A Daughter’s Story:
One weekend in early September 2008, my mother was taken to the emergency room for shortness of breath. Being the amazingly strong and resilient woman that she was, we later found out that she had been struggling with this for a few weeks. In the ER, x-rays determined that she had a significant amount of fluid in her lungs. In the medical world, this is usually a tell-tale sign that something is wrong, although at the time, we didn’t know it. She was sent to a pulmonologist the following Monday where she had two liters of fluid removed from her lung cavity. Imagine TWO soda bottles of fluid. She felt immediate physical relief, but the real battle was just beginning. Testing performed on the fluid determined the presence of cancerous cells. Our amazing, incredibly strong mother had cancer. CAT & PET scans determined that she had no tumors, but rather that the cancer seemed to be within the tissue linings of her body; “no point of origin.” The news of cancer was hard enough. The news of cancer “without a name” sounded terrifying because although it would be treated, it wouldn’t be treated as specifically as if they knew exactly what they were dealing with. I remember looking up different cancers of the tissue and finding Mesothelioma, wondering, “is this what she has? Could past asbestos exposure have lead to this?” In the meantime, the oncologist at her local hospital was extremely knowledgeable and was already putting together a treatment plan. However, with any diagnosis of this magnitude, it’s common to obtain a second opinion. My aunt had a connection with a renowned oncology specialist on Long Island, so, my mother decided to pursue his opinion regarding her diagnosis and treatment.
I remember the time between these meetings with doctors seeming like months; every day that went by was time wasted on getting an answer. When we finally met with the doctor on Long Island, he talked with my mom, got a full medical history and did an examination. Cara will later explain about a CA-125 screening that can sometimes prove inaccurate, but in my moms case, her numbers were astronomically high. Putting this together, along with his examination, it was determined that our mother had ovarian cancer. Stage IV ovarian cancer. Without chemotherapy she was given 3 months. With chemotherapy, given her age and cancer stage, she was given roughly 18 months. I was three months pregnant with the 10th of her grandchildren and her goal was to make it until March to meet him. As I mentioned, my mom was resilient and strong. She was also one of the kindest, sweetest, most unselfishly giving and honest people I knew. She would never hurt a soul. When it came to cancer, however, she was a fighter. Quietly, in her own nature, she fought a difficult disease. She constantly questioned us if she was going to make it through. She endured treatments and surgeries, and towards the end, painful side effects, but she fought through so that she could live to enjoy her family. She fought Ovarian cancer for 7 years and 3 months. To say she defied some serious odds is a huge understatement. To so many who have lost someone, not just to Ovarian cancer but any cancer, we might be considered “lucky” to have had her live not just months, but YEARS beyond what we could ever have imagined. However, as with all the lives lost of those we love, no amount of time is ever really long enough.
Shortly after my mom was officially diagnosed, it came to light that during a few routine check-ups with her gynecologist in that year, she had complained of a bloating feeling along the underwire of her bra around her upper abdomen. In fact, she went through so many different bras without underwire, or anything that she felt was “digging into her,” that she had a shopping bag filled. Her doctor told her she should go up a bra size and that she was probably just retaining water when she mentioned a “bloating” feeling in her lower abdomen as well. It was, instead, most likely “silent symptoms” of ovarian cancer.
When I first became aware that September is National Ovarian Cancer Awareness Month (sharing it with equally important Pediatric Cancer Awareness Month), I found it ironic that my mom was diagnosed in that very month. Not only can her story bring to light how a disease can so silently and quickly take over the body, health and life of a woman and flip it upside down, but perhaps it can also give hope to the women who have been or will be diagnosed. I pray that someday soon we will have a cure, or at the very least, an accurate, proper screening tool. I hope that together Cara and I as Doctor and Daughter can further raise awareness. Tell a friend, pay closer attention to your own health, and spread the word.
Ovarian Cancer: listen closely, it whispers.
From the Doctor:
Ovarian Cancer is really, really scary. It’s one of the diseases that frightens me as a physician because it’s sneaky and can be difficult to diagnose. The symptoms are often non-specific, it can grow and spread very quickly, and can be fatal once it is finally diagnosed. And did I mention we really have no great screening for it? So it’s really, really scary. Ovarian cancer accounts for about 3% of all cancers in women, which is pretty low. However, it causes more deaths than any cancer of the female reproductive system. Therefore, it’s important to know about symptoms and risk factors, and it’s extremely important to make sure you are going for regular physicals or gynecologic exams.
We do know that there are certain factors which increase our risk:
-Being older (most ovarian cancers happen after menopause)
-Obesity and higher fat diet
-Being age 35 or greater at first pregnancy
-Never becoming pregnant
-Certain fertility and hormonal drugs
-Family history of ovarian cancer, breast cancer, or other cancer syndromes
-Personal history of breast cancer
Certain factors are also known to decrease risk:
-Early age at first pregnancy
-Taking an oral contraceptive pill
-Eating a plant based diet
-Having had a hysterectomy or a tubal ligation (“tubes tied”)
Right now, only about 20% of ovarian cancers are found at an earlier stage. Your best bet in terms of prevention is to go for regular exams and to pay attention to any unusual symptoms. The difficult thing about ovarian cancer is that, often in the early stages, there are no symptoms. As things progress, symptoms like bloating, pelvic pressure, abdominal pain, urinating more frequently, feeling full quickly with eating, or abdominal swelling may be present. As I indicated earlier, the screening tests for this cancer are lacking. In women who have a higher risk due to family history or other factors, trans-vaginal ultrasound is used to screen periodically, but it’s not perfect. You will see a lot on the internet about a blood test for a tumor marker called CA-125, but it’s also not a great screening test because it generates a lot of false positives.
So – listen to your body, know your risks, and go for regular exams! I’m hoping that at some point soon in my medical career, research will grant us a great screening test, and, similar to breast cancer, this will become a disease that women live with and not die from!
For more information check out the American Cancer Society Website.
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