A recent series of articles in The Guardian again reveals the significant financial and debilitating cost of this terrible disease. My friend and colleague, Dr Geoff Reid outlines the tremendous impact this has on women and their partners. Increasingly it is becoming clear that advanced cases require multi-specialised teams to cope with the different facets of the disease. Far too many people are having repeat surgery. I am also coming to the opinion that our current definition is too simplistic and that we need to expand this to accommodate the reality of the clinical situation. Surgery alone is probably not optimal.