Archive for the ‘ovarian cancer’ Category

Living With Cancer: What to Expect After the Diagnosis

Wednesday, May 25th, 2011

Alicia Staley - Cancer Survivor - Visual (Image from her site - awesomecancersurvivor.com

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones.

Needless to say, the original cancer diagnosis marks the beginning of a difficult, frightening and frustrating experience. For this reason, it is critical not to despair. One must always remain hopeful, adjust, and prepare for the way to recovery. A fundamental step in this process is gaining an understanding and familiarity with the impending medical treatment and associated lifestyle changes. A good deal of stress can be avoided by simply understanding what to expect. While cancer treatment varies depending on the type of cancer and the individual characteristics of the patient, the patient should generally be aware of the following:

Chemotherapy

The vast majority of cancer patients will receive some degree of chemotherapy. This may consist of one or more chemotherapy cycles.  Each cycle can be as long as 3-6 months. Chemotherapy involves the administration of various chemical agents called antineoplastic drugs in order to stop cancerous cells from dividing. Antineoplastic drugs are designed to attack and kill cells that divide in an uncontrolled or rapid matter. Antineoplastic drugs, however, are not able to discriminate between cancerous cells and normal cells. Therefore, cells that divide rapidly as part of their normal life cycle are also attacked. Chemotherapy may cure the cancer entirely or control its growth. Many times, chemotherapy is used in conjunction with other treatments. Some associated complications of chemotherapy include:

  • Anemia
  • Hair Loss
  • Lethargy
  • Nausea and loss of appetite
  • Kidney damage
  • Liver damage
  • Heart damage
  • Deterioration of pre-existing medical conditions such as osteoarthritis, among other things.

Radiation Therapy

In addition to chemotherapy, a patient may also receive radiation therapy. Radiation therapy involves exposing cancerous tissue to ionizing radiation (electromagnetic waves), which tends to destabilize the molecular structure of cancerous cells. In essence, the electromagnetic waves will ionize the atoms of the cancerous cells, by displacing electrons within the inherent structure of the atom. In turn, this process destabilizes the molecules of the cancerous cells, causing them to die.

Surgery

In a number of instances, cancer patients will also require surgery to treat their cancer. Often times, the malignant tumor is identifiable and localized (as opposed to metastasized). In such instances, timely surgery is preferred. Chemotherapy of radiation therapy may follow the surgery. The type of surgery  will vary depending on the type of cancer and how advanced it is. For example, a woman with ovarian cancer will likely undergo a total hysterectomy, including the removal of the ovaries. A patient with intestinal cancer may undergo a laparotomy with dissection of the cancerous tissue. Generally speaking, the sooner the cancer is identified, the less extensive the surgery.

Monitoring

After surgery and chemotherapy/radiation therapy, each cancer patient/cancer survivor should establish a systematic and well developed course of monitoring and supportive care with his/her physician. This will often involve a number of other health care providers such as physicians, nurses, and physical therapists. For example, a patient who has undergone treatment for ovarian cancer may require monitoring by an oncologist, a surgical oncologist, an internist (primary care physician), a gynecologist, and even a urologist. One must then factor in the extent to which the cancer treatment resulted in additional complications or the extent to which pre-existing medical conditions deteriorated as a result of the cancer treatment. As such, the patient may require the involvement of additional specialists to address and monitor the side effects of the cancer treatment. It is very important that the patient maintain a healthy nutrition and exercise regimen, if and as prescribed by the physician.

The bottom line is that cancer patients will invariably have a long and difficult road to recovery, which may take months or even years. Drastic lifestyle changes may be necessary, and patience as well as perseverance are essential. A cancer patient must know what to expect and be proactive to create support structures involving health care providers and family members/loved ones.

Helping Others in Need

If you or someone you know is a cancer patient/survivor, I encourage you to share your story with our readers. What helped you most to cope and persevere on your way to recovery?

Related Posts:

Ovarian Cancer: Five Tips to Get the Medical Care You Need

Ovarian Cancer: Early Intervention is Key – What You Must Know…

Breast Cancer: What You Need to Know About Digital vs. Film Mammograms

Warning to Women of Menopausal Age: HRT Linked to Increase in Death From Breast Cancer

Ovarian Cancer – five tips to make sure you get the medical care you need

Wednesday, May 11th, 2011

Did you know that more than 21,000 women are diagnosed with ovarian cancer in the U.S. each year? An astonishing 15,000 women die from ovarian cancer each year. Despite numerous advances in healthcare, the mortality rate for ovarian cancer has not improved in the last 30 years. Simply put, ovarian cancer is the deadliest of all gynecologic cancers. If the cancer is diagnosed in its early stages (i.e. before it spreads to other organs), the five-year survival rate is about 93.8%. However, if it the cancer is diagnosed in its later stages, the five-year survival rate is about 28.2%.

