Practice A Patient’s Journey

The invisible worm: ovarian cancer

BMJ 2009; 338 doi: (Published 04 June 2009) Cite this as: BMJ 2009;338:b2072
  1. Gill Reeve, patient1,
  2. Stuart Mackay-Thomas, GP associate2
  1. 1London
  2. 2Hampstead Group Practice, London NW3 2QU
  1. Correspondence to: G Reeve gereeve2002{at}
  • Accepted 29 April 2009

It took nine months for her GP practice to diagnose Gill Reeve’s symptoms as ovarian cancer. She wants to know why it took so long.

O Rose, thou art sick!

The invisible worm,

That flies in the night,

In the howling storm,

Hath found out thy bed

Of crimson joy;

And his dark secret love

Doth thy life destroy.

I was a fit, healthy, active 66 year old writer and peace campaigner, but some indefinable part of me knew that somewhere, somehow, something was seriously wrong. This poem by William Blake came out of the blue in February 2008 when I was asked to write anything I wanted during a neurology test. I had been referred to University College Hospital Neurology Clinic because of the worry that my worsening memory problems might reflect my mother’s history of dementia. Nothing of concern was found apart from hypertension. A reading of the loss of a stone in weight never reached my GP practice.

Maze of symptoms

In September 2007 I had felt intermittent twinges of pain in my right side under my ribs. I had no idea which, if any, organ might be involved. I had a steep and protracted learning curve. My GP suspected gallstones and referred me for ultrasound. No gallstones were found, but a benign kidney cyst was suspected of causing my symptoms. In mid-November, when the pains seemed to be spreading, I went back to my GP, who suggested a referral to the urologist if things got worse.

I was busy, tried a wheat free diet, and when in early 2008 I saw my girth was extending I just thought it was middle age spread. But after a visit to Zambia I could ignore the pain no longer, and in early April the GP sent me to the urologist, who offered …

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