Recently, an angel was diagnosed with ovarian cancer. She is 87-years-old. I have known her for many years. She is an angel because she is kind, she is generous, she is caring and she believes in miracles. She has been an excellent wife, mother and grandmother. She lost her husband 17 years ago but managed to survive in Canada without speaking any English. She is one tough lady.
But now her time is up. Doctors have said her prognosis is poor. Once cancer has spread it is usually a losing battle. But how long the battle will last is anybody’s guess. In the meantime my angel is wasting away – slowly and sometimes painfully. Her sprit is high but the energy level is low. What keeps her going is her family and friends. Some of them have flown from all over the world. They are here to say thanks for the memories and good-bye. They want to pay their last respects.
Each year, about 2400 Canadian women or angels are diagnosed with ovarian cancer. Sadly, 1700 women with the disease die each year. In North America, ovarian cancer is the second most common gynecologic malignant disease and is the leading cause of death among women with gynecologic cancer.
Why do so many women die of ovarian cancer? More than 60 per cent of the women are in advanced stage when first diagnosed. Their five year survival rate is less than 30 per cent. Their prognosis is poor and they have very few treatment options. Some studies have reported higher survival rates of greater than 90 per cent in women with stage one disease. Only 25 per cent of the women are diagnosed early.
Is there anyway we can detect ovarian cancer early? In early stages symptoms are usually non-specific and vague, but as the disease progresses they may include abdominal distention or pain, change in bowel and/or bladder habits, and gynecologic complaints such as pain during intercourse. Pelvic examination does not help in early cases but generally detect ovarian cancer that is at an advanced stage. So, early diagnosis is difficult.
There have been several studies to examine the efficacy of routine ultrasound and screening using blood test CA125 for early detection. Unfortunately, these techniques have not been clearly shown to be effective for early detection. Therefore, there is no recommendation to use ultrasound or CA125 blood test for screening.
There are two risk factors for ovarian cancer: first, 10 per cent of women with ovarian cancer have a family history of the same disease and second, a much larger group includes postmenopausal women who are over 50 years of age, in whom 90 per cent of ovarian cancer occurs sporadically.
One study suggests that women who do not have regular medical check-ups or pelvic examinations and who have no regular family physician or health care provider are at increased risk of ovarian cancer. The authors of the study say that although the exact mechanism of this association is unknown, women, especially those who are postmenopausal, should be encouraged to maintain regular medical care. Women who are found to have benign diseases of the ovary are also thought to be at a higher risk for ovarian cancer.
Many aspects of ovarian cancer are poorly understood. So screening is not currently recommended for the general population. There are a number of trials going on which may give us answers in the future. But this may take many years.
For now, there isn’t much good news for women in general and my angel in particular. I hope she does not suffer for too long. Some days pain and vomiting is unbearable. Some days things are not bad. I worry and have sleepless nights about my angel because she is precious and she is my mother.
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