Survivor Stories: An ovarian cancer thriver

While Cathy Frazier is no stranger
to the residents of these Islands, the details of her battle with ovarian
cancer are not so commonly discussed.

While a good place to start may be
her diagnosis in February of 2003 at the age of 45, the truth is that to begin
there is to paint only half the picture.

Veta Merren-Bodden dearly wanted to
become a mother, but had difficulty conceiving. Her desire to become a mother
led her to take a drug called diethylstilbestrol, which was commonly given to
women who were having such difficulties conceiving between 1938-1971. After
having two miscarriages, Mrs. Merren-Bodden finally became pregnant with Cathy,
who was born in 1957.

While Cathy was a healthy baby, it
was later discovered that the daughters of women who took DES while they were
pregnant have an increased risk of developing cancer of the vagina and cervix.
Cathy herself experienced difficulty conceiving, suffering three miscarriages
prior to giving birth to her first-born, who was born premature. 

After her second child was born,
also premature, it was determined that the reason for this was linked to her
mother’s use of DES. As a result, Cathy was referred to a high-risk specialist. 

It wasn’t until several months after
having been diagnosed with ovarian cancer that Cathy discovered that being the
daughter of a woman who took DES is considered a risk factor for certain gynaecological
cancers. Cathy often says that her second child, her daughter, saved her life
because “had she not been born prematurely too, I may have never seen a specialist
until it was too late.”

Starting in 1986, Cathy was tested
twice a year by a gynaecologist trained to carry out a variety of tests to
detect any kind of abnormalities very quickly. She consistently tested
negatively for said abnormalities, and after a number of years of having a
“clean slate” she was given the choice by her doctor to either continue the biannual
testing or test only once per year. Deciding to err on the side of caution,
Cathy chose to continue her biannual checkups. This decision may very well have
saved her life.

During one of these checkups on 4
February, 2003, Cathy did her regular physical exam and blood test. Her
physical exam was fine, however, on Valentine’s Day she received a phone call
from her doctor’s office stating that her blood test results showed an
elevation (CA-125 tumour marker) and was asked to retest. Upon obtaining the
results for the second set of blood tests, she was advised by her doctor that
she would need an ultrasound as her tumour marker number jumped from 43 to 90.
“All women should have tumour markers done regardless of what their doctors may
advise,” Cathy states. “Early detection saved my life; that and the grace of
God.”

What followed was a whirlwind of
emotions and doctor’s visits. The ultrasound performed locally spotted a small
bit of calcification on one of her ovaries and she was advised to go to Miami.
When she arrived in Miami she had another ultrasound done, however, the radiologist
did not see anything at all.

Due to the fact that her original
ultrasound had spotted something and that the tumour marker had shown a drastic
increase, the Miami specialist decided to operate. “It was a precaution,
because the second ultrasound didn’t show the calcification,” she explains. “He
said he would go in and if anything was found he would remove it and that the
whole procedure would be over in 20 minutes,” she adds.

Six hours later the 20-minute
procedure was finally over.

“It was such an aggressive cancer
that had I waited another six months I would have been dead,” she says. Equally
aggressive was the surgery, which gave Cathy a complete hysterectomy – ovaries,
uterus, cervix and fallopian tubes were removed, as were her appendix and gall bladder.

The surgery also revealed that
Cathy had clear cell adenocarcinoma- a type of cancer that did not show up in
the ultrasound.

“That’s why the blood work is so
important, it can catch this even if it is invisible to the eye or other
tests,” she explains.

As if her personal battle were not
enough, Cathy’s husband Jerry was recovering from tonsillar cancer at the same
time that she underwent her surgery in Miami, having himself been diagnosed
only six months prior. Cathy was still grieving the loss of her father, who
passed away from prostate cancer in 2001 and she worried for the future of her
children, specially her eldest son Jule who has special needs.

“Two things helped me through: my
faith and my family,” she says. “I prayed to God and I said ‘God, if it’s your
will to see me through this and keep me alive, then You’re gonna have to get me
through this and heal me’. And you know what? He spoke to me and told me to
open my Bible to 1st Samuel 22:40”.

