Tomorrow is my birthday and three years ago I gave myself a birthday present and decided to make all my yearly appointments that I’d neglected the previous year while dealing with my in-laws.  I was dealing with a new city, new insurance region, new doctors. As with any insurance these days, I needed referrals to specialists.

When I received the first referral in the mail, I called to make my appointment. The receptionist was quite pleasant, but I was quite taken aback when she asked what my cancer diagnosis was.  I said I didn’t have one and she said I’m sorry we can’t see you then, but that’s good news.  I called my doctor back and asked for a new referral.  In all, I was seeking 3 referrals for 3 separate problems.  The next week I received the referral for problem number two and was met with a similar conversation with another receptionist.  Once again I called my doctor’s office back and started over on the referral process.  Next came the third referral for another doctor at the same facility.  I was met once again with the same conclusions, “sorry we can’t accept you because you have no cancer diagnosis”.  All of these referrals were to MD Anderson.  

My doctor’s office never did get any of the referrals handled with the insurance company. I called the insurance company myself and found that I didn’t even need a referral for my well woman exam in this region and they gave me the information for the UTMB women’s clinic.  It was here that I was finally seen and originally diagnosed.  It was here that a humble doctor said he wasn’t comfortable dealing with this and asked where I’d like to be referred.  I know and believe that all of these “misdirected” referrals were so that MD Anderson would be on the tip of my tongue.   When the doctor said the tumor was the size of large grapefruit I was distressed.  When he told me he was uncomfortable removing a tumor that size and wanted to refer me somewhere else, I said MD Anderson.

Spillage (yep, that’s a technical term) of tumor cells influences the incidence of local recurrence.  Spillage of tumor cells,  has a negative effect on survival rates. When the diagnosing doctor used the term “spillage”  I thought  he was making it up.  Then I looked it up.  Spillage is basically what happens when a tumor tears, rips or ruptures.

980 days ago, I was diagnosed with the “silent killer”, Ovarian Cancer.  Ovarian cancer, if detected early is 90 percent curable. But very few cases are discovered in the earliest stage. Then, there are miracles, while not many, and I am blessed to be one. Keep in mind I also believe one of the things that saved my life was a very progressive rhuematologist that helped learn to live without chemical drugs 28 years ago by convincing me to eat a healthy diet free of preservatives, altered sugars, etc… As she said if it’s blue and not a blueberry, don’t eat it and the same goes for orange.  Damn, there went the cheetos. The oncologist is convinced that the cancer had nothing in my body to thrive on because I eat healthy, fresh home prepared foods without hormones and preservatives.

When my surgeon, Dr. Diane Bodurka (a wonderful lady, doctor, surgeon, oncologist – there’s a good reason she’s head of the department)  said that she believed she got the tumor out intact without spillage, I felt relieved.  When she told me it was actually the size of a volleyball, had torsioned itself around everything, but not adhered to any major organs, I felt blessed. 947 days later – in the throes of REMISSION and alive to live another birthday I feel twice blessed.

When I was first diagnosed, they limited ALL my activity including driving in an effort to prevent rupturing the tumor.  Ironically the year prior had been full of strenuous activity, moving boxes and furniture – once again proving that my guardian angel was looking out for me.  The only symptom I ever had, I didn’t even know I was having because it mimicked a chronic appendix of some 35+ years.
Ovarian cancer is often called the “silent” killer because many times there are no symptoms until the disease has progressed and it’s too late.  Most die within five years of their diagnosis — because by the time doctors find the disease, it has already spread. Early symptoms of ovarian cancer are often mild, making this disease difficult to detect.  Sadly, a lack of symptoms from this disease means that about 75% of ovarian cancer cases will have spread to the abdomen by the time they are detected and, unfortunately, most patients die within five years. 

New methods for early screening of ovarian cancer are being investigated including ultrasound in conjunction with a blood test. The blood test may detect a cancer protein called CA 125, which is sometimes detected in the blood of women with ovarian cancer. This is the test that would have probably saved Gilda Radner’s life.

