The fight against ovarian cancer

MONTREAL — Each year, over 2,600 Canadian women are diagnosed with ovarian cancer, and more than half succumb to the disease. These figures make this malady the most serious of all gynecological cancers.

Research shows that many types of tumours can start growing in the ovaries. Most are benign (non-cancerous) and never spread beyond the ovaries. Benign tumours can be treated successfully with surgery, by removing either the ovary or the part of the ovary that contains the tumour. Tumours that are not benign are malignant (cancerous) and can spread (metastasize) to other parts of the body. They require more complex treatment.

According to the Ovarian Cancer Canada website, ovarian cancer is not easy to diagnose as the symptoms in the early stages may be vague. The symptoms makes for scary reading, because at any given time, a woman may experience some or all of these problems for any number of other non-life threatening reasons: swelling or bloating of the abdomen; pelvic discomfort or heaviness; back, leg or abdominal pain; fatigue; gas, nausea and indigestion; change in bowel habits; frequent urination; menstrual irregularities; and weight loss or gain.

If you have one or more of the above  symptoms and they persist longer than three weeks, visit your family doctor and/or gynecologist. Early detection and treatment of ovarian cancer could bring the survival rate to as high as 90 per cent.

The Ovarian Cancer Canada website notes that most Canadian Jewish women are of Ashkenazi descent, and about one in 50 Ashkenazi Jews carries a BRCA 1 or BRCA 2 gene mutation that increases the risk for breast, ovarian and related cancers. This mutation can be inherited from either the mother or father’s family.

Increased risk of ovarian cancer includes family history of breast, ovarian or colon cancer; never having children; age (it is most common after age 50); and never having used oral contraceptives.  Risk reducers are use of birth control pills; breast-feeding; tubal ligation; term pregnancies; and removal of the ovaries, if risk is high.

In 1985, at 34 years old, Gurit Lotan was diagnosed with LMP (low malignant potential) ovarian cancer, also known as borderline epithelial ovarian cancer. A slow-growing tumour that is not well understood, LMP ovarian cancer is usually a non-life-threatening condition that tends to affect pre-menopausal women. This disease is distinct from the most common forms of ovarian cancer in its evolution and treatment modalities.

Lotan had been experiencing various ailments, including indigestion, constipation, diarrhea and severe backaches for quite some time before she took action.

“It was more than a month of not feeling well and friends telling me how ragged I looked before I went to see my family doctor,” says Lotan, a child psychologist.

The doctor attributed her complaints to constipation and suggested she increase her intake of bran and orange juice. This did not help and her discomfort increased to the point that she was unable to tolerate eating anything. Her abdomen continued to increase in circumference, and the pain became so severe that she was unable to even tolerate any fabric against her skin.

“When I began to bleed vaginally, that is when I called the gynecologist,” says Lotan, “finally admitting to myself that something was seriously wrong with me.”

 She learned that she had a very large ovarian cyst and was admitted to hospital. The imaging studies suggested it was indeed a very large mass and that it was most likely benign.

“So I went into surgery optimistic, except that I had been prepared that I might need a colostomy,” continues Lotan.

On seeing the surgeon’s face after her surgery, she knew bad news was coming, even before he uttered the word “malignant.”  

The chemotherapy she received post-surgery caused life-threatening complications, and she became despondent when she realized that the doctors were at a loss as to what to do.

“Finally I was put on a treatment that slowly brought me back to a physical state where chemo could be resumed,” she says.

Five years later, as she was rejoicing at the possibility of being “cured,” she had a recurrence, which was more traumatic than her first bout of cancer. In spite of several surgeries, the disease continued to recur and treatment options kept decreasing. She also sought consultations from specialists in the United States.

“The responses were the same, that I was getting the best care possible and there were no other indicated approaches,” she says.

Eight years ago, her oncologist went out on a limb, giving her a medication that had been used to treat breast cancer.  It shrank the tumour that she had been told was inoperable.

“If I’m still here, it’s thanks to him,” she says.

It has been well over 20 years since Lotan was first diagnosed, and she says she truly feels fortunate to have so many caring people supporting her on this difficult journey.

“I see it as an unpredictable journey, as I never know where it will take me, both in terms of challenges to overcome and new friends who have entered my life,” says Lotan, who became involved with the Ovarian Cancer Canada (OCC) organization about four years ago.

OCC is a registered Canadian charitable organization dedicated to overcoming ovarian cancer, raising awareness and funding research. For Ovarian Cancer Awareness Month in September, OCC  has organized two events: the 2008 Winners Walk of Hope, which takes place on Sept. 7 in Mount Royal Park (Smith House), and the Voices of Hope conference, scheduled for Sept. 26 to 28 at the Delta Montreal hotel. To register for the walk, go to www.winnerswalkofhope.ca, or phone 1-877-413-7970. For information about the conference, visit www.ovariancanada.org.