For years, ovarian cancer has been dubbed as the ‘silent killer’. Jacqui Farrugia, who was recently diagnosed with ovarian cancer, wants to raise awareness of the signs and symptoms of ovarian cancer by sharing her story as a woman affected by the disease. Here, Jacqui Farrugia opens up about her battle with ovarian cancer.

How many times have we uttered that worn out cliché; ‘life’s too short’ whenever we yearned for something that always seemed unattainable, or felt guilty for sometimes wanting life’s simple pleasures and somehow, we always justified it by that overused phrase? Anyone?

You only realise its true meaning when you are sitting in front of your surgeon and he tells you that you have the big C. Just like that. How bad and what stage it is, they would know after they perform urgent surgery. All you know is that the day before, you were fine and then the next day, you feel your whole world collapsing around you.

I swear, I could hear everything he was telling me, but nothing could register. I only felt numb. What I clearly remember though was that he told me I was ‘fortunate’ in my misfortune. I was ‘fortunate’, if I can use this word, because after two and a half years in menopause, I started feeling pre-menstrual symptoms; tender breasts, the usual bloated feeling, lower back pain, the usual tummy spasms and crankiness. I did find it weird, and even weirder when a few days later I had a full blown cycle…same old period pain included. Some said, “Oh, it does happen sometimes during menopause”, others said, “why not check with your GP”. So that same week I visited my GP. Without any hesitation he set up an urgent appointment at the hospital with a gynaecologist.

Two days later, we went for the appointment. The gynaecologist carried out a transvaginal scan and also a pap smear. We presented her with my previous scans which were clear from less than a year ago. She sat down and said that there were ‘cysts’ which looked normal – not solid, no fluid in the abdomen, nothing really to worry about. I asked her if I needed any surgery to have these ‘cysts’ removed. “Surgery?” she said. “No, no surgery required”, looking at me like some hypochondriac. She then said, “If you would like to have the CA 125 and CA 19-9 tests for cancer, you can still do them although they are not covered by national health.” As if that mattered to us at that time. She said that if we do the tests and the results are normal, I should go for another visit in two weeks’ time. I suppose some people would have just stuck to what the gynae said; that “all looked fine” and just went on with their day.

We had the tests done the next day. In the evening, my husband came home. I was preparing dinner. I remember I was chopping carrots. Such a silly detail. He did not say anything but went to his studio and went on the internet to check the results for the blood tests. I then heard him call the hospital. I heard him say he wished to speak to our gynae as the reading of one of the tests was extraordinarily high. I cannot tell you what went through my head at that moment. I calmly continued chopping methodically, but tears could not stop rolling down my face. That horrible emotion – fear – took over immediately.

That is how I found myself in front of the surgeon the following Monday. He went straight to the point, no beating around the bush. The usual drill: radical hysterectomy with biopsies to diagnose the stage of the cancer for further debulking if necessary. This will be followed by six cycles of adjuvant chemo after recovery. Hair will fall out but I can wear foulards and wigs….that it will be a tough and painful journey, and that I will have good days and bad days. I remember so many papers and consent forms were signed.

In less than two weeks I underwent surgery, a terribly long surgery since the biopsies showed that the cancer was in the ovary but also metastised in my lymph nodes so they had to debulk further. I was diagnosed with Stage IIIC ovarian cancer.

The days that followed were, I think, the worst days of my life-the anticipation, the fear, the anger…they totally consumed me. Nothing mattered anymore. Everything becomes secondary. All you think about is that you have cancer. You never really are prepared for something like that are you? You start looking around you and watch people leading normal lives. It was just before Christmas and I actually felt jealous of people in malls buying gifts and shopping for their Christmas lunches. Begins to bother you; you cannot tolerate people complaining about stupid things. It started getting harder to feel positive.

Pressing the fast forward button… going through six weeks of recovery. It was nothing like a previous major surgery I had had where you know that every day you will get better, even if you are in pain. In this case, you know that albeit the terrible pain, you will also have to go through that dreadful chemo. The worst thing you can ever do is Google stories. I console myself with the fact that although the survival rate is one in five, you only read about the bad cases on the internet. Whatever you read drives you even crazier as the survival rate is so low. So I solved that problem and stopped reading.

