Ovarian Cancer Awareness

M. D. Anderson Cancer Center

Cancer Newsline Audio Podcast Series

Date: March 02, 2009

Duration: 0 / 13:53

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Lisa Garvin:

 

Welcome to Cancer News Line, a weekly podcast series from the University of Texas M.D. Anderson Cancer Center. Cancer News Line helps you stay current with the news on cancer research, diagnosis, treatment and prevention, providing the latest information on reducing your family's cancer risk. I'm your host Lisa Garvin. Today we're talking with Andrea Quinn who is an ovarian cancer survivor and Dr. Judy Wolfe who is a Professor of Gynelogic Oncology here at M.D. Anderson. Welcome ladies.

 

Andrea Quinn:

 

Thank you.

 

Judy Wolfe:

 

Thank you.

 

Lisa Garvin:

 

Let me start with you Dr. Wolfe. Let's talk about ovarian cancer. The common thing that we call it is The Silent Killer. Why do we call it that and is that still a valid statement?

 

Dr. Judy Wolfe:

 

It's been called the silent killer because the symptoms have often been missed and not noticed. I would say that today, no it's not considered a silent killer anymore and over the last few years, 3 or 4 papers have been written that clearly delineate the symptoms of ovarian cancer. The reason it's still silent or some people say it whispers, is that the symptoms are fairly nonspecific but they're quite common for every woman who has ovarian cancer. And they include such things as abdominal bloating, fatigue, low back pain, changes in bowel habits, feeling full early, urinary symptoms. Almost every woman with ovarian cancer has those symptoms, but the problem is almost everybody has those symptoms at some time or another.

 

Garvin:

 

And Andrea, it sounds like to you that you had these same symptoms. And what caused you to finally go to the doctor?

 

Quinn:

 

Well I went to the doctor because after 2 weeks of feeling this fullness feeling, my stomach started to distend. And once my stomach was distending, it was a gradual process so I kept looking at myself and thinking, "Am I really losing my waste line?" And I just kept looking and looking and it would just seem to get larger and larger and I finally went to my internist who did an x-ray of you know my upper GI and there was no blockage and he automatically assumed it was some sort of gastrointestinal problem. And then I began to feel worse over the weekend so that following Monday I went to my gynecologist and I thought she could refer me on to whoever she thought was appropriate. And that's how I was diagnosed.

 

Garvin:

 

How did you react? What was your...

 

Quinn:

 

Oh well, the first thing I thought of was that I was going to die. And I have 2 young boys and at that time they were 5 and 9. And I just you know couldn't believe it and especially in my family ovarian cancer was the last thing in the world that I thought I would have. I have grandparents that lived till their 90s and I just -- I mean at 42, who would think that that's what the diagnosis was going to be from the doctor. So...

 

Garvin:

 

And then Dr. Wolfe became your doctor?

 

Quinn:

 

Well I knew Dr. Wolfe because my mother in law had actually had ovarian cancer. And she's not a blood relative of mine and hers was found a lot differently and diagnosed differently than mine was, so when I heard the word ovarian cancer we thought immediately to contact Dr. Wolfe. And then she knew who I was through my mother in law and her experience with here so...

 

Garvin:

 

Dr. Wolfe, as far as the symptoms go women of course we're typical. We tend to blow these things off. We have families to take care of and so forth. At what stage is ovarian cancer usually diagnosed?

 

Wolfe:

 

Well I would say that women don't blow off the symptoms so much but as Andrea did, she went to doctors and often times it takes a few visits to a doctor to figure it out. But because they're so nonspecific, ovarian cancer unfortunately is most commonly diagnosed when it's Stage III or Stage IV, when it's spread outside of the ovaries and into the rest of the abdominal and pelvic cavity. And probably because a lot of the symptoms that we talked about don't occur until that's happened.

 

Garvin:

 

And women are diagnosed -- it's not really a strictly over 50 disease. I mean ovarian cancer seems to run the age spectrum.

