Understanding Ovarian Cancer
- Rachel Danchek, a 31-year-old woman from Pennsylvania, suffered bloating, painful periods, and infertility before being diagnosed with stage 3, high grade ovarian cancer. After undergoing fertility preservation and finishing up cancer treatment, she is now cancer free and spreading awareness on the importance of pushing for answers when it comes to your health.
- Ovarian cancer is often harder to catch in its early stages because of its subtle symptoms, such as bloating, weight gain, and abdominal pain, that can mimic regular menstrual cycle fluctuations.
- After ovarian cancer patients complete initial treatment, maintenance therapy may be recommended to try and delay possible recurrence.
- SurvivorNet offers a comprehensive guide to ovarian cancer features advice from some of the nation’s top gynecologic oncologists, to guide you through every stage of the diagnosis and treatment process. Check out SN Local, featuring 20 cities across the U.S., to explore expertise and community near you.
Danchek took to Instagram to offer insight into her cancer journey, writing, “I’m sharing this for two reasons. 1. To spread awareness. You never think it will be you (believe me). Be your own advocate. Cancer is scary but modern medicine is incredible. If I didn’t push for answers in my infertility journey, my prognosis would be a lot different right now.
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As for what led to her cancer diagnosis, she told The Patient Story that prior to her diagnosis she dealt with “really bad periods,” night sweats, bloating, and infertility issues.
She ultimately learned she had cancer at the start of 2024, after doctors did a CA-125 blood test, which is commonly used to measure the amount of cancer antigen 125 (CA-125) present in your blood, and in her case showed to be extremely elevated, and an internal ultrasound, which found a mass on her left ovary.
Danchek explains in one of her Instagram posts, “There are no words in the English language that can articulate how it feels to hear these three words: you have cancer. On the evening of Monday, February 19th, after waking up from a surgery where we hoped to find endometriosis, I heard just that.
“The even scarier part- it took four days of absolute agony and numbness to get the results back from pathology – stage 3b ovarian cancer. A diagnosis most common in women over 60, not an active 30 year old.”
She continued, “After a year of infertility, my doctor found a cyst the size of a grapefruit on my left ovary. A week after surgery, I went through 2 back to back rounds of IVF to save my eggs.”
Danchek then underwent chemotherapy, which she began on April 8 and a second surgery to remove her other ovary, in addition to receiving Hyperthermic Intraperitoneal Chemotherapy.
She later rang the bell to celebrate beating the disease on September 3, 2024.
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Recounting her cancer journey to Newsweek, Danchek said her painful periods were dismissed until she pushed for answers regarding her infertility struggles.
She told the news outlet, “I had terrible periods and the brain fog was crazy—to the point where I was scared to drive during my period. I never felt like leaving my house and would sit on my couch with my heating pad. The night sweats were so extreme that I would wake up drenched and have to change my pajamas.”
Looking back on how she used painkillers, acupuncture and heating pads to attempt to alleviate the pain, she said none of it helped.
It wasn’t until about a year after she got married in June 2022 that she continued pushing for answers as to why she wasn’t getting pregnant.
“The anxiety and bad periods were definitely overlooked, and I just assumed the bloating was weight gain. The main symptom that I kept pushing was infertility, since that was extremely important,” she told Newsweek.
“My OBGYN took me seriously as she knew how important kids were to us. My pelvic exam, blood work and Pap smear were all normal, so she sent me to a fertility specialist who had me do a CA 125 blood test and an internal ultrasound, which showed a grapefruit-sized mass on my left ovary.”
Before undergoing six rounds of chemo, surgery to remove her ovary and appendix, Danchek chose to freeze her eggs. She was thankfully able to collect five embryos.
She added, “We didn’t know if I’d be able to keep my uterus, but I’m so thankful the cancer didn’t touch it and it wasn’t removed. My husband and I are hoping to use a surrogate for our first baby and then I’ll carry our second once I’m done with medication.”
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Battling Ovarian Cancer
Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.
“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.
Many ovarian cancers begin in the fallopian tubes. A few cancerous cells first grow on the fallopian tubes. Then, as the fallopian tubes brush over the ovary, these cells stick to the ovaries and eventually form a tumor.
Helping Patients Understand Treatment Options for Ovarian Cancer
- Advances in Ovarian Cancer Treatment
- ‘An Important Step Forward’: New Drug Combo Shows Promise For The Treatment of Some Ovarian Cancer
- A Targeted Ovarian Cancer Treatment– The Role of Avastin (Bevacizumab)
- An Extraordinary New Treatment Option for Ovarian Cancer: PARP Inhibitors
- “You Are Your Own Best Advocate” – Recognizing the Subtle Symptoms of Ovarian Cancer
- 11 Ovarian Cancer Tests Used for Patient Diagnosis
- After Recurrence: PARP Inhibitors Can Improve Ovarian Cancer Survival Rates
“The symptoms include things like feeling full earlier than you usually would when your appetite is strong and feeling bloated. Some changes in your bowel habits. Some pain in the pelvis. These are symptoms women may have every month. These are not very specific. But we’ve found this constellation of symptoms from multiple studies,” Dr. Karlan added.
