English: I'm delighted to speak in this debate. I wasn't a member of the committee at the time, but I have read the report and the Government response, and I have spoken to a number of organisations who've brought forward concerns on this matter. I'd like to thank everyone who contributed to this report. I'd like to thank the Chair and his clerking team, and I'd particularly like to thank the petitioner, Margaret Hutcheson, because she used her democratic right to bring before us all a very important matter - very important because the horrifying statistic is that a woman dies every two hours from ovarian cancer in the UK. As Margaret herself said, two of her close friends - both chemotherapy nurses - did not spot the signs of ovarian cancer. So, it just goes to show that it is a very difficult cancer to spot. Many people do describe it as a silent killer, but it does have some very clear symptoms: persistent bloating, persistent stomach pain, difficulty eating, feeling full more quickly, and needing to wee more frequently. So, rather than think of ovarian cancer as a silent killer, I would suggest that it's a mistress of disguise. Forty-one per cent of women had to visit their GP more than three times before being referred for diagnostic tests, because the symptoms are very hard to identify. They can be very similar to irritable bowel syndrome, or seen as a consequence of menopause. Herein lies one of the sad consequences: if ovarian cancer is caught at stage 1, survival rates are in the order of 90 per cent. I know that the Chair's made this point, but I do think that's a really important point to re-emphasise - 90 per cent if caught in stage 1. But, by the time a woman reaches stage 3, her survival rate plummets to only 19 per cent. In other words, 81 per cent of all women at stage 3 will die. And that's one hell of a death sentence. This is more than a sobering statistic, but it's a world of sorrow for those individuals and for their families, and I think it is very important that we take a look at this. So, my challenge to the Welsh Government - and to you, Minister - is this: in rejecting recommendation 3, how confident are you that the symptoms of ovarian cancer, this mistress of disguise, will become more well-known by both women and the medical community, particularly GPs, because they are our front line? What exactly, may I ask, does your response mean when you say - I'm just going to read from your response, Minister - about the cancer delivery plan: It includes a commitment to raise awareness of the symptoms of cancer. The cancer implementation group will determine the content of this activity based on tumour prevalence and outcomes'? Now, I read that as 'tumour prevalence' meaning how many people might have it. Well, I guess not huge numbers, but enough for a woman to die every two hours. But what is very clear about ovarian cancer is once you've got it, unless it's caught quickly, you're not in for a good ride. So, we know that prevalence. We also know that Wales has the worst survival rate in all of the home nations. The five-year survival rate, Minister, for ovarian cancer in Wales is only 38 per cent. So, as the Chair said, 62 per cent of all women in Wales with ovarian cancer will die within five years. So, I believe it's imperative that you ensure that the symptoms of ovarian cancer are made very well known to women and the medical community. Minister, would you agree with me that a commitment by you and the Welsh Government to follow the NICE guidelines and ensure that anyone with a 10 per cent risk of carrying one of the BRCA genes is tested? Would that not be a good place to start? Whilst I do understand the pressures on finances, and how very difficult it is for us to make all cancers known to all people, the problem with this particular one is that your chances, once it goes beyond a certain stage, become very slim indeed. There is just a 10 per cent survival rate after five years if you've got to stage 3. So, it would be of great importance if you could look at ensuring that ovarian cancer is taken very seriously in terms of its messaging to people. Very simple, women and GPs: there are four or five very strong key symptoms, and if a woman keeps presenting, more than once or twice with that, you must get them tested, and you must enable them to be moved forward, up through the diagnostic path. But you need to tell women that it's not just having heartburn or having a funny tummy and not feeling well, and you need to make sure that GPs really understand what those symptoms of ovarian cancer are. The way to do that is through public health messaging. Thank you.