There is no question that ovarian cancer is quite deadly and that early diagnosis and treatment is key for survival. There is an abundance of information about ovarian cancer online and in other written sources. Simply put, take the time to familiarize yourself with the symptoms of this terrible disease. Let’s share with you some information, which I believe can make a difference. Call it a male lawyer’s perspective, if you will. I’ve seen what happens when early detection should have happened, but tragically did not.

1. Examine Your Medical History

Whenever the possibility for ovarian cancer exists, consider your medical history as you discuss your symptoms with your physician. If you are having symptoms consistent with ovarian cancer, take the initiative and discuss your symptoms and history with a gynecologist as opposed to your primary care physician. Make sure to tell your physician if you have any cancer history. Don’t forget to include information about any family history of cancer (parents, siblings, etc.). Of particular importance is any history of breast or ovarian cancer, although any cancer history is relevant. Unfortunately, women with a personal or family history of ovarian cancer or breast cancer are at a higher risk.

2. Understand and Appreciate Your Symptoms

Although your physician is likely to talk to you about ovarian cancer, it is always a good idea to familiarizer yourself with the signs and symptoms of ovarian cancer before your doctor’s appointment. Many of the symptoms of ovarian cancer overlap with the symptoms of cervical cancer. Therefore, if you are experiencing symptoms of cervical cancer, you and your physician should also discuss the possibility of ovarian cancer. We have seen cases were a physician will consider one or the other but not the possibility of both cancers. Here are some of the more common symptoms of ovarian cancer:

-          Irregular uterine bleeding

-          Abdominal  and/or pelvic pain

-          Abdominal fullness or bloating

-          Fatigue

-          Unexpected weight loss

-          Fatigue

-          Headaches

-          Frequent urination

-          Low back pain

Watch this video for more information about symptoms of ovarian cancer:

httpv://www.youtube.com/watch?v=fH9N4auMblE

 

Watch this video for more information about symptoms of cervical cancer:

httpv://www.youtube.com/watch?v=HHA_0HsjeBI&feature=related

3. Is it a solid mass?

If your radiographic studies reveal a mass, make sure that you get a clear answer as to whether the mass is solid or fluid-filled.  A fluid filled mass will typically turn out to be a cyst. It could also be a blocked fallopian tube (i.e., hydrosalpinx, hematosalpinx, pyosalpinx). Generally speaking, a fluid filled mass is less likely to be malignant. However, if your radiographic studies reveal a solid mass, especially one that arises from an ovary, the possibility of ovarian cancer must be seriously considered. If you are found to have a solid mass, talk to your gynecologist or primary care physician about consulting with a surgical oncologist.

4. Should you have a CA 125 blood test?

CA 125 is a protein. It is a tumor marker or biomarker for ovarian cancer because it is more prominent in ovarian cancer cells. The CA 125 test is a test designed to test the levels of CA 125 in a patient’s blood. Elevated CA 125 levels can be indicative of ovarian cancer. If your CA 125 levels are elevated, you and your physician should seriously consider the possibility of ovarian cancer. An elevated CA125 should prompt your physician to order additional radiographic studies, including a CT of the abdomen and pelvis, an ultrasound of abdomen and pelvis, a PET scan or even a CT pyelogram. You should also consider consulting an oncologist or a surgical oncologist. If you are found to have a solid mass and your CA 125 level is elevated, time is of the essence for further investigation and surgical intervention.  Ask your doctor about other tumor markers that can be tested.

5. Who is reading your ultrasound?

Many patients who present to their gynecologist with symptoms of ovarian cancer will initially undergo an ultrasound. A great number of gynecologists will themselves perform and interpret the ultrasound. Here is the problem. With all due respect to gynecologists, they are not trained ultrasonographers or even radiologists! Ultrasounds can be particularly difficult to read. This can be due to the patient’s position and, more frequently, the size of the patient. In heavier patients, a pelvic ultrasound can be quite limited if one is trying to visualize the ovaries, discern the presence of mass, or determine whether the mass is solid or fluid-filled. So, if your gynecologist is the only person to read your ultrasound, the result is potentially quite devastating. The mass could remain undiagnosed, and you may be told to come back if your symptoms get worse. The ultrasound may be interpreted as limited, and, for whatever reason, your gynecologist may simply neglect to order a more sensitive study (i.e. a CT scan). Instead, he or she may choose to monitor you for any further deterioration of symptoms.

