'By the time you are diagnosed, it's too late for many'

THE symptoms came on quickly - extreme tiredness and a bloated tummy. Alex Ford was in the process of moving with her partner to a new home in Sheffield and initially put her complaints down to the stress of the move. In fact, her vague symptoms could be put down to any number of factors, she reasoned. But then she lost her appetite too.

"I just remember thinking 'new job, new house', it's no wonder I'm tired," says Alex. "But then my partner cooked a curry later that night and I just couldn't eat it. My appetite had gone, it was really bizarre. It was such an acute symptom I went to see the doctor."

Little did Alex know that she had an ovarian cyst as big as a bag of sugar growing inside her, a cyst so big it was pressing against her stomach. When she went to her doctors, tests also revealed she had stage one ovarian cancer. Alex was just 34.

"I can remember lying on the floor at about the time I lost my appetite and thinking 'why is one part of my stomach bigger than the other?'" she recalls. "But that's why we call it the silent killer, because the symptoms are so vague and by the time you get diagnosed, it's too late for many. I was lucky enough to have the cyst."

Alex had an operation to remove the cyst and as the cancer was in its early stages, she did not need chemotherapy. After a successful operation she learned that the cancer had not spread, but she then faced the trauma of deciding whether or not to have a hysterectomy and her second ovary removed in order to prevent a reoccurrence of the cancer. The operation meant she would never be able to have children. "It wasn't an easy decision but it was probably easier for me because my partner didn't want children and I wasn't that bothered about having them," she admits. "But I was lying in hospital the night before thinking 'am I really making the right decision'?"

Unlike some sufferers, Alex says she never experienced anger over why she had the disease. But she did go into denial.

"I shut down and pretended that it wasn't happening because I thought if I did, then I wouldn't have to deal with any of it and it would go away," she says. "I think looking back on it now, and my decision to go and work for women's cancers, it is driven by the fact that I feel unbelievably strongly that ovarian cancer is the forgotten cancer.

"I didn't think that at the time, because I was too busy dealing with my own emotions."

Alex went on to become director of fundraising and marketing with Breast Cancer Care before taking over as chief executive of the ovarian cancer research charity, The Eve Appeal, which was launched in January this year.

The charity is supporting the world's largest ovarian cancer screening trial - headed by Professor Ian Jacobs of University College London - which will recruit its 200,000th woman in November.

Ovarian cancer kills more than 70 per cent of the women who develop it, but if diagnosed in the early stages, more than 90 per cent survive - a figure which highlights the need for a reliable screening test. Figures so far reveal that out of 7,000 women who are diagnosed with ovarian cancer every year, 5,000 will die from it. They include American actress Madeline Kahn, who died from ovarian cancer in 1997 and Cassandra Harris, actor Pierce Brosnan's first wife, who was 41 when she died. This compares to the 40,000 of women who develop breast cancer every year, with 12,000 dying annually.

"The breast cancer cause is able to promote prevention through its five point code encouraging women to check their breasts," says Alex, who now lives in London. "But with ovarian cancer, it is extremely difficult because the symptoms are so vague and often they are not related to cancer."

Symptoms include a constantly swollen abdomen, unexplained nausea or indigestion, ongoing excessive fatigue, abnormal bleeding and unexplained back or abdominal pain - which are common to a wide range of ailments and are easily missed.

But there are two certain tests to detect whether a woman has ovarian cancer. One is a protein detected in the blood known as CA125 which is produced by cancer cells and the other is a transvaginal ultrasound to assess the ovaries, where a probe is inserted into the vagina.

The 200,000 women taking part in the screening trials across the country include those who will have no tests; those who will have one of the tests and those who will have both. The James Cook University Hospital in Middlesbrough and the Queen Elizabeth Hospital in Gateshead have both taken part in the trials.

It is hoped that the results will reduce deaths by ovarian cancer by half in ten years time by leading to a national screening programme which will become as common as going for a smear test for cervical cancer.

Two of the scientists involved in the programme will be coming to the James Cook University Hospital in Middlesbrough on Monday to draw attention to the screening programme and the work carried out by The Eve Appeal.

Alex is 42 now and has been clear of cancer for eight years. But her experience has made her even more determined to combat the "silent killer."

"It really is the forgotten cancer," she says. "It's fantastic that the breast cancer cause is so high profile and so well funded and with cervical cancer there is the possibility of a vaccine, but ovarian cancer is hardly ever talked about.

"It's a silent killer in all sorts of ways, because you don't know about it until it's too late and because nobody talks about it either."

* For more information about The Eve Appeal contact 020 7380 6900 or visit www.eveappeal.org.uk.