As for her family she is equally as
grateful: “my family is the best”. She found comfort and support not only from
immediate family members, but also cousins, friends and her church.
Additionally, Cathy is grateful to the excellent care received from her doctor
and his staff in Miami, as well as the visiting oncologist from Jamaica and the
oncology staff at HSA.

Shortly after her February 2003
surgery Cathy began her chemotherapy treatment here in Cayman; every three
weeks starting in March and ending in October of that year. In November 2003
she underwent a second surgery, considered a cell wash, to ensure there were no
cancer cells, and was given the all clear. Ever since she has had, and
continues to have, tumour markers done every three months – twice a year in
Miami and twice a year here on island. She also has regular physical exams
twice a year. So far everything has come back negative, and while she is
grateful, she is also a believer in prevention.

“My daughter gets checked up
annually,” she declares in a way that only a concerned mother and survivor can.

Ovarian cancer used to be called
the silent killer because it was a commonly held belief that there were no
signs or symptoms of the disease until it was in the advanced stages. In recent
years, by studying women diagnosed with ovarian cancer, doctors have been able
to develop an ovarian cancer symptom checklist. 
Symptoms of ovarian cancer include: bloating or increased abdominal
size, pelvic or abdominal pain, difficulty eating or feeling full too quickly,
needing to pass urine more frequently and/or urgently, frequent heartburn,
upset stomach or indigestion, pain during intercourse, change in bowel habits
(i.e. constipation), tiredness, back pain and menstrual changes. Many women
experience these symptoms for reasons other than cancer; however, if any of
them began within the last 12 months and have been experienced nearly every
day, then they should consult a doctor for tests as it may be a sign of ovarian
cancer. 

Tests for detecting ovarian cancer
may include a trans-vaginal ultrasound and the CA125 blood test. Neither the
American College of Obstetricians and Gynaecologists, nor the American Cancer
Society recommend that routine screening for ovarian cancer be performed in
asymptomatic women due to the fact that the CA 125 blood test is not sensitive
for early disease and is elevated in a number of benign (non-cancerous) conditions,
even in older women. Due to this high number of false positives (a test indicates
a disease is present when it is not) and the associated risks of unnecessary surgery,
it is recommended instead that all patients routinely undergo a risk
assessment.

What are the risk factors
associated with ovarian cancer?

Age – Ovarian cancer usually occurs
in women after they have experienced menopause. The majority of women are aged
63 or older at the time of diagnosis.

Oestrogen exposure – Oestrogen is
an essential female hormone. The more oestrogen your body is exposed to over
your lifetime the greater your risk for ovarian cancer.

Women who can answer YES to any of
the statements below may be at increased risk:

      I
started having my monthly period before the age of 12.

      I
went through menopause after the age of 55.

      I
had my first child after the age of 30.

      I
have never been pregnant.

      I
have used hormone replacement therapy for more than five years.

Family history – Increases your
risk especially if your mother or sister was diagnosed with the disease.  Additionally if there is a family history of
breast, colon endometrial or prostate cancer your risk may be increased.

Most cases of ovarian cancer are
not caused by inherited genes. However individuals who have inherited the BRCA1
or BRCA2 gene from their parents may be at increased risk for ovarian cancer.

Personal medical history – If you
have previously been diagnosed with cancer of the ovary or with breast or colon
cancer your risk will be increased.

Infertility – Women who have taken
fertility drugs are at increased risk.

Endometriosis – A disease in which
endometrial cells spread to other parts of the body. Women who have been
diagnosed with this condition are at increased risk for ovarian cancer.

Obesity – Being overweight or obese
increases your risk.

Smoking and alcohol

The Cayman Islands Cancer Society
is a non-profit organisation dedicated to preventing the development of cancer
through its education programs and screening initiatives as well as providing
financial assistance to cancer patients and their families with treatment
related expenses. The Society also offers counselling and support to cancer
patients and their families. The Society funds its programs through fundraising
events and donations from the public and from the corporate sector whose
generosity is very much appreciated.

On Thursday, 9 September, Dr.
Tomlinson from CTMH will present on ovarian cancer seminar at the William
Pouchie Memorial Church (United Church) in North Side at 7pm. Refreshments will
be provided. For more information on the Society, gynaecological cancers or on
activities during the month of September call 949-7618 or email [email protected]

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