Unmasking the silent killer

Around 400 women in Ireland are diagnosed with ovarian cancer every year and up to 270 die from the disease annually. The cause is unknown, but symptoms can be vague so it is important for women to be vigilant, know the signs and seek help if they have any concerns.

Wednesday marks World Ovarian Cancer Day and Ireland’s foremost ovarian cancer campaigners, researchers and patient advocates are advising women across the country not to ignore the warning signs of a disease commonly known as the ‘silent killer’.

Caroline Quinn knows only too well the dangers of this strain of cancer. Three years ago, after several months of “minor ailments”, she suffered strong stomach pains and was admitted to hospital where it was discovered she had a cyst in her bowel. This news was not welcome, but it was nothing compared to the shock she felt a few months later when she was diagnosed with ovarian cancer.

“I started to notice that my periods were harder to get through. I was always tired, had a lot of bloating and felt very full after meals,” says the Cavan woman, who is married to Martin and has three sons.

“Then I got severe abdominal pain and was admitted to hospital where a scan showed that I had a cyst. Instead of getting better, the pain got worse over the coming months, so I opted to have it removed and during surgery, they discovered that my bowel and womb were stuck together, so they decided to do some biopsies.

“But when I woke up [after the procedure], my world came crashing down as I was told I had ovarian cancer – I fell into my husband’s arms and we just cried and held each other.”

The 43-year-old, who works as an accounts manager, was told she had stage three cancer and would need both extensive surgery and chemotherapy.

“I had numerous organs removed, including a full hysterectomy, spleen, gall bladder, appendix, half of my stomach, part of my colon and liver, and also some tissue,” she says. “I had to learn to walk again and was fed through tubes, but I got through it all thanks to the excellent care in the Mater Hospital where the staff are amazing.

“I made little goals such as taking two steps one day and four the next. Every day the doctors would come and talk to me and the nurses would smile, so I smiled back through the pain and kept going. The wards are obviously hard places to work, but the happiness and positivity just shines through these people. I was eventually moved to another ward where I met an amazing woman called Bridie, who was also a patient and became like a mother to me while I was in there.”

Caroline left hospital with a colostomy bag and an appointment for chemotherapy, which she found very tough, but thanks to family and friends, she made it through.

“After leaving hospital, I had to face chemo and deal with the bag, but I was so happy to get home to my husband, my boys, my pets and my beloved horse,” she says. “I live in a small parish and everyone was so nice to me – sometimes they didn’t know what to say, but would just give me a hug and a smile. My friends also helped me through it by bringing me to appointments, to get my head shaved and fitted for a wig – we had lots of laughter and tears as best friends do.

“Cancer is horrible and we dread hearing the word, but I believe positivity, love and prayers all help. Life is so precious and sometimes we can overcome so much by being positive in the face of this terrible disease.”

Ann Marie Hoade has also had to face ovarian cancer. The Galway woman thought she had a kidney infection and was originally diagnosed with ovarian cysts, but when the pain continued, she was referred for further tests which revealed the bad news.

“I had frequent urination and pain in September 2016, and thought I might have had a kidney infection,” says the 43-year-old. “I googled ovarian cysts after a friend said she had them and suffered with very bad pain. But then I woke up one morning with such terrible pain that I got sick, so I went to the doctor who diagnosed me with cystitis and prescribed antibiotics. The pain disappeared but returned a few weeks later and I noticed that my stomach was bloated, so I went back to the GP who said it could be IBS or an ovarian cyst. He gave me some pain killers and said to come back if it didn’t go away. But I spoke to a friend who advised me to get it checked further, so I went back a third time and the doctor referred me to a consultant who sent me for a pelvic ultrasound and CT scan, which revealed a cyst on each ovary and spots on my lungs – I was very worried.” Further tests revealed that the spots on her lungs were due to a condition called sarcoidosis and doctors suggested a hysterectomy would be the best course of action to deal with the cysts.

“I had surgery in February 2017 and afterwards, the doctor said he had seen some suspicious lumps and bumps in the pelvic area and I might need further treatment,” says Ann Marie.

“This was my first inkling that I might have cancer – then during my post-surgical review, I was told that cancer had been found in both of my ovaries and the stomach area and I would need six to eight sessions of chemotherapy every three weeks. I was totally shocked and spent the next few days in disbelief, and couldn’t get my head around the fact that I had stage 3 ovarian cancer.

“I started my chemo two weeks later and finished in August 2017. Then the doctor said he would test me for the BRCA gene and last summer I found out that I tested positive for it. This was even more of a shock as there is no family history of it, so I am now being monitored for breast cancer. I have been told I have an 80pc chance of getting it in my lifetime and am being encouraged to have a double mastectomy, but have to wait until I am three years post chemo in case the ovarian cancer comes back.”

There is no national ovarian screening programme in Ireland at present. But the ICS advises all women to be aware of the BEAT signs and symptoms.

What are the BEAT signs?

⬤ Bloating that is persistent and doesn’t come and go.

⬤ Eating less and feeling full more quickly.

⬤ Abdominal and pelvic pain you feel most days.

⬤ Toilet changes in urination or bowel habits.

The charity says it’s also important for women to know that cervical screening tests (smear tests) will not pick up signs of ovarian cancer so again, listening to your body and being aware of persistent symptoms is key.

Indeed, cancer survivor Ann Marie says women should always seek advice if they are worried about something, regardless of how insignificant they may seem.

“I would urge every woman who has any symptoms, which are even vaguely associated with ovarian cancer, to get checked out,” she says. “I would have put it on the long finger if it wasn’t for a friend telling me to go to the doctor – and that would have been a totally different story.”

The cause of ovarian cancer is unknown, but there are certain risk factors that can increase your chances of getting the disease. These include:

⬤ No children: Ovarian cancer is more common in women who have not given birth;

⬤ Age: As you get older and have gone through the menopause, you are more likely to develop it;

⬤ Family history of cancer: A faulty gene can lead to ovarian cancers in a very small number of women. It is also linked to the faulty genes found in breast cancer. If you or a member of your family have a history of ovarian, breast, womb or bowel cancer, your risk is higher. If your mother or sister gets ovarian cancer, you have an even higher risk of the disease.

⬤ HRT: There is a slightly higher risk if you have received hormone replacement therapy (HRT) and received drugs to stimulate the ovary during infertility treatments. Some research suggests that being infertile may be a slight risk, but research is ongoing to know for certain.

If you feel you may be at risk of ovarian cancer, first talk to your family doctor, who may advise you to visit a specialist.

There are also specialist clinics for people worried about the risk of ovarian cancer in their family; some may offer screening or genetic counselling. Your family doctor will advise on what to do.

Wednesday May 8 is World Ovarian Cancer day. For more information visit cancer.ie or call the Cancer Nurseline on Freephone 1800 200 700.

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