 

Wolfe:

 

Yeah, the average age for ovarian cancer is the early 60s but it can be occur in much younger women like Andrea. Andrea's a little bit of an atypical person who has ovarian cancer. She did all the right things to reduce her risk. She has no personal family history. She's younger than most women with ovarian cancer. But it just goes to show that all the things we know that are risk factors don't mean anything to the individual patient: that any woman could be at risk for ovarian cancer.

 

Garvin:

 

And you said you were 42 when you were diagnosed?

 

Quinn:

 

I was 42, yes.

 

Garvin:

 

Wow, that must have been something with you know young kids and -- and so did you dive right into treatment? Tell me about your treatment regimen.

 

Quinn:

 

Well what we did was immediately contacted M.D. Anderson and Dr. Wolfe. And as soon as we got into see her, we started the process. And truly between the time of knowing I had ovarian cancer and seeing Dr. Wolfe was really the hardest time because I didn't know what was going to happen or what really was there. And so once I saw Dr. Wolfe and we scheduled surgery, then it seemed like after the surgery it was much easier to deal with. And easier is relative because it was horrible. But easier than it was prior to that, to not knowing what was going to happen. And then I had surgery and 3 weeks later -- and the surgery was complete hysterectomy and also removal of my omentum and I started intraperitoneal chemotherapy 3 weeks later. And did that well approximately once a month I guess for -- until about 6 months or so. And then that was it. That was the end of my treatment: no further treatment after that.

 

Garvin:

 

And you've been disease free for how long?

 

Quinn:

 

Now it's been well I was diagnosed 3 years ago this month. So...

 

Garvin:

 

Yeah, isn't it amazing how we have anniversaries for when we were diagnosed with cancer. It's quite a life changing event. Did you have to worry about fertility issues at your age? Did you want to have more kids?

 

Quinn:

 

Well no, I didn't have to worry about it since I had 2 children, but honestly I had been at the OB-GYN in January the month before I was diagnosed asking her "Could I have another baby if I really wanted?" So you know and I hadn't been able to get pregnant and we hadn't been not trying to get pregnant. So you know, obviously this is probably why or the cancer was probably why. But anyway, so it was a non-issue since I had 2 healthy children but at the same time I might have had another child. I don't know.

 

Garvin:

 

Dr. Wolfe, I know that fertility is a concern for some women. Have we had any advances in fertility preservation in women with ovarian cancer?

 

Wolfe:

 

Well for women who have Stage I ovarian cancer where it's confined to just one ovary and fertility is an issue, there are reports and we do offer those women if everything else inside is normal and there's no spread of the cancer, to removal of the ovary. Many of them still need chemotherapy after surgery but certainly a lot of them in that situation have been able to get pregnant and have children. Certainly we can't leave any diseased ovary inside if there's cancer in it, but if one ovary is normal there's no reason that we can't safely leave that ovary in the uterus for those women as an option. I also just want to follow-up on Andrea's treatment that she mentioned. The intraperitoneal chemotherapy that she got is something new and different that was not available when her mother in law had ovarian cancer more than a decade ago. And often times it feels like we aren't making any difference but when you look back in time and see what we have and what we didn't have, we certainly are and intraperitoneal chemotherapy has been proven to be better than intravenous chemotherapy. And so we are making steps forward and so Andrea's chances of being cured were much higher than her mother in law's and the other women who unfortunately were diagnosed earlier.

 

Garvin:

 

And intraperitoneal chemotherapy is where you actually fill the area with the drug, is that correct? Can you explain the procedure?

 

Wolfe:

 

Right, so we put in a catheter underneath the skin in the upper abdomen and with a needle access that catheter and give the chemotherapy right into the abdominal cavity which is where the ovarian cancer spreads and likes to stay. And that chemotherapy not only gets at a very high concentration there, it's also absorbed into the bloodstream so that you get the benefit of having it throughout the body also. It is very toxic and difficult. She minimized it. It's a tough regimen but I think for those women who are able to get it and tolerate it, it certainly is beneficial.

