[2021-05-08] World Ovarian Cancer Day
Today is World Ovarian Cancer Day. It's an appropriate occasion to retrace the discovery of my disease and, in recounting my story, to remind readers of the symptoms of ovarian cancer.
For those of you who have been following my story from the beginning, you know that I was informally diagnosed with ovarian cancer by an ER doctor on July 29, 2020. I had gone to the Queensway-Carleton Hospital in Ottawa with a pain in the upper right quadrant of my abdomen. Following an ultrasound (including a transvaginal ultrasound) and blood work, I left with the shocking diagnosis of ovarian cancer. A CT scan the next morning, also at the Queensway-Carleton Hospital, confirmed the presence of tumours that had spread beyond my ovaries and into my abdomen but, thankfully, not further.
I don't know when the tumours started to grow―whether it had been weeks, months or years before their chance discovery. That's one of the biggest challenges with ovarian cancer: the symptoms are mild and difficult to distinguish from run-of-the-mill ailments, which means that most people diagnosed with ovarian cancer are already at stage 3 or even stage 4. (Once my tumours were removed and analyzed, my oncologist could confirm that I was at stage 3C.)
I know that in early 2020, I began feeling full quickly―a symptom of ovarian cancer―but I attributed this to the stress of leading the Government of Canada's health communications during a pandemic. I had butterflies in my stomach almost all the time and was working non-stop, save for five to six hours of sleep each night. I started eating smaller meals. I can't say whether this complaint was ever really associated with my ovarian cancer because it seemed to pass.
Though I may have been eating less and working more, I thought that I was actually gaining weight, as my abdomen seemed to be getting bigger. I brushed this off as a consequence of eating a few more sweets than usual. What I didn't realize―since I was wearing only casual clothes and sports bras beginning in March when I started working from home―is that I was actually losing weight elsewhere. So while my belly was getting slightly bigger, the rest of me was getting smaller. Abdominal bloating is a symptom of ovarian cancer.
In July 2020, I thought I had a bladder infection because I felt the need to urinate frequently. I called my doctor's office and was able to talk to a resident the same day. She agreed that it sounded like a bladder infection and sent a prescription for an antibiotic to my local pharmacy. Not surprisingly, the antibiotic didn't resolve my issue.
On July 29, after having gone to bed at 1:00 a.m., I awoke a few hours later with a pain just under my right rib. At 6:00 a.m., I called Telehealth Ontario to get advice. The agent asked me dozens of questions and then advised me, strongly, to go to the emergency department of the nearest hospital. Though I didn't know what she suspected, I took her recommendation and immediately went to the hospital. Both I and the attending physician thought that the problem could be my gallbladder, hence his call for an ultrasound.
During the ultrasound, the technician said, "I'm going to ask the radiologist whether he has all the pictures he needs." To me, that sounded like standard procedure. When she returned a few minutes later and said that the radiologist wanted her to do a transvaginal ultrasound, I didn't give it any thought. I didn't know then that a transvaginal ultrasound is a helpful tool in the diagnosis of ovarian cancer.
Following my ultrasound, I was asked for another blood sample, which found that my CA125―the level of a cancer marker in my blood―was highly elevated. It was 920 when the normal range is below 35. As a point of comparison, my most recent CA125, following surgery, chemotherapy and the start of a maintenance drug, is 7.
There is no reliable test for ovarian cancer. The disease is often discovered by chance or only after the symptoms get so severe that the individual or their doctor requests tests to determine the source of the issues.
I will never know whether my abdominal pain was associated with my cancer, my gallbladder or something completely different. But I'm lucky that I did experience something sufficiently out of the ordinary to prompt my trip to emergency. The advantage of having gone to a hospital is that they had the equipment to investigate symptoms right then and there. Had I gone to my doctor (or simply chatted with her on the phone), it would no doubt have triggered a series of diagnostic tests, but ultimately might have taken much longer to get to the diagnosis. Call it serendipity.
But we shouldn't have to rely exclusively on serendipity to detect a disease that is life threatening and that is found in 3,100 Canadians every year. Until researchers develop a reliable screening method, women and people with female reproductive systems need to know the signs of ovarian cancer and to advocate for their health. The graphic below, from Ovarian Cancer Canada, can help.
Sharing my story through this blog has been a privilege. If my writings prompt even one person to seek medical help to discover or rule out ovarian cancer earlier than they might otherwise have done, my efforts will have been worthwhile.
