them for further tests.  By the time 75 per cent are diagnosed, the malignancy has spread through the body and is much harder to treat.’

 
About 90 per cent of women diagnosed are over the age of 45, many post-menopausal. The difficulty for GPs is that, although it’s the fourth most common cancer in women, most will only see one case every five years.  Until recently, early signs had not been identified but in 2008, a UK consensus group advised that if women suffered one or more of the following symptoms, they should talk to their GPs.  The charity Ovacome (www.ovacome.org.uk) has coined the acronym BEAT, which stands for: 

• Bloating, which is persistent, not fluctuating, plus increased abdominal size
• Eating with difficulty, and feeling full more quickly than normal
• Abdominal and pelvic pain on most days
• Talk to your doctor
  

Other symptoms may include urinary disorders, changes in bowel habit, extreme fatigue and/or back pain, which may occur alone, or with those above. 

‘It’s important to realise, however, that in most cases the cause will not be ovarian cancer,’ says Sean Kehoe, gynaecological oncologist at the Churchill Hospital in Oxford and medical advisor to Ovacome.  Although early symptoms are similar to GI disorders, he says ‘the key differences are persistence and frequency, also sudden onset – GI problems have usually rumbled on for years’.  As Loretta emphasises, it’s important not to neglect these signs of possible disease, and to ‘be audacious if symptoms persist and you don’t feel you’re getting a satisfactory answer’.  

Loretta and Ovarian Cancer Action’s Dr Sarah Blacklidge give free corporate awareness presentations in the London area, and by video conference nationally and internationally.  For more information about these presentations, email info at ovarian.org.uk, and for details of fundraising events (including   an Ovarian Cancer Symptom Diary and other details, visit www.ovarian.org.uk  

Ovacome Support Service (nurse-led), tel: 0845 371 0554. 
 

Super buggies for yummy mums

For new mums, back pain (from hunching as you breastfeed and also carrying your ever-heavier infant) is par for the course. Also, the pregnancy hormone relaxin leaves ligaments soft and vulnerable to overstraining.  Hours spent pushing a buggy can add to the problem, so it’s important to adopt a good posture by having the handlebars at the right height. Our mummy tester found the Micralite range of strollers (from newborn) incredibly light to push, even one-handed (great when your phone rings or your other child runs off), with multi-position handlebars that are easily adjusted to mum’s (or dad’s) height. We tried the Fastfold (from £165) which fitted easily through shop doorways, into lifts and sailed across muddy paths. From independents and www.kiddicare.com, see www.micralite.com for nearest stockists. 
 

Website of the week: www.mooncup.co.uk

Lots of readers have written recommending Mooncup reusable silicone menstrual cups as an alternative to tampons.   Benefits include comfort and economy; it may take practise but fans say it’s worth persisting.