Ovarian Cancer.. The Facts .. My Opinion .. and the Journey so far

HOPE for a CURE

Little Known Ovarian Cancer types

We have all heard of ovarian cancer and so most people know the typical symptoms. I started researching the possibility of having ovarian cancer back in 2007 but was not diagnosed properly until January 2012 after an oophorectomy of my right ovary was performed by a gynecologist. I would like to disclose symptoms I experienced along the way along with my cancer type as well as other less known cancer types that fall under Ovarian Cancer. The following are symptoms that I had before diagnosis.

  • menorrhagia - excessive bleeding and heavy periods and sometimes skipping periods
  • enlarged ovary - solid mass ovary with no fluid ascites
  • weight gain and loss - 20 or more lbs weight gain or loss over a 30- 60 day period
  • increased blood clots that can reach the size of an orange or larger with uterine contractions that mimic pregnancy contractions
  • mood swings
  • loss of appetite and getting full quickly after eating meals that are equivalent to a kids meal and maybe smaller
  • extreme fatigue that was accompanied by fever at times of 101 to 105 degrees
  • pelvic pain that may be sensitive to the touch (1st diagnosis in 2012)
  • pain with intercourse and vaginal tightness (2nd diagnosis 2014)
  • extreme nausea and vomiting which may include bile and acid reflux
  • severe pelvic pain that hinders the ability to walk, sit or stand without extreme discomfort
  • increased blood pressure usually the systolic number was at 160 or higher with the diastolic rarely exceeding normal. averages 160/101 when extreme and 160/85 when the bottom number was normal

The above is a listing of all the symptoms I have endured between the first and second diagnosis of ovarian cancer. I hope that it is helpful for someone else so that you are not misdiagnosed because of age or little known symptoms. The normal process is to be tested with a CA 125 test and possibly the OVA 1 test. OVA1 is used on women who already have an ovarian mass but may need a determination of if its malignant before surgery. If it is malignant then you have a better chance at proper staging and grade because it will be performed by a gynecological oncologist. I have a rare cancer type known as Granulosa Cell Tumor and it is classified under Sex Cord Stromal Tumors. There are a several other less known cancer types with the classification being Germ Cell Tumors and the following being the Cancer types.

  • teratoma
  • mature cystic teratoma
  • immature teratoma
  • monodermal teratoma
  • dysgerminoma
  • yolk sac tumor
  • embryonal carcinoma
  • choriocarcinoma

Sex Cord Stromal Tumors also have various cancer types

  • granulosa cell tumor
  • thecoma
  • sertoli-leydig tumor
  • sertoli cell tumor
  • leydig cell tumor
  • fibroma
  • fibrosarcoma
  • sclerosing stromal tumor


The most common type of tumors for Ovarian Cancer is Epithelial and it has its own list of various tumor types along with each category of tumors having three classifications for each tumor type which are benign, malignant and borderline tumors.


*Granulosa Cancer cell tumors are a rare type of Ovarian Cancer that is not detected with a CA 125 test and may not carry all of the symptoms of regular epithelial cancer. I listed symptoms above that I had over the years which are a result of Juvenile Granulosa Cell tumor Ovarian Cancer. In the next capsule I will go into more detail about the Granulosa Cell tumor.