These tests are useful in evaluating tumor growth, however neither of them has been proven as a reliable way to screen for ovarian cancer.  In my own case, the blood work was within normal range while there was a volleyball sized tumor inside me.  Quite possibly they were within range because the tumor was still intact, having NOT spread, but no one knows for sure so be vigilant!!!
Ultrasound can detect changes, but it does not give enough information alone to diagnose ovarian cancer. The CA 125 blood test can return positive results when no cancer is present due to other conditions a woman may experience including fibroid tumors, endometriosis, pelvic infection, pregnancy, or other non-gynecological problems. 

The treatment for ovarian cancer varies according to a number of factors. For most women, the first treatment is also a diagnostic procedure which involves surgery to determine the extent to which the disease has spread. As a result of surgery, the cancer will be staged.

Stages range from I to IV, with I being the earliest and IV being the most advanced stage. Treatment of ovarian cancer is based on the stage and grade of the disease. A pathologist will determine the grade (how likely it is to spread) of the malignancy. 
Many times ovarian cancer and breast cancer are linked. Because of my family history with breast cancer (which is what I was always afraid of getting) I also had the genetic BRCA 1&2 tests done this year.  I would have cut off my breasts had they been positive.  Once again fortune smiled down on me.  The results were negative.  I guess one cancer was enough!

Are You at Risk?

  • An immediate (mother, sister, or daughter) family member who has had ovarian cancer increases your risk of developing this disease about three times, giving you a 5% to 7% risk of future ovarian cancer.
  • When the cause is genetic, ovarian cancer usually shows up a decade earlier in each successive generation. (If your mother had ovarian cancer in her 60s, you stand a good chance that this disease will develop in you in your 50s.)
  • Genetic counseling is a good idea for women with a family history of breast or ovarian cancers. Women with a family history may opt for oophorectomy, although this procedure does not offer absolute protection it does reduce risk by 75% to 90%
  • Research has determined that women who use powders to dust their genital areas have a 60% higher risk of ovarian cancer. Feminine deodorant sprays can almost double your risk.
  • Women who use oral contraceptives for at least five years reduce their chance of developing ovarian cancer by half for the short-term following use and possibly for lifetime. The longer you use the pill, the lower your risk.
  • Having two or three children can cut your risk by as much as 30% over women who never conceive or give birth. Having five or more children reduces the risk up to 50%, and breastfeeding your children can further reduce your risk.
  • Tubal ligation reduces a woman’s risk up to 70%.

Remember, the best way to detect ovarian cancer is by regular  examinations.

Symptoms of Ovarian Cancer

If symptoms are present, they may include:

  • unusual abdominal feeling of fullness
  • pelvic discomfort
  • unexplained indigestion, gas, or bloating
  • pain during sexual intercourse
  • abnormal bleeding
  • swelling and/or pain in the abdomen

Ovarian Cancer Fact 1. Ovarian cancer is the leading cause of gynecologic cancer deaths among American women.

Ovarian Cancer Fact 2. Only 24 percent of ovarian cancers are diagnosed at an early stage, when the cancer is confined to the ovary. Most cases are diagnosed after the cancer has spread to other parts of the body, making it difficult to treat successfully.

Ovarian Cancer Fact 3. One woman out of every 55 (approximately 1.8 percent) will develop ovarian cancer at some point in her lifetime.

Ovarian Cancer Fact 4. Ovarian cancer is most common in women who have already gone through menopause. The average age for developing ovarian cancer is 61 years old.

Ovarian Cancer Fact 5. For the small number of women who are fortunate enough to have their cancer diagnosed before it has spread beyond the ovary, the chance for recovery is 85 to 90 percent. (A fact not lost on me)

Ovarian Cancer Fact 6. For the majority of women in whom the disease has spread beyond the ovary, the chance of living for five years after the diagnosis is 20 to 25 percent.

Ovarian Cancer Fact 7. A major risk factor for getting ovarian cancer is a personal history of breast, endometrial or colon cancer.

Ovarian Cancer Fact 8. The only sure way to diagnose ovarian cancer is through microscopic examination of abnormal fluid or tissue, obtained by needle aspiration (withdrawal of fluid or tissue from a suspicious area though a special, wide needle) or surgery.

Ovarian Cancer Fact 9. Hycamtin is one of the first of a new kind of anti-cancer drugs that kills cancer cells by inhibiting an enzyme essential to the replication of human DNA.

Give yourself a birthday present too!
Make your annual well woman appointment today.