Ears That Hear

September is Ovarian Cancer Awareness Month.  Every woman knows about breast cancer.  Very few know the  symptoms of ovarian. Last month I was a guest blogger at the Scope Blog published by the Stanford School of Medicine. I've printed my column almost in its entirety.  Please read on.

Several years ago we moved back to the Midwest, and I needed to find a family physician. I opted for a female doctor, hoping that as a woman she might be more tuned to my aging female body and to its potential health problems. Potential, I say, because I thought I was in good health.  (Disclaimer...my new doctor was practicing in the Bigger City, not here in our hometown.)

I liked my new doctor and enjoyed my annual physicals and other visits. But looking back, I wish she would have listened more closely to my seemingly minor complaints. I may have been ignorant about the subtle and near-silent symptoms of ovarian cancer, including rib pain and the frequent need to urinate, day and night, but my doctor should have known. I expected her to know.

It was in 2007 when I first mentioned nightly pain under the edge of my bottom right rib.   I told my Doc I couldn’t sleep on my right side. Six months later I mentioned it again, and in late 2008 I once more mentioned the nagging discomfort. During that visit my doctor did a two-second rectovaginal pelvic examination and, as part of my physical, a full blood work-up. The results were still at the lab so before I left I asked her to send me a print-out.
 
Several days later my blood results arrived in the mail. Three pages. At the top of the first page my doctor had written, “Looks great!” endorsed by an inked smiley face. I casually scanned down the first page. Everything looked normal. But when I got to the third page I noticed my alkaline phosphatase reading was abnormally high, and I did what any normal person does these days: I Googled. Possibilities included problems with the gall bladder or liver and that dastardly word “cancer.” (Note! Always ask for copies of blood labs and other tests and read them.)

Naturally, I opted to think it was a gall bladder problem and asked for an ultrasound, which showed a large gallstone that I went in to get removed. 

My gall bladder surgeon was the one to give me the bad news. As I came out from under the anesthesia, his face swirled in the white light above me while he told me he had found cancer in my abdomen and on my liver (right where I had been experiencing pain). I remember distinctly the photos he showed me. Still under the influence of anesthesia, I replied quietly, “That is not good news.”

Fortunately for me, my surgeon referred me to a Gyno/Onc who debulked me, removed 95 percent of the cancer, tied my intestines into little “animal balloons” (I jest only slightly), returned them to my ab cavity and put me back together with 43 metal staples. I had just endured the “mother of all surgeries.” It was a brutal surgery but without it I would be long dead. The official diagnosis was ovarian cancer (stage III-C), and chemo followed. And followed. And followed.

Three and a half years later, I’m on my 5th chemo regimen. All things considered I’m doing fairly well: I lead an active life, do some volunteer work, take care of my home. I’m grateful to be alive. (Yes, I've been bald. Three Times!)

But I can’t help but think that if my doctor had listened more closely, more sharply, with “ears that hear,” to my ongoing complaints about rib pain, or if she had provided me with a simple informational brochure so I would been more knowledgeable, perhaps I would have been diagnosed long before Stage III-C.  

Every woman knows about breast cancer. But very few know about the symptoms or diagnostic tests associated with ovarian cancer – which could be why most of us are diagnosed late in the game, when statistics for survival are grim. Awareness is the most important piece of diagnosis – awareness by both the medical professional and the patient – and so I ask doctors to educate themselves and their patients about this deadly cancer.

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Perhaps it was unfair, but I "fired" that female doctor. Now I work with a family practitioner in our small town.  He watches over my overall health and follows my progress (or lack of it) in regards to my chemo. I like it that he's one of my neighbors and now and then I catch a glimpse of him riding his bicycle home after a long day at the clinic. Without using his hands on the handlebars!  Yikes! I like it even more when he takes the time to sit and really listen as we discuss what is going on in my "health".  

And those "silent symptoms" of ovarian cancer?  They can be easily mistaken for digestive and other problems.  But if symptoms are persistent, YOU be persistent with your Doc. Symptoms can include:

• Bloating
• Pelvic or abdominal pain (including under the bottom right rib)
• Trouble eating or feeling full quickly
• Need to urinate urgently or often (day and/or night)
• Fatigue
• Upset stomach or heartburn
• Back pain
• Pain during sex
• Constipation
• Menstrual changes
• (in my case, a mild anemia with no known cause)

If symptoms persist daily for more than two weeks the National Ovarian Cancer Coalition advises you to ask your physician for a combination pelvic/rectal exam, transvaginal ultrasound, and CA-125 blood test.  Tell 'em I sent ya.

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