By Marie Y. Lemelle
After seven months of panic, anxiety and stress, coronavirus continues to captivate our attention. Medical professionals warn that fear of seeking treatment, especially for cancer patients, should not be the reason to stop therapy for chronic conditions such as ovarian cancer.
Ranked fifth in cancer deaths among women, the American Cancer Society estimates in the United States for 2020 more than 21,000 women will be diagnosed with ovarian cancer and more than 13,900 will die. The National Ovarian Cancer Coalition reports that all women are at risk and pap tests do not detect ovarian cancer.
In 2010, President Barack Obama declared the month of September as National Ovarian Cancer Awareness Month to bring awareness to the public about early warning signs to ultimately save lives. While there has been a lot of research to develop a screening test, there still are only two tests available and they are not considered 100% reliable.
In this COVID-19 environment, women who have battled or are actively fighting ovarian cancer are at high risk because they are immune compromised. Statistics show that one in 78 women will get ovarian cancer and one in 108 will die from it. Dr. Nolan Jones, a board-certified OB/GYN based in Los Angeles, studied trained, and taught at Martin Luther King Jr. Community Hospital in Los Angeles. In 2009, he retired to focus on medical research and a birthing chair technology. Jones talks about Monica, a patient who was diagnosed with ovarian cancer at the age of 14.
ML: Tell me about Monica’s journey.
NJ: Monica, a 14-year-old teenage girl who is smart, very outgoing, energetic, was not sexually active although was kissed by a boy and “it felt funny.” She began to experience bloating, fatigue and swelling of her stomach which increased. Finally, she told her mom who strongly suspected pregnancy, which she strongly denied. The family doctor did a common pregnancy test, which showed a positive result. Immediately everyone was in shock and Monica broke down in tears. Confused, ashamed and sickened, she withdrew and melted into a downward emotional spiral of depression.
An ultrasound of her pelvis was soon performed that surprisingly revealed a pelvic mass and no evidence of pregnancy. She was greatly relieved, but now even more confused by her progressive abdominal swelling and constant fatigue. After laboratory tests, physical examinations and diagnostic radiographic procedures, it was confirmed she was not pregnant. Excess female hormones were produced by the cancerous ovarian cells, which can be falsely interpreted as pregnancy.
Instead Monica was diagnosed with ovarian cancer, germ cell type. Her germ cell type cancer was in Stage 3. Her physician advised her family to agree to surgery for Monica to safely remove all visible evidence of cancer followed by several courses of chemotherapy.
ML: What is ovarian cancer and germ cell type?
NJ: Cancer of the ovary is the most common gynecological cancer. Ninety-five percent of ovarian cancers are epithelial type. The rest is either germ cell cancer or a mixed type. No other group of cancers encompasses such a wide range of biologic, pathologic and clinical diversity and their occurrence is predominantly in adolescent girls. Cancer of any type, including ovarian, can be benign or malignant.
ML: Explain the different types of ovarian cancer and how serious is the germ cell type?
NJ: The types of ovarian cancer are categorized by the cells of origin. Since the ovary is a major sex organ it comprises cells that produce primarily two female hormones, estrogen and progesterone. Additionally, other hormones that participate during the childbirth experience are also timely created. While Monica’s cancer is very serious, her chances of being cured were favorable.
ML: How varied are ovarian cancer symptoms?
NJ: Early stages of ovarian cancer are mostly symptomless, but symptoms noted during the advancing stages are abdominal swelling, fullness and pain, feeling full after eating very little, tiredness, change in bowel and bladder habits, shortness of breath, leg swelling, abnormal menstruation, weight gain/loss, and unexplained back pain. The advance stages may present with conditions such as pleural effusion (fluid in the lungs); small bowel obstruction and venous thromboembolism (blood clots).
ML: What are the current screening tests used for ovarian cancer?
NJ: The two tests are not reliable, but are used most often are transvaginal ultrasound (TVUS) and the CA-125 blood test. TVUS uses sound waves to look at the uterus, fallopian tubes and ovaries by putting an ultrasound wand into the vagina. The CA-125 blood test measures the amount of a protein called CA-125 in the blood. Many women with ovarian cancer have high levels of CA-125. This test can be useful as a tumor marker to help guide treatment in women known to have ovarian cancer. The problem is, not everyone who has ovarian cancer has a high CA-125 level.
ML: Describe the four stages of ovarian cancer.
NJ: The four stages are: One: the cancer is confined to the ovaries and hasn’t spread to the abdomen, pelvis or lymph nodes, or to distant sites. Two: the cancer is in one or both ovaries and has spread to the pelvis organs such as fallopian tubes or uterus. Three: the cancer is in one or both ovaries and has either spread beyond the pelvis to the lining of the abdomen or the cancer has spread to the lymph nodes in the back of the abdomen. Four: the cancer has metastasized to distant sites, such as the spleen, liver or other organs outside the abdomen and pelvic region.
ML: How is Monica?
NJ: The good news is Monica recovered successfully and is now a college student.
Marie Y. Lemelle is the founder of www.platinumstarpr.com and a film producer. She can be reached at MarieLemelle@platinumstarpr.com. Follow her on Instagram @platinumstarpr.