Coping With Metastases in Advanced Ovarian Cancer

Metastases is a dirty word. For me and many others in the advanced ovarian cancer network, it defines a change, the spread of cancer cells from where they first formed to another part of the body. In metastasis, cancer cells break away from the original (primary) tumor, travel through the blood or lymph system, and form a new tumor in other organs or tissues of the body.

About 4 and a half years ago, I first learned about the diagnosis of ovarian cancer. Surgery clarified the extent of the disease. My left and right ovaries were wrapped in the omentum, a pad of fat cells covering the stomach and intestines. It is known that ovarian cancer spreads to the omentum quickly.¹

Evaluating the stage

Further microscopic evaluation of the cancer cells and the locations in which they are found determines the stage. While all this was relatively new to me, I realized that, in general, a lower stage means the cancer is more localized, whereas a higher number means the cancer has spread.

Visual findings and a pathology report indicated stage III C. From the start, cancer was in one or both ovaries or fallopian tubes or is primary peritoneal cancer. It spreads to organs outside the pelvic region with deposits larger than 2 centimeters. The tumor was also located in the pelvic or para-aortic lymph nodes or the surface of the liver or spleen.

I quickly realized I was facing an advanced case of cancer at the start of treatment. Therefore, I was about to fight a disease that had already taken an aggressive path.

A reason to go on

Despite knowing the extent of my situation, why do we subject ourselves to the most grueling treatment? I know I do it because I am all about hope and possibilities. With every infusion, I envision chemotherapy could make a difference in combatting this disease.

From the start, I have been a willing candidate. I am just not done yet with this life. And I have seen good results in slowing this disease. But, to be perfectly clear, I don't expect to live a long life.

The both/end experience in having cancer

Unfortunately, each PET scan reinforces reality. I decided I was in this to live while at the same time trying to address all the what-ifs.

Despite all my best efforts to keep everything at bay, this sister's ovarian cancer took a new turn last week. In actuality, I noticed a change in elimination where stool became pencil thin instead of the usual way accustomed. I also had trouble eating. And, usually, I love to eat.

Additionally, gas was bounding in my abdomen as my colon made every effort to eliminate the problem.

A new treatment plan

I quickly reported my finding as I remembered the danger of an obstruction. My oncologist tried every laxative, stool softener, and suppository with little effect. Upon examination, we learned I had no bowel sounds. Because this was a sign of blockage, I was sent immediately to the emergency room. A CT scan clarified that this was not feces but was likely due to pressure from a new tumor in my colon.

While I had hoped it could be easily removed, a conference with my oncologist and a surgeon made it clear. It was too risky to try to resection the colon. In addition, I had Avastin on board. I received this maintenance drug in an infusion every 3 weeks. Unfortunately, it detracts from healing by reducing the blood supply to the area. As a result, I am now the owner of a permanent colostomy.

Changing all odds

Please forgive me, but I am writing this as I recover from surgery and try my best to accommodate another challenge. My usual Pollyanna self has not yet kicked in, and I am struggling with the fact that having a colostomy will be my new lifestyle.

While it enables me to survive the pressure cancer places on my colon, I have not yet reached acceptance. Permit me another week, and I hope to offer you a better narrative. For now, I am holding on to the courage I usually give out so freely. However, I close with my love for you all.