Changing the course of ovarian cancer through early detection and tailored care

Ovarian cancer is one of the most challenging cancers to detect early with around 7,000 women diagnosed annually in the UK. By the time most women receive a diagnosis, the disease has often progressed, making treatment more complex and reducing survival rates. Research led by Professor Richard Edmondson is working to change this, by improving early detection and ensuring treatment decisions are more personalised and equitable.

Understanding where ovarian cancer begins

Ovarian cancer is difficult to detect because its symptoms are often vague. Persistent bloating, feeling full quickly, or needing to urinate more frequently can easily be attributed to other everyday causes.

This has made early detection particularly challenging. However, one of the most important advances in recent years is the discovery that many aggressive ovarian cancers do not originate in the ovary itself, but in precursor lesions in the fallopian tube- offering a new opportunity to detect the disease earlier.

Professor Richard Edmondson’s research focuses on identifying these earliest biological changes, working closely with colleagues across Manchester, including with clinicians at The Christie NHS Foundation Trust, as well as other national and international partners in the United States.

Because ovarian cancer does not behave the same way in every patient, a single diagnostic test or treatment approach is unlikely to be effective for all. This makes early investigation and awareness of persistent symptoms critical to improving outcomes.

Detecting cancer earlier: the NEMO programme

A key focus of this work is the Novel Early Markers for Ovarian Cancer (NEMO) consortium, which is designed to study the earliest stages of ovarian cancer using real patient samples. Women undergoing gynaecological surgery can consent to donate small tissue biopsies, which allows researchers to investigate how the disease develops at a biological level.

Historically, much cancer research has relied on cell lines grown in laboratories over long periods of time. While valuable, these models do not always reflect how cancer behaves in patients today.

By working directly with human tissue, researchers can gain a more accurate and clinically relevant understanding of disease progression. Early findings are already revealing differences in protein expression between healthy tissue and tissue at risk of becoming cancerous.

In the long term, this research could enable the development of technologies to identify and remove pre-cancerous lesions before ovarian cancer develops- potentially preventing disease altogether and reducing the need for major surgery.

Improving treatment decisions: the IMPRESS2 study

Innovation in ovarian cancer is not limited to early detection. It also extends to how treatment decisions are made once a diagnosis is confirmed.

National data shows that women with advanced ovarian cancer can receive different treatments depending on where they live in the UK. These variations are rarely due to differences in the disease itself but instead reflect differences in clinical decision-making.

To address this, Professor Edmondson leads the national IMPRESS2 study, involving 18 treatment centres across the UK, which aims to reduce variation and improve consistency in care.

Traditionally, treatment decisions have often been clinician-led. However, this research is helping to shift towards a shared ‘patient and clinician’ decision-making model, ensuring patients are fully informed and actively involved in choosing their care.

As part of this work, a personalised digital decision-support tool has been developed helps patients to understand the risks and benefits of different treatment options, including surgery and chemotherapy.

By supporting more balanced and transparent conversations between patients and clinicians, the approach aims to improve both health outcomes and the patient experience. Crucially, this work is grounded in real patient experience, bringing together surgeons, scientists, psychologists and patients themselves to ensure decisions reflect both clinical evidence and individual needs.

The tool will be evaluated in a clinical trial beginning in 2027, with the potential to inform decision-making across wider areas of cancer care.

Looking ahead

Improving outcomes in ovarian cancer will require progress on multiple fronts: detecting disease earlier, preventing it where possible, and ensuring treatment decisions are fair, informed and personalised.

If successful, this work could transform how ovarian cancer is managed- ensuring women receive the right treatment at the earliest opportunity, regardless of where they live, and have access to better treatment options if the disease returns.