In yet another instance, if the ultrasound is limited, a solid mass may be confused for a fluid-filled mass. Under these circumstances, you may be asked to follow-up in six months. The problem with all of these permutations is delay, and you cannot afford delay with ovarian cancer. Make sure that your radiographic studies, whatever they may be, are read by a skilled specialist in the interpretation of whatever study you undergo.

As we always say, be your own patient advocate and be an informed patient. Be an active participant in your medical care by being informed and by demanding the care you require. Having an understating of the types of mistakes that can be made during medical treatment is simply prudent.

Please share your familiarity or experience with ovarian cancer treatment. What do you think women should watch out for should they find themselves afflicted by this terrible disease?

For more information, see our other blogs:

Ovarian Cancer – Early Intervention is Key, What You Must Know…

New study links gene to ovarian cancer and may assist in early detection 

Ovarian Cancer – The Smear Test Won’t Tell You Much

 

Image from cancersyptomspage.com

Ovarian Cancer – Early Intervention is Key, What You Must Know…

Monday, January 3rd, 2011

According to the American Cancer Society, about 22, 000 women are diagnosed with ovarian cancer in the U.S. each year; about 14,000 of these patients will die as result of their cancer.  It is most noteworthy that the five-year survival rate is 90% when ovarian cancer is diagnosed before it has spread beyond the ovaries.  Yet, only about 20% of ovarian cancers are detected in the early stages.

Screening, more screening, monitoring and an understanding of the signs and symptoms of ovarian cancer are key to early detection.  A myth that must be dispelled is that cervical cancer is the same as ovarian cancer.  Just because a patient has a normal pap smear, does not exclude the possibility of ovarian cancer. Simply put, the pap smear test has nothing to do with the diagnosis of ovarian cancer. Unfortunately, recent studies suggest that many women rely on their normal pap smear result to conclude that they do not have an ovarian problem.

It must also be understood that what some doctors loosely characterize as an ovarian cyst does not necessarily exclude the possibility of ovarian cancer. If your doctor tells you that you have an ovarian cyst because of a mass identified on ultrasound, make sure to inquire about the basis for the conclusion that the mass is”just a cyst.” Sometimes the ultrasound is the only study performed to identify the mass.  As great as ultrasounds are, they are not always the most accurate studies.  This is particularly true for patients who are obese or overweight. Radiologists will often read ultrasounds in such patients as limited because of “body habitus” (the physique of the patient). Keep in mind that most of these ultrasounds are performed in clinics, and they are read by obstetricians, who are not trained radiologists. You must ask your physician if the mass is a solid mass or a mass filled with fluid. If it is a solid mass or your physician cannot answer the question, you may want to consider further studies. Don’t let your physician simply guess that the mass must be a cyst because of its size or because of some general statistical probability. In any event, both cysts and solid masses require further monitoring.

The symptoms of ovarian cancer include but are not limited to:

  • Swollen abdomen
  • Unusual or excessive vaginal bleeding
  • Pelvic and/or abdominal pain and/or heaviness
  • Back pain
  • Unexpected weight gain or loss
  • Increased urinary frequency or urgency
  • Lethargy
  • Constipation
  • Indigestion
  • Nausea and vomiting

If you and your physician suspect ovarian cancer, the following are useful diagnostic modalities:

  • Alpha fetoprotein
  • Blood chemistry
  • CA125 (may be done if ovarian cancer is strongly suspected or has been diagnosed, and to follow the cancer during or after treatment)
  • CBC
  • Quantitative serum HCG (blood pregnancy test)
  • Urinalysis
  • Abdominal CT scan or MRI of abdomen
  • GI series
  • Ultrasound
  • Pelvic laparoscopy
  • Exploratory laparotomy

If you are experiencing these symptoms, you may want to address the possibility of ovarian cancer with your physician.  Some physicians will generally perform an ultrasound. If they are not impressed with the ultrasound, they may not pursue any other diagnostic modalities.  If the ultrasound reveals a mass, some physicians may elect to wait and perform a follow-up ultrasound in a few months.

Notwithstanding how aggressive your physician is to rule out ovarian cancer, remember that physicians rely on your feedback, and you alone truly know the extent and severity of your symptoms.  Depending on your clinical presentation, waiting for 3 or 6 months for a repeat ultrasound may be unacceptable. Ovarian cancer can spread quickly within a matter of a few months from a stage I cancer to a stage IV cancer.  Take the initiative to fully explore all available diagnostic modalities with your physician. Don’t be uncomfortable asking your doctor for additional diagnostic tests or more frequent monitoring.  The worst thing you can do is become a passive participant in a complex and stressful process guided by a physician, who may not fully appreciate the extent and severity of your symptoms.

If you are an ovarian cancer patient, share your story with our readers. How long did it take for you to find out you had ovarian cancer? In retrospect, what would you have done differently as a patient?