Welsh: Rwy'n falch iawn o gael siarad yn y ddadl hon. Nid oeddwn yn aelod o'r pwyllgor ar y pryd, ond darllenais yr adroddiad ac ymateb y Llywodraeth, a siaradais â nifer o sefydliadau a gyflwynodd eu pryderon ynglŷn â'r mater hwn. Hoffwn ddiolch i bawb a gyfrannodd at yr adroddiad hwn. Hoffwn ddiolch i'r Cadeirydd a'i dîm clercio, a hoffwn ddiolch yn arbennig i'r deisebydd, Margaret Hutcheson, gan ei bod wedi defnyddio ei hawl ddemocrataidd i gyflwyno mater pwysig iawn ger ein bron - pwysig iawn oherwydd yr ystadegyn arswydus fod menyw'n marw bob dwy awr o ganser yr ofari yn y DU. Fel y dywedodd Margaret ei hun, ni lwyddodd dwy o'i ffrindiau agos - y ddwy'n nyrsys cemotherapi - i adnabod arwyddion o ganser yr ofari. Felly, mae'n dangos ei fod yn ganser anodd iawn i'w ganfod. Mae llawer o bobl yn ei ddisgrifio fel lladdwr tawel, ond mae ganddo rai symptomau clir iawn: bol wedi chwyddo'n barhaus, poen parhaus yn y stumog, anhawster i fwyta, teimlo'n llawn yn gyflymach ac angen i basio dŵr yn amlach. Felly, yn hytrach na meddwl am ganser yr ofari fel lladdwr tawel, byddwn yn awgrymu ei fod yn feistres mewn cuddwisg. Roedd 41 y cant o fenywod wedi gorfod ymweld â'u meddyg teulu fwy na thair gwaith cyn cael eu hatgyfeirio am brofion diagnostig, oherwydd bod y symptomau'n anodd iawn i'w nodi. Gallant fod yn debyg iawn i syndrom coluddyn llidus, neu gael eu gweld fel un o ganlyniadau'r menopos. Dyma un o'r canlyniadau trist: pe bai canser yr ofari yn cael ei ddal yng ngham 1, mae cyfraddau goroesi oddeutu 90 y cant. Gwn fod y Cadeirydd wedi gwneud y pwynt hwn, ond rwy'n credu ei fod yn bwynt pwysig iawn i'w ailbwysleisio - 90 y cant os caiff ei ddal ar gam 1. Ond erbyn i fenyw gyrraedd cam 3, mae ei chyfradd goroesi'n plymio i 19 y cant yn unig. Mewn geiriau eraill, bydd 81 y cant o'r holl fenywod ar gam 3 yn marw. A dyna ddedfryd marwolaeth uffernol. Mae hwn yn fwy nag ystadegyn sobreiddiol, ond mae'n fyd o ofid i'r unigolion hyn ac i'w teuluoedd, ac rwy'n credu ei bod yn bwysig iawn ein bod yn edrych ar hyn. Felly, fy her i Lywodraeth Cymru - ac i chi, Gweinidog - yw hyn: wrth wrthod argymhelliad 3, pa mor hyderus ydych chi fod symptomau canser yr ofari, y feistres mewn cuddwisg, yn dod yn fwy cyfarwydd i fenywod a'r gymuned feddygol, yn enwedig meddygon teulu, oherwydd hwy yw ein rheng flaen? A gaf fi ofyn beth yn union y mae eich ymateb yn golygu pan fyddwch yn dweud - rwy'n mynd i ddarllen o'ch ymateb, Gweinidog - am y cynllun cyflawni ar gyfer canser: 'Mae'n cynnwys ymrwymiad i godi ymwybyddiaeth am symptomau canser. Bydd y Grŵp Gweithredu ar gyfer Canser yn penderfynu ar gynnwys y gweithgarwch hwn ar sail nifer yr achosion o diwmor a'r canlyniadau'? Nawr, darllenais hynny gan gymryd bod 'nifer yr achosion o diwmor' yn golygu faint o bobl a allai fod ag ef. Wel, nid niferoedd enfawr, mae'n debyg, ond digon i fenyw farw bob dwy awr. Ond yr hyn sy'n glir iawn am ganser yr ofari, pan fydd arnoch, oni bai ei fod yn cael ei ddal yn gyflym, nid ydych yn mynd i gael amser hawdd. Felly, gwyddom beth a olygir wrth nifer yr achosion. Gwyddom hefyd mai gan Gymru y mae'r gyfradd oroesi waethaf o bob un o'r gwledydd cartref. Mae'r gyfradd oroesi pum mlynedd, Gweinidog, ar gyfer canser yr ofari yng Nghymru yn ddim ond 38 y cant. Felly, fel y dywedodd y Cadeirydd, bydd 62 y cant o'r holl fenywod yng Nghymru sydd â chanser yr ofari yn marw o fewn pum mlynedd. Felly, credaf ei bod yn hanfodol eich bod yn sicrhau bod y symptomau'n cael eu gwneud yn hysbys iawn i fenywod a'r gymuned feddygol. Weinidog, a fyddech yn cytuno â mi fod ymrwymiad gennych chi a Llywodraeth Cymru i ddilyn canllawiau NICE a sicrhau bod unrhyw un sydd â risg o 10 y cant o gario un o'r genynnau BRCA yn cael prawf? Oni fyddai hwnnw'n lle da i ddechrau? Er fy mod yn deall y pwysau ar gyllid, a pha mor anodd yw hi i ni wneud yr holl ganserau'n hysbys i bawb, y broblem gyda'r un arbennig hwn yw bod eich gobaith, unwaith y bydd wedi mynd y tu hwnt i gam penodol, yn mynd yn fain iawn yn wir. Dim ond 10 y cant yw'r gyfradd oroesi ar ôl pum mlynedd os ydych wedi cyrraedd cam 3. Felly, byddai'n bwysig iawn pe gallech geisio sicrhau bod canser yr ofari yn cael sylw difrifol iawn o ran y negeseuon i bobl. Yn syml iawn, menywod a meddygon teulu: mae yna bedwar neu bump o symptomau allweddol cryf iawn, ac os bydd menyw yn parhau i fynd at y meddyg fwy nag unwaith neu ddwywaith â'r rheini, rhaid i chi ei gwneud yn bosibl iddynt gael prawf, a rhaid i chi eu galluogi i gael eu symud ymlaen, drwy'r llwybr diagnostig. Ond mae angen i chi ddweud wrth fenywod nad yw'n fater syml o fod â dŵr poeth neu boen bol a theimlo'n gwla, ac mae angen i chi wneud yn siŵr fod meddygon teulu yn deall beth yw symptomau canser yr ofari mewn gwirionedd. Y ffordd i wneud hynny yw drwy negeseuon iechyd y cyhoedd. Diolch.