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Ovarian Cancer- A Husband's Perspective

This is an brief account of my wife's recurring ovarian cancer. There are too many of us out there needing more information that should have been given "before" cancer treatment.

In 1972, my wife was diagnosed with ovarian cancer, when she presented with a left DVT (deep vein thrombosis) and pulmonary embolism at a hospital in San Diego, CA. DVT is not uncommon in patients with ovarian cancer (it may be a presenting sign). Workup which was triggered by this presentation revealed that she did have an ovarian carcinoma for which she was cured with total abdominal hysterectomy and Chlorambucil (Leukeren) treatment.

At Stage I, ovarian cancer has a five-year survival rate of around 93%. She went twenty-four years before experiencing any recurrent ovarian cancer.

The cancer recurred in 1996 on her diaphragm and was removed at the Fox Chase Cancer Center.

It is commonplace to give the same treatment to a recurrence as was given for the original tumor(s). However, our hometown hospital in Pennsylvania gave her a 'hard and fast' drug combination of Taxol and Carboplatin. This suppresses the immune system, which can allow tumors to grow and can weaken the blood-brain barrier, potentially inviting cancer cells into the central nervous system.

Sure enough, the cancer turned up in her cerebellum in 1998, and was removed at the Hershey Medical Center. Our home town hospital then treated her with Whole Brain Radiation. Literature suggests that this can result in permanent side effects such as dementia and memory loss in 90% of patients over 60. My wife was 66. Hershey suggested treatment with focal radiation to the local tumor bed. Scans to check for a possible spinal tumor were also suggested but never fully carried out.

In 1999, three tumors were found on her spine and were eradicated. In the end, my wife died of the effects of Taxol and Carboplatin, which may have caused the cerebellum tumors, and the terrible effects of Whole Brain Radiation, which further scans revealed had caused extensive damage to her brain.

Why, after 24 years, had ovarian cancer cells proliferated inside her diaphragm? Her presentation of a left DVT and PE in 1972 (DVT is not uncommon in patients with ovarian cancer and it may be a presenting sign) enabled the doctors to find her ovarian cancer at it's earliest stage where just surgical oncology alone is over 93% curative. In 1972 her postoperative chemotherapy was among the slowest acting and least toxic of the alkylating agents whereas the depression of the immune system was slow and reversible, allowing it to regenerate and contribute to healing her cancer. Plus, she was only 40 years of age.

My wife had been taking Premarin for over twenty years. In July 2002, the National Institutes of Health published articles about two large studies indicating the increased risk of ovarian cancer linked to Estrogen Replacement Therapy. For women who used estrogen for 20 years or more, it was increased by more than 300% (3-fold), compared to women who had never taken it. And from the North American Menopause Society, "it has been known for many years that estrogen therapy is also associated with an increase in DVT's and pulmonary embolism". As one email respondent to me noted, "well that's interesting, I wonder why they didn't choose to let us in on it!"

Gregory D. Pawelski, husband
gdpawel@attglobal.net

Visit Johns Hopkins Pathology website for the full story about Ann's ovarian cancer: http://pathology2.jhu.edu/ovca/story.cfm?PersonID=33

References:

Lacey JV, Mink PJ, Lubin JH, et al: Menopausal Hormone Replacement Therapy and Risk of Ovarian Cancer. JAMA Jul 17, 2002; 288(3):334-341.

Rodriguez C, et al: Estrogen Replacement Therapy and Ovarian Cancer Mortality in a Large Prospective Study of US Women. JAMA 2001;285:1460-1465.

 

 

 

 

 

 

 

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Updated  05/15/2010