Amazon Trail
Community Compass
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The Amazon Trail A Simple Test |
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by Lee Lynch
CA 125. That's a term every woman should know. It's a blood test given to detect ovarian cancer. In a healthy woman, the normal reading would be around 35. In a woman with ovarian cancer, which is what my girl had, it can go up into the thousands. If a doctor had ordered a CA 125, she might be here today.
Not every elevated CA 125 reading indicates cancer. It can reveal pregnancy, an infection, menstruation, liver disease, endometriosis, even benign tumors of the ovaries, according to medicinenet.com
For Marcia, because her symptom was rectal bleeding and because the tumor appeared in the colon, her blood was tested not for ovarian cancer, but for colon cancer and was perfectly normal. These tests are not foolproof - it isn't unusual for someone who had colon cancer to get a normal reading, so the surgeon removed the tumor in her colon and detached where it had spread to her bladder. Marcia went on to have eight months of chemotherapy for colon cancer. At the end of her treatments the colon marker still read zero and a CT scan showed no tumors. Daughter #1 and I danced in exultation at the foot of Marcia's gurney.
Marcia happened to be an R.N. and a particularly talented massage therapist. She could find - and often fix - the most subtle roots of pain in her clients. So when she noticed a persistent discomfort in her upper abdomen she paid attention. We went back to the surgeon. After a CT scan, he told Marcia to sign up for hospice. Marcia, drawing on her medical training, asked whether he would authorize a CA 125.
While we waited for the results, Marcia, Daughter # 1, Daughter #2 and I went to Eugene, Oregon, where a super gynecological oncologist, Audrey Garret, has her practice. The four of us crowded into an examining room waiting for Dr. Garrett, when we heard her being paged by Marcia's surgeon. A few minutes later, Dr. Garret came in with the glad news that Marcia's CA 125 was off the scale. Never has there been such rejoicing at a positive cancer result. If it had been colon cancer, we were out of options, but ovarian cancer was treatable! The four of us danced around the examining room. Dr. Garrett, who had treated Marcia's late partner for uterine cancer, was as pleased at the results as we were.
Marcia had three sessions of chemotherapy for ovarian cancer, underwent a debulking surgery to get as much tumor out as possible, then did more chemo. This chemo had the advantage of not taking Marcia's hair, but the disadvantage of making her much less functional. She'd supported herself through the colon chemo, but became too sick and too fatigued to work. This life-loving dynamo of activity could do less and less and then developed new symptoms.
The urologist saw Marcia right away. He performed a cystoscopy that same day and, while Marcia grimaced at the discomfort, we watched as the camera revealed, on the floor of Marcia's bladder, what looked like a huge, bumpy white mushroom. That first surgeon had not gotten all of the cancer. Marcia would need a stent inserted into her bladder or, if the tumor was too difficult to get through, they would have to put the stent in through her back. She chose quality of life over quantity and refused those last ditch procedures.
I did not ask Marcia's permission to tell her story in print, but I know she'd be glad if her story could save a life. Ovarian cancer is a silent killer; its symptoms could be signs of almost anything. Those listed at the Gilda Radner Familial Ovarian Cancer Registry (www.ovariancancer.com) are: feeling of being bloated, vague abdominal and pelvic discomfort, gastrointestinal symptoms such as gas, nausea, indigestion; constipation, diarrhea, frequent urination, back pain and fatigue, discomfort during sex and vaginal bleeding. What woman hasn't experienced one or more of these conditions by the time she's Marcia's age at the time - 58? It's tragic that Marcia, and thousands more, go through the misery of chemotherapy for the wrong kind of cancer, or are sent home with advice about stool softeners or losing weight to relieve back pain, when a simple blood test might just catch this cancer. Marcia estimated that she'd had ovarian cancer at least six or seven years by the time it was diagnosed. And it was only diagnosed because she was savvy enough to ask.
The Gilda Radner Registry recommends that women who have at least one close relative with ovarian cancer have a 1) pelvic examination, 2) a vaginal ultrasound to look for ovarian tumors, 3) a CA 125 test that can detect early ovarian cancer, every six months. With or without a family history of ovarian cancer, why didn't one of her doctors take note of the classic long-term symptoms and order the test before the cancer could take my sweet Marcia away?
Let's not lose another woman for lack of a simple test. We can challenge our insurer-driven health system by asking for what we need.
Lee Lynch's 12th book, the novel Sweet Creek, will be released from Bold Strokes Books in January 2006. Lynch lives on the Oregon Coast. Her web page is at leelynch6.tripod.com
© Lee Lynch 2005