[2022-03-11] Quarterly oncology follow-up
I had my quarterly oncology follow-up today, this time with Dr. Faught. I have a soft spot for this particular member of the gynecologic oncology team at The Ottawa Hospital, as he was the first oncologist I met, back in August 2020.
On that occasion, he described ovarian cancer as "a tough cancer," noting that the majority of patients with stage 3 ovarian cancer see it come back in the first 12 to 18 months. He indicated then that if I got to 2-3 years beyond surgery, I would have a better chance of longer term remission. He also noted that if my CA125 (then at 920) came down quickly, it would be a good sign. Given that it did come down significantly—from 920 in July 2020, when my ovarian cancer was discovered, to 19 in December 2020, after three rounds of chemotherapy—Dr. Faught considers it a good indicator for me.
We spoke again in October 2020, when he informed me that the pathologist had found the BRCA2 gene change in my tumours. Dr. Faught recommended that I get genetic testing to determine whether the gene change was in my tumours only or in all my cells. It would turn out that I did have the BRCA2 gene change in all my cells, meaning I had inherited it from one of my parents. Through subsequent genetic testing, it was concluded that I inherited the gene change from my father, who died in 1976.
But the gene change was not all bad news. As Dr. Faught mentioned back in October 2020, the gene change was "good news overall." That's because ovarian cancer patients with a BRCA gene change are more receptive to chemotherapy and have more options for treatment. Among those options is the PARP inhibitor called olaparib (marketed under the brand name Lynparza), which I've been taking twice a day for the past 13 months. Dr. Faught reiterated today that olaparib, which was designed and tested on BRCA-positive people, reduces the risk of recurrence, particularly among those who carry a BRCA gene change.
With these factors in my favour—along with my consistently low CA125 (which has been in the normal range for the past 15 months) and my recent pelvic MRI, which found "No abnormal pelvic soft tissue masses to suggest local recurrence of ovarian malignancy"—I am considered to be in a very good position.
Of course, there are no absolutes in the treatment of ovarian cancer. Recurrence is common. Predictions are impossible to make.
However, given all indicators and the amount of time without recurrence since my surgery, now more than a year and a half, my odds look better. No one can predict what those odds are, only that—today—everything looks "very good," as Dr. Faught is accustomed to saying.
Despite the lack of certainty in today's call, I'm feeling positive about where I sit at this moment. Ovarian cancer epitomizes the medical guidance that no news is good news.
In truth, this morning's call doesn't really change my outlook. I continue to try to focus on the present. As I wrote recently, tomorrow is not promised to me, but today, I can live, love and make a contribution.
