Cancer During Pregnancy
- At 30 weeks pregnant, Emily Wiles, 28, started experiencing increasingly painful cramps that didn’t go away. To her shock, a few weeks later after an emergency room visit, an ultrasound revealed a life-threatening growth on her ovaries, which wound up being an 11-lb cancerous tumor.
- The subtype of her ovarian cancer, small cell carcinoma of the ovary hypercalcemic type (SCCOHT), is rare and highly aggressive — roughly affecting one out of every 10,000 ovarian cancer diagnoses, and women in their 20s are more likely to get it.
- With ovarian cancer, chemotherapy is usually the first stage of treatment, but staging the cancer is a little more difficult to tell until your doctor performs a surgery.
- Since there are often very vague symptoms associated with ovarian cancer, it’s important to pay attention to your body and seek medical attention if anything seems amiss.
For the safety of Emily and her unborn child, doctors determined that the best plan was to expedite the baby’s delivery via cesarian section (C-section) and remove the tumor immediately after. Thankfully, Emily gave birth to a healthy baby boy, Eli, who was born 7 weeks early.
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The subtype of her ovarian cancer, small cell carcinoma of the ovary hypercalcemic type (SCCOHT), is rare and highly aggressive. Roughly affecting one out of every 10,000 ovarian cancer diagnoses, women in their 20s are more likely to get it.
Learning About Ovarian Cancer
Emily Wiles is very young to develop ovarian cancer. According to the American Cancer Society, it is rare in people younger than 40, as it usually occurs in people after menopause. Half of all ovarian cancers diagnosed are in people older then 63.
With ovarian cancer, chemotherapy is usually the first stage of treatment, but staging the cancer is a little more difficult to tell until your doctor performs a surgery.
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For ovarian cancer, gynecologic oncologists recommend a staging procedure after a diagnosis when they have evidence that the cancer may be early or limited, which has to do with the location of the tumor. Based on where the cancer is found, it will be assigned a stage.
In a previous interview with SurvivorNet, Dr. Amanda Fader explained staging ovarian cancer through surgery.
“If it’s remained in the ovary where it was initially found or developed, then the cancer is Stage 1,” says Dr. Amanda Fader, vice chair of gynecologic surgical operations at Johns Hopkins University in Baltimore, tells SurvivorNet.
How Do I Know The Stage of My Ovarian Cancer? Staging Surgery Determines Spread
“But if the cancer has started to spread to other organs or through the lymph nodes to other parts of the body, then it would be identified as Stage 2, 3, or 4,” Dr. Fader adds.
The Stages of Ovarian Cancer
- Stage 1: The cancer is confined to the ovaries or fallopian tubes
- Stage 2: The tumor involves one or both ovaries with extension to other pelvic tissues (or is a primary peritoneal cancer)
- Stage 3: The cancer has spread outside of the pelvic peritoneum including to the outside of the bowel, liver and spleen and/or it involves the lymph nodes
- Stage 4: There are distant metastases (outside of the pelvis and abdomen) or metastases to the inside of the spleen or liver
When doctors have evidence before the surgery, such as from imaging tests, that the tumor may be limited to the ovary, they will usually recommend a staging procedure. During that operation, doctors remove all or part of the ovary with the tumor and send itwhile the patient is still asleep on the operating table to a pathologist who will examine the tissue and identify the type of tumor so doctors can decide how best to treat it.
If the tumor is determined to be benign, the surgery can end. Otherwise, more extensive surgery is usually performed.
Prior to the surgery the patient and her doctor would have discussed the various possible findings, so that depending on the result of the ovarian biopsy, the surgeon knows what the patient’s wishes are and how to proceed. “We would have made these decisions ahead of time through our preoperative counseling,” explained Dr. Fader.
Ovarian Cancer Symptoms
Ovarian cancer is known for presenting very vague symptoms, if any, and often similar to the symptoms many women experience every month with their menstrual cycle. However, if you are experiencing any of the following symptoms, and they seem to be “crescendoing,” or getting worse, it is worth it to see a doctor to rule out ovarian cancer:
- Feeling full earlier/decrease in appetite
- Feeling bloated
- Changes in bowel habits
- Pain in the pelvis
- Urinary symptoms, such as an urgent need to go
- Extreme fatigue
- Abdominal swelling
- Pain during sex
Since most women are diagnosed with ovarian at an older age, many doctors will write off symptoms as signs of menopause, and only about 20% of cases are diagnosed in the early stages, per the American Cancer Society.
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