 

Garvin:

 

Andrea, talk about the side effects of that treatment if you would.

 

Quinn:

 

Well mainly the side effects that I had from the chemotherapy was what your typical side effects of nausea and so on, but in this particular case having the intraperitoneal chemotherapy administered I think of on top of my organs that had been manipulated during surgery I had some complications. And the complications were I had some severe abdominal pain and at that time I went to the emergency room one time and they said it was -- well they weren't really sure what it was. They thought it was just indigestion of something. But then a few weeks later I went again and they did CT scan and so on and they could tell that the bowels were irritated and therefore they were somewhat closed and fluids weren't going through and nothing was working in my system. And the pain was horrible. And then I spent a weekend in the hospital with that. So...

 

Garvin:

 

Well let's move onto the research arm because one thing about M.D. Anderson, we have the Blanton-Davis Ovarian Research Program which had funneled money through the Sprint for Life Annual Fun Run. Funding is obviously an issue but it looks like -- has funding from this program helped with your work in ovarian cancer Dr. Wolfe?

 

Wolfe:

 

Absolutely, since the program started we've used funding to support a lot of preclinical research in ovarian cancer but also help fund our trials. Andrea was actually treated on a clinical trial that we had here with the intraperitoneal chemotherapy and we've had trials of gene therapy and targeted therapy and such that came out of preclinical laboratory research that we have done at M.D. Anderson supported by the program. So it's made a big difference. And for me being a runner, and loving to take care of women with ovarian cancer it seemed to make sense to start the Fun Run as we did in 1997? 1997 was our first race so this will be our 12th annual race this year: First Run for Life. And it's raised over 2 million dollars for our program.

 

Garvin:

 

Wow, that's great. And I know that every year you tend to get more and more runners every year.

 

Wolfe:

 

Yeah.

 

Garvin:

 

And for all of you listening the 12th Annual Spring for Life does take place in the Texas Medical Center on Saturday, May 9th of this year. You can register online I believe: preregister. And I think you can still register the day of the race I believe.

 

Wolfe:

 

Yes.

 

Garvin:

 

Okay. Any final thoughts from either of you? Andrea any final thoughts?

 

Quinn:

 

Well, I guess my thought about it is I wish that the Sprint for Life and some of the ovarian cancer types of fundraising would multiple and be larger than they are. And of course you know of course I feel that way. But when I see so much for breast cancer and I think that that's warranted, I just feel like "Oh gosh, I wish we could have as much research" because then maybe we could be further down the road on treatment and the people that came after me would have even a better treatment than I did.

 

Garvin:

 

Dr. Wolfe?

 

Wolfe:

 

Yeah, I think that what Sprint for Life does and what I hope we can do with telling people about ovarian cancer is raise awareness, raise research money but also let women know about what the symptoms are of ovarian cancer and that they could be at risk so that they have the knowledge to hopefully get diagnosed even earlier down the road. It's not just raising money. It's raising awareness and I think that that's what we try to do with the program and with Sprint for Life. And also Sprint for Life means a lot to our survivors. A lot of Houston ovarian cancer survivors come whether or not they've been treated at M.D. Anderson and it's their special day. And that means so much to me and I know it means 10 times as much to them. So I think it's a very special event.

 

Garvin:

 

Great, thank you ladies for being with us today.

 

Quinn:

 

Thank you.

 

Wolfe:

 

Thank you.

 

Garvin:

 

If you have questions about anything you've heard today on Cancer News Line, contact Ask M.D. Anderson at 1-877-M.D. Anderson-6789 or online at www.mdanderson.org/ask. Thank you for listening to this episode of Cancer News Line. Tune in next week for the next podcast in our series.

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