The emotions you go through are indescribable. I had read somewhere that there are five stages of cancer; denial, anger, bargaining, depression or sadness and acceptance. Yes, you go through all of them. Chemo is hard not only physically but also emotionally. From one cycle to another, you sometimes feel you are just existing and not living. However, every chemo is different and every person reacts differently. As I am writing this I am half way there, but I prefer to think that after next week, I will only have two cycles left. You will need all the support you can get. I do not have family here, but it is amazing what real friends and relatives do to help you along. I am so grateful for that. So make sure you are surrounded by all those who love and support you.

I have been offered to contribute this article for a purpose. There is already a lot of awareness about breast cancer. Doctors insist that we keep checking our breasts, and doing regular mammograms or ultrasounds. But we hardly hear anything about ovarian cancer awareness. They call Ovarian Cancer, “The Silent Killer”, as there are hardly any symptoms. The symptoms usually appear in late stages. It tends to be an aggressive cancer that can grow in just months. So my plea here is to insist on getting checked if you feel any of the symptoms below. Unfortunately, we tend to dismiss most symptoms as simply annoying ailments. Do not let anyone tell you that you are acting like a hypochondriac. Listen to your body. Not everyone gets a menstrual cycle as a symptom. Again; this was my “fortune in my misfortune”, according to my surgeon. If that did not happen, it would have been far too late just a couple of months later, he had said.

As usually happens, I realised in hindsight that i had felt some of these symptoms, but blaimed other conditions that I have – like my hypothyroid, celiac disease, and even menopause itself. I started feeling so tired, to the point of exhaustion, and became constipated in the last month, always feeling full and bloated after eating. But I ignored these symptoms and just made appointments for celiac and thyroid bloodwork to make sure all was okay. But those were just a few of the symptoms.


SYMPTOMS

• Bloating, persistent indigestion or gas

• Feeling full quickly after eating

• Pelvic discomfort or abdominal pain

• Urinary urgency

• Changes in bowel habits

• Back pain

• Shortness of Breath

As you can see the signs are vague and even doctors can misdiagnose you with IBS for these symptoms. Even the CA-125 blood test (so-called tumor marker) is not an accurate test. Some can still have ovarian cancer if the test reads normal which is 0 to 35 units/ml. Some might run into thousands and it can be because of some infection like PID (Pelvic Inflammatory Disease). So as such, it can just be a slight indicator, which when followed up by a CT scan can help confirm the diagnosis. A Pap Smear does not diagnose Ovarian Cancer either.


CERTAIN FACTORS CAN INCREASE THE RISK OF OC 

• Age – more common between 50 and 60 but there are cases of women who were younger when diagnosed

• Smoking

• Endometriosis or PCOS (Policystic Ovary Syndrome)

• Age when menstruation started. If you started menstruating before the age of 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher

• Faulty inherited genes BRCA1/BRCA2, or a family history of the disease, like breast or colorectal cancer

• Fertility Treatment

On the other hand, you have a lesser risk if you delivered at least one child before the age of 30, if you breastfed your children and if you used oral contraception. The longer these oral contraceptives were taken, the lower the risk. A hysterectomy or a tubal ligation (tying of Fallopain tubes) also lowers the risk.

Having a risk factor does not mean you have ovarian cancer, just as not having any of these risk factors means you don’t.

You might ask, “So what can I do?” Ovarian cancer is difficult to diagnose, but if you feel any of these symptoms which start to occur almost daily, and are present for more than 2-3 weeks, and you also feel you are running some of the risks above, consult with your doctor. Ask to have a transvaginal ultrasound (TVU), and also if you can have the CA-125 blood test, followed by imaging if it is high. Hopefully this will help to be diagnosed sooner. Very few are diagnosed at stage I or II.

I just hope that with this, I can raise some awareness. Maybe I can help someone. I don’t know what is going to happen to me now, or where this journey is taking me. I just prefer not to think about it. Going back to the cliche “life’s too short”, it is out of my book of idioms now, and has been replaced by a simpler one …”live life”. If you have just been diagnosed, and feel the need to ask questions, talk, or even open up, I will be here to help you in whatever way I can. Do not hesitate. I can be contacted through Facebook.

 

© 2018 – VIDA Magazine – Jacqui Zammit