Related Blogs:

New study links gene to ovarian cancer and may assist in early detection
Ovarian Cancer – The Smear Test Won’t Tell You Much

New study links gene to ovarian cancer and may assist in early detection

Tuesday, August 10th, 2010

A new study by Yale University Cancer Center identifies new genetic markers that may be used to assess a woman’s risk for ovariancancer. Specifically, researchers concluded that women with variations or mutations of the KRAS gene were more likely to develop ovarian cancer. The KRAS gene is a stretch of DNA, which is specifically designed to code the KRAS protein. The KRAS protein serves an important function in tissue signaling. In many ways, the protein is a catalyst. When it is activated, it  promulgates various growth factors and stimulates a number of receptors. It has been known for some time that KRAS gene variations or mutations are linked to various types of cancer. This study suggests that the KRAS gene variation is specifically linked to ovarian cancer.

About a quarter of all patients with ovarian cancer were found to have a KRAS gene mutation. About 61% of the patients with ovarian cancer that also had a family history of ovarian or breast cancer were found the have the KRAS gene mutation as well.

To date, scientists have identified a number of genetic markers for ovarian cancer. Among the better known markers are the BRCA1 and the BRCA2 genes. The new KRAS marker appears to have a stronger correlation to ovarian cancer. While about 50% of women with ovarian cancer had the BRCA1 and BRCA2 genes, 60% of women in the same patient population had the KRAS gene mutation. It is also important to note that women with the BRCA genes were more likely to develop ovarian cancer at a younger age. In contrast, the incidence of ovarian cancer in the population of women with the KRAS mutation was more prevalent after menopause.

The Yale study appears to be great news for all women. Ovarian cancer is a particularly difficult and lethal cancer because of its apparently latent and suttle  development. The sings and symptoms are not easy to recognize, and for many women, it is often too late by the time the cancer is diagnosed. This study suggests that testing for KRAS gene mutations is a significant step forward to better screen and assess women for ovarian cancer. For more information on ovarian cancer, please read our prior posting entitled Ovarian Cancer – The Smear Test Won’t Tell You Much.

Ovarian Cancer – The Smear Test Won't Tell You Much

Sunday, February 28th, 2010

According to an article published by the UK Press Association, a UK study revealed that one in three women mistakenly believe that a smear test can diagnose ovarian cancer. The test is also known as Papanicolaou test, Pap smear, Pap test, or cervical smear.

[The smear test] is a screening test used in gynecology to detect premalignant and malignant (cancerous) processes in the ectocervix. … In taking a Pap smear, a tool is used to gather cells from the outer opening of the cervix (Latin for “neck”) of the uterus and the endocervix. The cells are examined under a microscope to look for abnormalities. The test aims to detect potentially pre-cancerous changes (called cervical intraepithelial neoplasia (CIN) or cervical dysplasia), which are usually caused by sexually transmitted human papillomaviruses (HPVs). The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. The test may also detect infections and abnormalities in the endocervix and endometrium.

While the smear test is customarily used to diagnose cervical cancer, it is not very helpful in diagnosing ovarian cancer. Cervical cancer and ovarian cancer are distinct medical conditions with distinct symptoms. Cervical cancer refers to malignant tissue developing in the cervix – the organ, which connects the uterus and the vagina. Last year, there were about 4,070 deaths associates with cervical cancer. The smear test is effective in diagnosing cervical cancer.

Ovarian cancer refers to malignant tissue in one or both of the ovaries. Last year, there were about 14,600 deaths associated with ovarian cancer – a much higher mortality rate when compared to that of cervical cancer. Symptoms of ovarian cancer include, but are not limited to : abdominal pressure, abdominal distention, urinary urgency, abdominal pain and discomfort, indigestion, constipation, changes in menstruation, lethargy, and pain during intercourse.

According to the article,

Almost one in three women (29%) mistakenly believe a smear test will pick up signs of ovarian cancer. …  Only 4% are confident they could spot symptoms of the disease themselves and many believe it is less common than cervical cancer. … The poll of more than 1,000 women found that twice as many (66%) had been given information about cervical cancer as those who had details on ovarian cancer (33%). Of women diagnosed with ovarian cancer, more than half (56%) did not know anything about the disease beforehand.

These numbers reveal a dangerous misconception about ovarian cancer. Many more women are diagnosed with ovarian cancer than cervical cancer. Moreover, many more women die as a result of ovarian cancer than as a result of cervical cancer. Early diagnosis is key in both instances. In this regard, being knowledgeable about these medical conditions can be a matter of life and death. Be mindful that a smear test is not helpful in diagnosing ovarian cancer.

Contributing author: Jon Stefanuca