Ovarian Cancer Awareness
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
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
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
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