When you
get a diagnosis of Ovarian Cancer the only word you really hear at first is
"cancer". It's such a huge shock and a life changing moment
that you can't really take anything else in. However, you'll soon want to know
more your specific type of cancer. Where is the cancer? How serious
is it? Can it be treated, and if so, how? What are the chances of
success of these treatments? What caused it? How did I miss the
symptoms? Below I'll share with you some of the things I've learned about
Ovarian Cancer.
Symptoms
I had no
idea about the symptoms of ovarian cancer and like most women who are diagnosed
with this type of cancer, I was diagnosed quite late, after it had spread to
other areas in my body. As the cancer develops deep inside your body you
don't tend of get much of an early warning, but there are signs that you can
look out for:
- bloating or stomach cramps
- pelvic or abdominal pain
- feeling full quickly or difficulty eating
- needing to go to the toilet often
I noticed
bloating and stomach cramps, but only a few weeks before my diagnosis.
When you
are diagnosed with ovarian Cancer you will learn that your cancer is measured
in two ways. Firstly with a CT scan, which measures how much visible
tumour there is. And secondly by a blood test, which measures a protein
in the blood produced by mainly cancer cells called CA-125. The
reason that I have underlined these two words if that neither of these methods
are 100% reliable and one of the things I was shocked to discover at one of my
first consultations, is that there is no way of reliably detecting if there
is any cancer left after treatment. This is hard to take in as you then
realise that you will never be able to breathe a sigh of relief knowing that
the cancer has gone for good - this is something you have to learn to come to terms with.
The
doctors will use the information gathered from your surgery, scans and
pathology results to determine how bad your cancer is. This is done in two
ways: firstly what Stage it is, which indicates how much it has spread, and
secondly what Grade it is, which indicates how fast it is spreading. I
was diagnosed with Stage 3b, Grade 3. Both the Stages and the Grades go
from 1 to 4, with 4 being the worst. As Ovarian Cancer is not easily
detected, most women are diagnosed with Stage 3 or 4.
It is
also worth noting that most women are diagnosed after their menopause.
The average age at which women are diagnosed is 63 (see this article for more
about the risk factors for Ovarian Cancer: Ovarian Cancer Risk Factors). However,
there are many younger women who get Ovarian Cancer - I was diagnosed at the
age of 38.
Treatment
Ovarian
Cancer is conventionally treated first with surgery (typically called debulking
surgery as it removes the bulk of the cancer) and then with chemotherapy, if
not all the cancer could be removed through surgery. The surgery often
involves a full hysterectomy and the surgeon may remove other 'non-vital'
organs as well if it might help to eliminate the cancer. I had a full
hysterectomy and they removed my omentum and appendix. As I had not yet
started my menopause, the removal of my ovaries immediately brought on the
menopause for me. Menopause brought on by surgery can often result in
stronger symptoms than menopause that happens naturally. I suffer quite
badly with hot flushes. I've tried various different remedies for this
but found that progesterone cream and genistein supplements help me the most.
When it
comes to chemotherapy, in the UK there is a one-size-fits-all approach and
patients with ovarian cancer are given a standard combination of Paclitaxol
(taxol) and Carboplatin, as these drugs have been shown to give the best
results for initial treatment after diagnosis out of those available. It
is worth mentioning here that the NHS assesses 'best results' by looking at two
things: Overall Survival and Progression-Free Survival. In the world of
cancer treatment, Overall Survival tends to mean the chances of living for
another 5 years. Progression Free Survival means the period of time after
treatment before your disease starts to get worse again. Neither of these
are long-term indicators and you will probably find, as I did, that the medical
profession seem to only be interested in prolonging
life rather than curing the cancer
and that they seem pleased if they find a way to give you a few extra
months. There is a presumption that this is best for you and that it is
better to have a good chance of
extending life by a little than a slim
chance of extending life by a lot.
If you
are not familiar with chemotherapy you will learn that chemotherapy is
effectively an indiscriminate poison – it kills cancer cells but kills other
healthy cells at the same time, hence why people lose their hair with some
chemo drugs (including Paclitaxol). The
treatment is highly toxic and has significant side effects, including damaging
your immune system, but it does usually work, at least at first. However, as we use our immune system to fight
off disease, long-term damage to the immune system reduces the body’s ability
to fight off this and other diseases as it normally would, and it can take a
long time for the immune system to get back to full strength after 6 cycles of chemotherapy.
Prognosis
Unfortunately
although Ovarian Cancer tends to initially respond very well to chemotherapy, reoccurrence
rates are very high, as this form of cancer is very hard to kill off completely
- it only takes a few surviving cancer cells for the cancer to be able to
spread again. Repeated chemotherapy is common but over time the cancer
builds up resistance to the available drugs and if this happens you eventually
run out of options. I am being very blunt here but sadly these are the
facts - the average 5-year survival rate for late-stage ovarian cancer patients
is between 17% and 39% (Ovarian Cancer Survivor Rates).
However, it is important to remember that these are averages and nobody is
average. There are long-term survivors and there is no reason that you
should not be one of them. There is hope.
I am
doing all I can to improve my prospects by following the best advice I can find
about diet and lifestyle and by exploring alternative treatments that are not
available under the NHS. When you start to research cancer treatments you
will soon learn that the NHS can only offer drugs that have been through
extensive and costly clinical trials to prove that the benefits they bring are
worth the cost. The costs of these
trials are met by the drug companies who will go on to profit from the drugs if
the trials show that the drugs work.
However, there are many natural substances that have been shown to fight
cancer which haven’t been through clinical trials as no one company can lay exclusive
claim to them, so there is no business case for investing in trials. Without clinical trials to prove the benefits
the NHS can’t prescribe these substances.
However, most are readily available and have been used as non-toxic
treatments for cancer for years with varying success. I can't say what is best for you - only you
can decide that - but I do recommend doing as much research as you can as there
are other options for treatment than chemotherapy. A good book to inspire you about this is "Mum's Not Having Chemo" by Laura Bond. If you want to buy it, search for it using my Amazon link on the right and you'll give my fundraising a boost at the same time!
