All October long, I saw pink ribbons and merchandise touting breast cancer awareness everywhere I went. On bags of pink M&Ms in the grocery store; on lapels; on the Google home page every time I opened my Internet browser. By now, is there any American who’s NOT aware of the disease and the stated importance of early detection?
During this same period, I’ve been dealing with my mother’s stage 3-C ovarian cancer. Dubbed "the silent killer" because it often goes unnoticed until it has progressed, ovarian cancer will touch one in 71 women in their lifetime. (The risk of breast cancer is 1 in 8.) Unlike breast cancer, ovarian cancer is difficult to detect early, when it is most treatable. Even at later stages, it is very treatable, though almost always fatal in time.
My mother turned 90 on October 31, five days after her total hysterectomy and tumor "debulking" surgery–a goal she was determined to reach when diagnosed last spring. It chilled me to realize she’d probably had the disease for some time. I later learned that though she had had regular medical checkups, her physician hadn’t offered her an internal exam in more than 20 years. And so many of her symptoms could so easily be attributed to something else – upset stomach and heartburn to indigestion, shooting pain near her buttocks to a pinched spinal nerve, bloated ankles to water retention from other medications she was taking. It is perhaps no wonder she waited until she was disabled by pain, fatigue, and bloating to go to the emergency room.
The good news is that the chemotherapy drugs used to treat ovarian cancer are some of the more easily tolerated, especially with today’s anti-nausea medications. It wasn’t easy to watch my mother lose her full head of silver hair, but it was very heartening to see her rally a few days after each round, enjoying her Netflix, cooking (and eating) dinner, and arguing as usual with my father.
Ovarian Cancer: The Basics
At 89, my mom was older than the median age of diagnosis, 63. Ovarian cancer is usually a disease of middle to old age (80 percent of those diagnosed with it are between 45 and 84). Some 62 percent of cases are diagnosed after the cancer has already metastasized; at that stage, the relative five-year survival rate is a meager 28 percent, (The 15 percent of patients whose cancer is caught before it’s spread have an impressive 94 percent five-year survival rate.) Ovarian cancer strikes White and Black women the most, although the five-year relative survival rates by race are about 46 percent for White women and only about 37 percent for Black women. There were some 14,600 deaths due to ovarian cancer in 2009 (compared with 40,000 for breast cancer and 4,000 for cervical cancer).
All of these facts are easily accessible on the National Cancer Institute’s (NCI) website (http://www.cancer.gov) and elsewhere. But because it’s not the media darling breast cancer is, you have to seek this information out.
Cervical cancer, which affects "only" one in 145 women, has a much higher profile because methods of early detection (the annual Pap smear) have been developed and implemented into standard reproductive health care. Moreover, there’s now a preventative vaccine that, while still controversial, can be given to girls and young women to prevent infection with the most common virus that causes cervical cancer.
Besides being potentially fatal, later-stage ovarian cancer is particularly devastating because its treatment typically involves not only chemotherapy but the removal of ovaries, fallopian tubes, and uterus, uniquely female organs that are part of our gender identity. Removal of the reproductive organs causes hormonal changes, bringing on instant menopause–with all its unpleasant symptoms–in younger women with the disease. This major abdominal surgery takes several months to heal fully and, as one hysterectomy patient told me, "You don’t feel up to par for about a year."
For those who have not had but wanted children (or more children), the loss of one’s reproductive organs is especially heartbreaking. (Fortunately, if the disease is caught earlier, fertility can often be preserved.)
It may sound a little cheesy, but knowing my mother’s womb would no longer be part of her greatly saddened me. She no longer "needed" it, but it was my first home, before I could even remember.
I don’t know what color ribbon ovarian cancer awareness should adopt, but I do know information on the disease needs to be better promoted.
Few reliable methods of early detection, much less prevention, yet exist for ovarian cancer. More research on identifying ovarian cancer early is needed, as are more effective, less invasive treatments.
Till then, women need to know about symptoms that can be signs of the disease (I’m quoting the NIC here):
- Pressure or pain in the abdomen, pelvis, back, or legs
- A swollen or bloated abdomen
- Nausea, indigestion, gas, constipation, or diarrhea
- Feeling very tired all the time
Now that I myself have a relative with ovarian cancer, I realize that means I’m at greater-than-average risk for the disease. I want some way to protect myself and pre-empt an untimely death. The breast cancer cause is a very urgent one, but let’s not let it crowd out other women’s health problems that also require our attention.