[2023-02-10] A hope-filled gynecologic oncology follow-up

August 14, 2020

Two and a half years ago, almost to the day, I met with Dr. Faught of The Ottawa Hospital Gynecologic Oncology Team. Just a few weeks before, I had been told by an emergency room doctor at the Queensway Carleton Hospital that I had ovarian cancer.

I knew nothing about ovarian cancer. That first meeting with Dr. Faught was grim—not because he made it so. He is a lovely man. But the information he shared with me, and no doubt had shared with countless other women before me, was not to be sugar coated. Among the facts I took down in my notes that day were these:
  • Ovarian cancer is a tough cancer.
  • The majority of patients with stage 3 cancer (70-80%) will see it come back in the first 12 to 18 months.
  • If you get to 2-3 years, you have a better chance of longer-term remission.
  • If it comes back, it's often not curable in the long term.
I kept most of this to myself, revealing very little of it in my blog post of that day (First oncologist visit). It was too much to take in and too much to share with loved ones, who were already worried enough. They didn't need to hear these dire statistics.

February 10, 2023

Fast forward to today. While I had had several conversations with Dr. Faught since August 2020, I had not seen him in person since that first meeting. That's partly a result of COVID, which shifted routine follow-up discussions to phone calls, and partly a reflection of the way the gynecologic oncology team works. My numerous check-ins—in person or over the phone—have been with various members of the team.

Today, I was delighted that the doctor who walked into my examination room was Dr. Faught. As I've said before, I have a soft spot for him. He exudes a mix of tenderness and realism.

He was aware of my blood work, especially my CA125 results, and the report of my pelvic MRI. These inputs, plus my own report of how good I feel, led him to conclude that I'm doing "very well."

This was to be the day we discussed my continued use, or not, of olaparib (marketed under the brand name Lynparza). Having been on the tumour-suppressing drug for two years, I thought that he might recommend my coming off this maintenance treatment. I had rehearsed questions in my mind if he had suggested that. But his recommendation was to keep me on the drug. I am fine with that, as being on olaparib—and seeing those low, steady CA125 results—gives me peace of mind. It appears to be working for me.

I asked him how many people he sees who have a profile like mine. "Not enough," he admitted. "I wish we had more patients like you." I do too. Knowing that so many other people who have had ovarian cancer have had recurrences makes me reluctant, at times, to share my good news.

Dr. Faught went on to say that I'm in a special category and that medical professionals can't explain why some people have recurrences and other people's tumours just seem to melt away.

And then he said something that is rarely heard among ovarian cancer patients. "You could remain in long-term remission and, at some point, we might even say you're cured."

To be clear, he did not say I was cured. And I didn't take it that way. But even the whisper of that other "c" word, as a possibility, is incredible.

As our discussion wrapped up, he put his hand on my shoulder. Not a quick tap, not a furtive nudge, but the kind of comfortable touch that one might give to a young person on graduation day. A touch that communicates, "look how far you've come."

Then he put out his hand to shake mine, which I reciprocated. I then said, "I feel like giving you a hug." Without hesitation and only a hint of surprise, he replied, "Oh sure," like this might have been the best part of his day. We hugged. It was the best part of my day.

It reminded me of my post on The power of touch, in which I had quoted a New York Times article (Evidence That Little Touches Do Mean So Much):

But in recent years some researchers have begun to focus on a different, often more subtle kind of wordless communication: physical contact. Momentary touches, they say — whether an exuberant high five, a warm hand on the shoulder, or a creepy touch to the arm — can communicate an even wider range of emotion than gestures or expressions, and sometimes do so more quickly and accurately than words.

The article went on to say:

A warm touch seems to set off the release of oxytocin, a hormone that helps create a sensation of trust, and to reduce levels of the stress hormone cortisol.

Perhaps most significantly, in the context of today's meeting with Dr. Faught, the article noted:

A sympathetic touch from a doctor leaves people with the impression that the visit lasted twice as long, compared with estimates from people who were untouched.

Indeed, my appointment with Dr. Faught today lasted about 10 minutes, though time could have been standing still when he spoke his hopeful words. It was hard for me to recall exactly what he had said, even moments after our discussion. I left the examination room and started typing on my phone everything I could recall. Though I may not perfectly remember what he said, I do know how he made me feel: full of hope and optimism for my future.