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