Interview 156

Age at interview: 38

Age at diagnosis: 33

Brief Outline: Ovarian cancer diagnosed in 1997 following investigations for infertility. Treated by surgical removal of affected ovary followed by chemotherapy. Diagnosis revised as 'borderline' and further treatment aborted in preference for regular monitoring.

Background: Doctoral student, married, two children.

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She and her husband had difficulty conceiving, and a laparoscopy showed that she had a lump the size of an orange on her left ovary. A small sample of the lump was taken, and blood tests conducted. She was soon told that she needed to have the ovary and lump removed, and after analysis, she was diagnosed with having a grade 1 ovarian cancer, which had also spread outside of her pelvis. After waiting for the scar to heal, she started a course of six sessions of chemotherapy (carboplatin). She was concerned that chemotherapy would affect her fertility, and found the oncologist insensitive in suggesting she should not be worrying about children and to perhaps consider adoption. However, she feels that deep down she did not fully believe or accept that she had cancer. She does not have a family history of cancer, and wonders whether food poisoning years before may have had any effect. Her husband and parents found her diagnosis very upsetting, and she feels that support available to them was lacking compared to the support offered to her. 

 

She found the nurses where she had her chemotherapy very supportive. She told close family and friends about her diagnosis and treatment, but did not want work colleagues or people more widely to know. She only had time off work after surgery. She experienced severe sickness during her chemotherapy, and lost some of her hair, but found that she recovered from each session within a few days. Constipation caused by the anti-nausea medication was an unwanted side effect. Prior to and throughout her chemotherapy, she had acupuncture and homeopathy. She found this gave her a ‘lift’ and talking to the practitioner was a great source of support. 

 

A biopsy of her remaining ovary showed that it too had grade 1 cancerous cells and these had spread to the top of her uterus. She was informed that she would need her second ovary and uterus removed, followed by chemotherapy treatment with Taxol. She and her husband were unhappy with this prognosis, and researched information on the internet. They suggested to the consultant that they would like a second opinion, but left it at that. The day before the surgery, the consultant told her that the surgery would not be going ahead as a second opinion had been sought, and her cancer was considered ‘borderline.’ The decision was made to monitor her condition and to seek a third opinion, which concurred with the second. She understands why the diagnosis was initially made of a grade 1 cancer, but feels that a second opinion could have been sought sooner, and prevented her being scheduled for surgery. She felt relieved that only one ovary was removed, as this left open the possibility of having a family.

 

She was offered IVF to try to assist her and her husband in having a baby, as it was envisaged that at some point she would still need to have her ovary and uterus removed. On the second course of IVF she became pregnant and had a baby. Her pregnancy was healthy and she had a natural labour. She and her husband then conceived again, naturally this time, and now have two young children. She now has check-up appointments every six months involving scans and blood tests. She has in the back of her mind that the cancer may come back. She anticipates having her ovary removed and a hysterectomy in the near future, and hopes that this will reduce her risk of a cancer recurrence. She feels that screening pre-menopausal women could be beneficial, as she did not have any noticeable symptoms that she was aware of. She urges people to ask questions and request a second opinion if they feel uncomfortable with or uncertain about a diagnosis. Having cancer had a ‘major impact’ and she feels that now she does not really fear anything after having been though it and coming out the other side. 

 

After having one cancerous ovary removed, a hysterectomy was cancelled because a 2nd opinion ruled that the borderline abnormality in her other ovary could be monitored while she started a family.

Anyway the day came where I had to go to... The operation was on a Wednesday and I had to check-in on Tuesday afternoon. And we got there, I think it was two o’clock check-in time on the Tuesday, it must have been about the 26th or something of July, and just as we were coming into the ward the consultant was doing her rounds. And she saw me and she pulled me off into a side room. And at this stage I’m thinking in terms of, I’m checking-in for hysterectomy, other ovary out, massive course of chemotherapy. 

 

She pulled me into a room and said, ‘Look, you know, you’re not having the operation tomorrow. We have sought a second opinion on the histology from another hospital, and it has come back saying that it’s borderline’. And she explained that that meant, as we thought, no treatment, you know, we just monitor it. She said, ‘But, you know, I’m keen to get a third opinion, with your permission, I’d like it to go to the international expert.

 

And then I went back to work, you know, and sat there and just waited for the third opinion to come through. It finally did in the September ’98 and basically it was in line with the second opinion that this was borderline and it needs to just be monitored. And the advice from the gynaecologist was, ‘Well look, you know, it was your original ambition to have children. We really think that you’re ultimately going to have to have everything taken out, but want you to basically try and get on with having your children as soon as possible and, you know, we’d like you to have IVF, try IVF to speed up the process’.

 

So in February ’99 I went off to start a course of IVF, which was unsuccessful. I mean they couldn’t stimulate the second ovary enough to produce sufficient number of eggs. I think we got, there were three follicles. Decided to abandon that cycle of treatment on the basis that you were unlikely to collect sufficient number of eggs for it to be worthwhile. And at that stage, you know, I think, very much of the view that perhaps the ovary was dying, I suppose, you know, I was probably going to menopause fairly soon and, you know, it was not going to be possible. But anyway, we decided to go for a second course with higher doses of stimulating hormones. And after the first set of drugs to stabilise my cycle before I actually had the Gonadotrophins, I discovered that I was pregnant. Well initially actually, when my period didn’t come I really did think I was having the menopause, but I thought in any event just to do a, you know, a pregnancy test, and it actually showed positive. 

 

So abandoned the drug-taking and was advised that I was probably likely, or very high probability I might have a miscarriage, but everything was fine and I had my first child with an extremely normal pregnancy and extremely normal birth. Monitored, you know, sort of ad hoc really, while I was pregnant, in terms of, you know, scans and blood tests.