When women worry about cancer, we tend to think first of our breasts. What woman hasn’t been exposed to numerous messages about the importance of mammograms and breast self-exams? Skin and cervical cancer also get a fair share of media attention. But ovarian cancer? Not so much.
That’s changing. September is national Ovarian Cancer Awareness Month, and St. Louis Ovarian Cancer Awareness (SLOCA), a network of patients, survivors and medical professionals, is working to educate area women about this stealthy and dangerous disease.
“The scary thing is that there is no screening exam or very obvious symptom of ovarian cancer,” says Karen Higano, a member of SLOCA who was diagnosed in 2005 at age 39. Higano’s case is unusual, both because of her relatively young age at the time of diagnosis and because of the circumstances surrounding it, she was told she had the disease on the day she was scheduled to leave the hospital with her newborn son.
Higano delivered her son via Caesarean section after a 36-hour labor. “When my son was born, the doctor saw four ovarian cysts that were removed at the same time,” she says. While the obstetrician wasn’t concerned, the cysts were sent to pathology for routine analysis. One of them was malignant.
“I was absolutely in shock,” Higano says. “I spent the week after my baby was born going to doctors to figure out what to do next.” Five weeks after giving birth, Higano had a total hysterectomy and began six courses of chemotherapy, administered every three to four weeks. “My first year with my son was spent fighting cancer. It’s not what I expected at all,” she says.
Now cancer-free for more than three years, Higano treasures every day. “I don’t worry about the little things, like whether the house is a bit dusty. If my son wants to play outside, we play. I enjoy every single day with him.”
Higano was fortunate to find her cancer early when it was most treatable. Although the incidence of ovarian cancer has decreased during the last 20 years, the American Cancer Society (ACS) estimates that about 21,650 new cases of ovarian cancer will be diagnosed in the United States during 2008. Most of those cases are in women older than 55, and many are not discovered until the cancer has spread. The ACS reports, “If ovarian cancer is found (and treated) before the cancer has spread outside the ovary, the five-year survival rate is 92 percent. However, less than 20 percent of all ovarian cancers are found at this early stage.”
Lisa Sienkiewicz, a SLOCA spokeswoman, was the fourth member of her family diagnosed with ovarian cancer, although none of the others were first-degree relatives (mother, sister or daughter). “I was the first member of my family to go to college, and I now have the distinction of being the youngest (45) diagnosed with cancer,” she says.
Although Sienkiewicz had experienced some menstrual irregularities, infertility and gallstones, it wasn’t until she began having heavy, irregular bleeding and subsequently was diagnosed with endometrial cancer that she went ahead with a hysterectomy. “I was told the next morning that there was cancer in an ovary,” she says. “The cancer was too small to be found in the operating room. It was discovered at the lab in a frozen dissection of the ovary.”
Sienkiewicz had a follow-up surgery to remove abdominal lymph nodes and underwent three courses of chemotherapy. She is now cancer-free but carefully monitors her health and is watchful for symptoms of other types of familial cancers, including colon, liver, pancreatic and stomach.
Symptoms of ovarian cancer include abdominal swelling or bloating, pelvic pressure or abdominal pain, difficulty eating or feeling full quickly, and/or urinary symptoms (having to go urgently or often). The ACS states, “Most of these symptoms also can be caused by other, less serious, conditions, but when the symptoms are caused by ovarian cancer, they tend to be more severe and are a change from how a woman usually feels.” Symptoms that occur daily for several weeks and cannot be attributed to another obvious cause should be assessed by a physician.
“My ovarian cancer would not have been found if it weren’t for the endometrial cancer,” Sienkiewicz says. “And if ovarian cancer is going to whisper, then I plan to yell as loud as I can about its signs and symptoms so that others won’t have to suffer.”