What Genetic Testing Can Reveal About Ovarian Cancer
The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
Understanding The Stages and Grades of Ovarian Cancer
While medical professionals use the staging of ovarian cancer to analyze how serious the illness is, how best to treat it and to provide a discussion about survival statistics, Dr. Beth Karlan, Director of the Women’s Cancer Program at Cedars-Sinai Medical Center observes, “The staging of cancers is really to help us with a dialogue, and the honesty of our outcome.” If you detect any symptoms of ovarian cancer, and a visit to your doctor confirms the diagnosis, then the next step would be discussing the stage of your illness.
- Stage I – Confined to the ovary
- Stage II – Spread to pelvic structures
- Stage III – Spread to abdominal structures
- Stage IV – Spread outside the abdomen or inside the liver or spleen
As a general rule, the lower the stage ovarian cancer, the less the cancer has spread.
Stage one refers to the earliest stage. At this point, it is limited to one or both ovaries, and is considered a confined form of the cancer; it has not spread to distant sites in the body. Stage two is when the cancer has spread from one or both ovaries to other organs in the pelvis, which can include the side walls of the pelvis, one or both fallopian tubes, the back of the uterus and the rectum or sigmoid colon.
With stage three, the cancer is in one or both ovaries, and has spread beyond the pelvis area to the upper abdomen, either to the omentum (a fatty apron that stretches over the abdomen), or other surfaces within the abdomen, such as along the diaphragm, the surface of the liver or the spleen, or possibly, nearby lymph nodes. At this stage, it has still not spread to distant sites. Finally, with stage four, the cancer cells have spread beyond the abdominal cavity to other organs: tumors inside your liver (not just on the surface), inside the spleen, in and around the lungs or other organs outside the abdomen and pelvic region, and possibly to the bones.
How Serious is My Illness? ‘Staging’ Ovarian Cancer
Several factors go into deciding on what kind of treatment is best, depending on the type and stage of ovarian cancer, the age of the woman and whether she is planning to have children in the future. But surgery is usually the first treatment recommended, with chemotherapy for use after treatment. For all four stages of ovarian cancer, two specific chemotherapy drugs are usually suggested. Chemotherapy is usually injected into a vein with an IV, given orally, or, in some cases, may be administered through a catheter directly into the abdominal cavity. There are currently two chemotherapies currently considered the backbone for the initial treatment of ovarian cancer. “We do know that two medicines together are better than one,” says Dr. Karlan.
Usually, a platinum compound (carboplatin), which kills ovarian cancer cells, and a taxane like paclitaxel (a chemical compound originally derived from plants, which interferes with the growth of cancer cells) are the therapies used. These two drugs are usually given as an IV into the vein, every three to four weeks.
Although, as with any chemotherapy, side effects can occur, Dr. Karlan tells us that even during this treatment, most women should be able to go about most of their daily routines, whether it is working or running a carpool, with the caveat that they will most likely feel more fatigue than normal. “I say most, because they are going to be more tired. Nobody’s typical activity includes coming to a hospital for chemotherapy,” notes Dr. Karlan. After treatment, most women should be able to resume just about all their normal activities.
Ovarian Cancer Treatment & Recurrence
The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.
Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal. With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.
Ovarian cancer is sub-categorized into two groups.
- Platinum-Sensitive Ovarian Cancer: Your cancer does not return for more than six months after treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
- Platinum-Resistant Ovarian Cancer: Your cancer returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
“The mechanism that causes platinum resistance will cause someone to be resistant to other chemotherapies, as well. That’s why we’re looking for what we call targeted therapies – precision medicine,” Dr. Noelle Cloven from Texas Oncology-Fort Worth Cancer Center explained.
Targeted therapies or precision medicine specifically target the proteins controlling cancer cells’ growth, division, and spread.
WATCH: Treating ovarian cancer.
Questions for Your Doctor
If you have been diagnosed with ovarian cancer and need guidance to further educate yourself on the disease and treatment, consider these questions for your doctor.
- What type of ovarian cancer do I have?
- What stage is my cancer in?
- Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
- What initial treatment options do you recommend?
- What are the possible side effects of the recommended treatment, and how can they be coped with?
- Will insurance help cover my recommended treatment?
Contributing: SurvivorNet Staff
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