To ask the Minister of Health to detail any treatments that are available for (i) women newly-diagnosed with ovarian cancer; (ii) women experiencing a recurrence; and (iii) those with low-grade ovarian cancer.

In Northern Ireland, surgery, where appropriate, remains the main stay of treatment for new diagnosis of ovarian cancer. Surgery usually occurs ‘upfront’ prior to 6 cycles of chemotherapy, or following 3-4 cycles of chemotherapy (neo-adjuvant). Surgery is intended to remove all visible signs of cancer within the pelvis, abdomen and occasionally thorax, it is termed cytoreductive surgery.

Low grade ovarian cancers are a different entity and for the most part do not respond well to chemotherapy. Where possible surgery will remove as much visible disease as possible, and this may be followed by hormone treatment called letrozole or anastrozole.

Guidance from British Gynae Cancer Society (BGCS) is followed which is due to be updated. Current guidelines are available at

https://www.bgcs.org.uk/wp-content/uploads/2019/05/BGCS-Guidelines-Ovarian-Guidelines-2017.pdf

The Department of Health has a formal link with the National Institute for Health and Care Excellence (NICE) under which NICE Technology Appraisals are reviewed locally for their legal and policy applicability in Northern Ireland. Where found to be applicable, they are endorsed for implementation within Health and Social Care (HSC). In practice, this means that treatments recommended by NICE for use on the NHS in England are made available in Northern Ireland.

For advanced ovarian cancer, this includes treatments such as olaparib with bevacizumab (TA946), rucaparib (TA1055) and niraparib (TA1129). The Department has endorsed all of these treatments for use in Northern Ireland and are commissioned in line with extant process.

Ovarian carcinomas are managed by the medical oncology team. Systemic therapy is the mainstay of management, however if patients become chemotherapy resistant, radiotherapy can be considered for symptomatic benefit.

Radiotherapy doses used are palliative in intent, however high dose palliative 45Gy in 25 fractions can be considered for patients who are of good performance status (ECOG 0-1) for management of pelvic symptoms.