Ovarian Cancer symptoms

Source

Granulosa Cell Tumor: My Experience

I wanted to provide an in depth look at the Granulosa Cell tumor (malignant) because I was diagnosed with this Ovarian Cancer in Jan. 2012. I initially visited the doctor because I had experienced a menstrual cycle that started Nov 15th 2011 and upon my visit on Jan 6th 2012, it had not ended and remained heavy and consisted of blood clots as well. I had begun to experience severe pelvic pain on my left side that hurt when touched as well as bloating. The doctor visit prompted my gynecologist to do an ultrasound of my left ovary and right ovary. The right ovary could be easily seen but the right ovary couldn't be detected at all and because of severe pain a transvaginal ultrasound was not an option. A salpingo-oophorectomy was scheduled for mid January assuming that I had an enlarged ovary or ovarian cyst that had ruptured and was causing the pain. There were no additional tests done to look for ovarian cancer at that time. The surgery in mid January did result in finding a tumor mass of 12 x 10 cm approximately, which had consumed the left ovary and that is also why the ovary could not be seen on the ultrasound. My gynecologist immediately told me his findings and based on the size that it could be cancerous and had the makeup of a Granulosa Cell /Sex Cord Stromal tumor. He would have to wait on pathology to confirm his findings and refer me to a gynecological oncologist. The pathology report of course confirmed malignant cells for cancer. I went through a ct scan to look for any remaining cancer cells but it appeared to be in remission after the surgery. I was classified as having stage 1 Ovarian Cancer and this stage only required regular checkups with a gynecologist and a blood test for Inhibin levels. Granulosa Cell tumors grow off hormones and therefore are found with Inhibin blood tests versus a CA 125 test. This meant I could no longer take birth control pills because of the hormones if the cells were to recur then the growth could be rapid within the organs. This cancer type requires check ups for the rest of your life because it can recur up to 20 yrs later or more for adult granulosa cell tumors. I had a brief scare in Jan. 2013 of a mass appearing on my right ovary but after a biopsy it showed that it was endometrium tissue. I was 32 years old and no children so my oncologist suggested I go to an endocrinologist and see a fertility specialist since I may have endometriosis. At this point my experience with facing ovarian cancer was over and I just had to deal with the thought of infertility and endometriosis. I became pregnant in May of 2013 and gave birth to a healthy baby girl in Jan 2014. It was during my pregnancy that my cancer had returned unbeknownst to me. I did have symptoms that appeared the same as my first experience with cancer and I listed those in the first capsule. I experienced morning sickness which included nausea and vomiting for the whole nine months. It became suspicious that something else was going on in my last 3-4 months of pregnancy. I began to vomit regardless of what I ate or drank and this was with nausea medication. I had a decrease in appetite and began to lose weight instead of gaining weight. The baby did maintain a healthy weight throughout my pregnancy and was not affected by the cancer recurrence. I had bile reflux and acid reflux, extreme fatigue, and started to experience pelvic pain that affected my ability to walk, sit or stand. The latter part of my pregnancy resulted in daily visits to the emergency room because I started experiencing labor contractions because of the obstruction and the phenergan with demerol shots were not easing the pain after the first couple of visits. At this time the recurrence of cancer still had not been discovered ,but my gynecologist also did not do any additional test to find out why certain symptoms had reappeared during pregnancy. I was simply told that some women experience a harder pregnancy than others and there was nothing that could be done to ease the discomfort and pain. I won't digress into the details of my numerous visits but it wasn't until my 38th week of pregnancy that I was given a low dose narcotic for the pain and recommended for induced labor. This was also around the time my doctor realized I was a former cancer patient and he had overlooked my health history which were in his files the whole time, but because I had a rare cancer type and my age was not typical it was an oversight. This oversight could have cost me greatly and I don't want anyone to suffer what I went through ever again so please know the signs. There were two suspicious masses found during my emergency c section which were confirmed as cancerous on the pathology report. They were found attached to my uterus and this was a sign that the previous ovarian cancer had recurred and spread to other organs. The pain and sickness I incurred during the last 3-4 months of my pregnancy were signs and symptoms of Granulosa Cell/ Sex Cord Stromal tumor. This discovery by my ob/gyn had to be referred back to my original oncologist and after recent surgery on March 4th, 2014, it has been confirmed that the other organs removed contained cancer cells as well. I will now have to undergo chemotherapy or hormonal therapy because of this late finding and diagnosis. This is my cancer experience so far and still a journey but I am a fighter so I shall be victorious. In the next capsule I will give you an insight on why the cancer came back so quickly and treatment options.

Juvenile GCT

The granulosa tumor that I have was able to grow back so quickly because it thrives on hormones especially estrogen. If you are in reproductive age a very common symptom is menometrohaggia which is prolonged or excessive uterine bleeding that can result in irregular bleeding or bleeding more frequently than normal. There are other conditions that would need to be ruled out before determining that cancer is a cause but if you experience symptoms longer than 2-3 weeks then you should consult a gynecologic doctor. The granulosa cell tumor can occur in children up to young adults in their 30's whereas the average ovarian tumor has a median age of 55 or older. The good news is that although symptoms appear with Juvenile Granulosa Tumor rather quickly, it is normally in stage 1 with good prognosis of recovery. A recurrence of this cancer though can mean that treatment outside of surgery needs to be considered in order to be in remission and avoid possible future recurrences. Ovarian cancer can still recur even without the ovaries so a hysterectomy will not omit you from future risks. JGCT like other ovarian cancers are staged the same and treated with similar therapies. I have listed the common therapies for JGCT below.

Currently, radiation is considered an option for advanced-stage patients and, in patients with pelvic recurrence, radiotherapy should be considered because a clinical response occurs in almost half of patients treated with radiation therapy.

Adjuvant therapy for GCTs has typically been carried out using chemotherapy. There is also data available regarding hormonal manipulation of these tumors using GnRH analogues and aromatase inhibitors. There is still limited information on what therapies work best for granulosa cell tumors since they thrive off hormones for growth. I have been offered chemotherapy or hormonal therapy as a possible option for my cancer recurrence. The treatments that currently exist are intraperitoneal chemotherapy, chemotherapy, immunotherapy and radiation therapy. I will try to create a follow up blog on how my therapy works once I have healed from my surgery and start the road to healing through therapy. I hope this hub has been insightful for those who have this same cancer and also those who were not aware of this rare cancer type.

my miracle baby that I carried full term in spite of cancer

She was born at 39 weeks full term. Due to the ovarian cancer recurrence and spreading I will not be able to have any more children so she is my miracle.
She was born at 39 weeks full term. Due to the ovarian cancer recurrence and spreading I will not be able to have any more children so she is my miracle.

Blood tests that detect ovarian cancer

what two blood tests can find ovarian cancer if it is suspected you have it?

  • CA 125 and OVA 1
  • Inhibin A or B and CA 125
See results without voting

Comments 1 comment

Mel 13 months ago

What an incredible story. You are an amazing warrior. And what a precious miracle baby...just beautiful. Praying for your continued healing and recovery. God Bless You and protect you.

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