The various doctors and pathologists involved in my mother’s diagnosis and treatment can’t seem to agree amongst themselves. As more information slowly trickles in, I can finally understand why they’ve been confused.
This bout of cancer was initially discovered by Mom’s urologist while reading a CAT scan of her abdomen (related to her chronic kidney stone problems). He proclaimed that they were not going to worry about her kidney stones, that her cancer was back, and that he was going to refer her to her oncologist for more information.
The oncologist and cancer centre doctors didn’t (and still don’t) know exactly what kind of cancer they were looking at, though there were murmurings of it perhaps being ovarian, or maybe something from her last breast cancer. The first biopsy is “inconclusive”. A little judicious Googling showed that ovarian cancer does match many of the physical symptoms my mother had been experiencing. But still no one could confirm anything and we couldn’t quite figure out how an upper abdominal biopsy fit in with ovarian cancer. A second, larger biopsy ultimately proved that, yes, there is indeed cancer but not what kind (though the doctor doing the biopsy helpful — and very casually — suggested that it was probably colon cancer, which is what killed my grandmother when my mother was ten years old).
(Sidebar: In the weeks leading up to the results of the second biopsy, my mother was extremely ill. In light of the cancer diagnosis, this had her wondering if perhaps things had progressed farther than anyone realized and that she wouldn’t make it to Christmas. She was in agony and couldn’t keep anything down. She also started experiencing chest pains, the kind of dry cough that makes you throw up, and shortness of breath — much like a pulmonary embolism — and I asked her to please go the ER. She decided to wait until her next doctor visit. Her oncologist, when they met to discuss the second biopsy results, finally convinced her to go to the ER because they couldn’t start any treatment until my mother was feeling better. At the hospital, they rehydrated her and gave her one of those marvelous Gravol shots plus some good old morphine. She sounded positively perky for the first time in weeks when she called me that night. The next day, with the help of the IV fluids they gave her at the hospital, she passed a total of 18 kidney stones, including one that was larger than a raisin. So much for not worrying about them.)
Today, Mom and Dad finally got word about how this will be treated, though I think the doctors and pathologists are still fighting it out over the complete diagnosis. Dad said that for the first time the word “omentum” was mentioned in regard to the cancer. I’d never heard of it before but now that I have, I think I have a better understanding of why the doctors couldn’t make up their minds.
The omentum is a layer of fatty tissue in the abdominal cavity that is attached to the stomach and lies over the intestines. If you find cancer cells there, they could have come from so many neighbouring organs and tissues. Without practically ripping open the abdomen, I’d expect it would be difficult to be 100% sure of the origin so they have to make educated guesses, and one doctor’s educated guess is another doctor’s hooey. One says “ovarian cancer”, another says “colon cancer”, and another says “leftover from the breast cancer”. (I’m inclined to think that it’s probably ovarian cancer, for a number of reasons, including the symptoms that my mother has been suffering over the last year or so and the fact that ovarian and breast cancer are linked. She gets regular colonoscopies (the doctors have been quite diligent about searching for colon cancer in light of the family history) but hasn’t had pelvic exams with the same regularity. (She had a hysterectomy, though not an oophorectomy, when I was about 15 years old.))
The two bouts of breast cancer my mother survived didn’t scare me. Breast cancer tends to have a higher survival rate than many other cancers simply because we are so hyper aware of it that it gets caught at an earlier stage than many of the others. Ovarian cancer, on the other hand, frequently goes unnoticed and undiagnosed for so long because its symptoms are common to a large number of other ailments. Thus, even though it is highly treatable if caught early, it has a high mortality rate. (It is apparently the fourth most common cause of death in women in the United States, though I haven’t yet found the source of that particular statistic.) If it is indeed ovarian cancer, then the fact that it has spread to the omentum would mean that it is at least stage III, which has a 20% 5-year survival rate. Scary stuff.
Still, we don’t have the whole picture yet so there’s no point getting scared now. (Well, there’s no point getting scared regardless, but you know what I mean.) She’s waiting to find out when she’ll have to go in for chemo. After the initial rounds of chemo (however many that will be), then they’ll decide what else to do.