Sneak attack

Brooke Keast’s mom, Pat McHale, was a very strong, healthy 73-year-old when she started complaining about feeling bloated.

“She walked two to three miles every day on the treadmill,” says Keast (the author’s sister-in-law). “She was in good shape. She had a little bit of extra weight around her middle, like a lot of older women do, but nothing that suggested cancer.”

There was also a loss of appetite and frequent urination. McHale said she knew something was wrong, but she refused for months to go to the doctor. When she finally did go, the doctor confirmed cancer, but recommended exploratory surgery to find its source. With the holidays around the corner, McHale decided to wait until the new year.

In January 2000, her exploratory surgery confirmed McHale’s suspicions: Cancer that had started in her reproductive system—likely with her ovaries and fallopian tubes—had spread throughout her body. She died that February.

“She went from feeling funny to dead in four months,” says Keast.

Not long before she died, McHale urged her daughter to do things differently.

“She grabbed my hand and said, ‘You get this stuff taken out,’” Keast remembers. Thus began a quest to find a doctor that would address Keast’s fears about developing cancer. She eventually found one who agreed that, for peace of mind, a yearly ultrasound was a good idea. And last fall, a couple of ovarian cysts turned up. That, paired with an erratic menstrual cycle and her mom’s history, was enough to strengthen Keast’s resolve to get a full hysterectomy. Her doctor agreed, and it was done last October.

A proactive approach

Ovarian cancer is the fifth leading cause of cancer deaths among women in the United States, according to the Agency for Healthcare Research and Quality. However, because there is currently no accurate method of advanced screening for it, 75 percent of diagnosed cases are in the advanced stages, which is why it’s often called “the silent killer.”

Dr. Bruce Farringer, a Reno obstetrician/gynecologist, urges patients to be proactive. “While there is no way to screen for it, the majority of patients with ovarian cancer do exhibit early symptoms,” says Farringer. “So it’s important that you really pay attention.” Early warning signs include a bloated or full feeling, frequent urination, pelvic discomfort, digestive or bowel discomfort, loss of appetite, increased girth in the midsection, menstrual changes or lower back pain.

“If you notice subtle symptoms, and especially if there’s a family history, a pelvic exam, an ultrasound and a CA-125 blood test may help to catch it,” he says. “You need a proactive approach, from both doctor and patient, and paying close attention to your body.”

Why not simply perform these tests routinely? Because the vast majority of the tests will produce false positive results. If you’re asymptomatic and have no reason to suspect ovarian cancer, such tests could do more harm than good. That doesn’t mean you shouldn’t remain vigilant.

On Sept. 11, which happens to be during Ovarian Cancer Awareness Month, the Food and Drug Administration approved OVA1, a new test that screens blood for protein levels that determine a patient’s likelihood of developing ovarian cancer. It’s unclear how effective this screening will be.

Meanwhile, Keast doesn’t regret her decision to have a hysterectomy, even though her ovarian cysts turned out to be benign. It was worth it for peace of mind, she says. She’ll encourage her teenage daughter to be aggressive about her own healthcare.

“My mom was the most outspoken person when it came to being independent,” she says. “So it frustrates me that she had such a fear of doctors and didn’t take the biggest step she could have taken in her own care.”